What is Rhinoplasty? Rhinoplasty is the art and science of restructuring the nose so that it looks and works better. It was one of the first facial aesthetic operations and is among those most frequently performed today. In rhinoplasty, deformities of the nose are corrected by removing, adding, rearranging, or reshaping cartilage and/or bone. It is the most complex and challenging of the facial operations. In rhinoplasty, form(appearance, style, the look) is always tied to function (the ability to breathe through the nose). In every rhinoplasty, the experienced surgeon must make sure that changes in form do not compromise function and vice versa.
Some people refer to rhinoplasty as a “nose reshaping” or a “nose job”. To call such a sophisticated operation a “nose reshaping” or “nose job” misses the point. A surgeon cannot just “reshape” a nose. The surgeon must also pay attention to the airway and to strengthening the underlying bone and cartilage framework.
Does Dr. Bentkover specialize in rhinoplasty? Yes. For Dr. Bentkover, Rhinoplasty is a true surgical passion. He has been an innovator in the field and welcomes the most difficult and challenging cases. He does primary (first time) and secondary (revision) rhinoplasty, treating patients from all over New England and other parts of the United States.
What is the difference between “open” and “closed’ rhinoplasty? I am concerned about the appearance of the incision. The difference between the “closed” and “open” approaches is structural and philosophical. It is not about the incision. The incision should not be an issue of concern. This is not an area that most people see. Also, the scar is generally minimal; and usually only you, your surgeon, and perhaps your significant other will see it. The real difference between the two approaches is what the surgeon can see during the surgery and the how the cartilages of the nose are modified. In the classic “closed” rhinoplasty, much of the operation is done without actually being able to see the tissues being modified. Surgeons are taught to remove significant amounts of cartilage to narrow or “thin” the nasal tip. The surgeon may not be able to see pre-existing irregularities of the tip cartilages and bones that could become more apparent after surgery. Also, over time the areas where the cartilage was removed can be replaced by scar tissue that leads to twisting of the nasal tip and difficulty breathing In an “open” approach rhinoplasty, there are no surprises. The surgeon can see everything that needs to be modified. Also, the basic philosophical difference is that in an “open” rhinoplasty the surgeon usually removes less cartilage and generally adds structure to the nasal tip that shapes and strengthens the underlying architecture and prevents twisting and other adverse changes as you age. Most commonly the surgeon uses your own septal cartilage for these shaping and strengthening cartilage grafts. In most cases, Dr. Bentkover favors the “open” approach. If he needs to make a small modification to an operated nose in a minor revision, he may use a “closed” approach to file the bones down a bit more or perhaps add a piece of cartilage to fill a small post operative depression. (The reality of revision rhinoplasty, however, is that most often it requires an “open” approach to replace large amounts of cartilage removed during the first procedure.)
I don’t want a nose that looks like it has been operated on. Can you guarantee that won’t happen? Dr. Bentkover’s goal is always to give you a natural looking nose, not a nose that has an operated look. While no surgeon can guarantee how your nose will look, we invite you to review the photos on our website (www.DrBentkover.com) and judge for yourself. We also have many more photos to show you at the time of the consultation. Dr. Bentkover takes great pride in his work and his patients are generally very happy. The art and science of rhinoplasty is a life long pursuit with changes in the field every year. If a surgeon’s results are not generally natural looking, it is very frustrating for the patients and the surgeon. If Dr. Bentkover’s noses consistently had an operated look, he would not be doing this operation.
I heard that if I have trouble breathing my insurance company will cover the cost of the operation. Is that true? Generally, no. If you are truly have difficulty breathing through your nose, your insurance may cover the surgeon’s fee, hospital fee and anesthesia fee to improve these functional problems only. However, your insurance will not cover any part of the cosmetic rhinoplasty. You will be responsible for the surgeon’s cosmetic rhinoplasty fee and the related hospital fee and anesthesia fee in addition to what is billed to your insurance company for your functional surgery. As far as your insurance company is concerned, you are essentially having two operations, one functional and one cosmetic. They do not cover any of the costs associated with the cosmetic operation. Also, Dr. Bentkover will only bill your insurance company for functional surgery if you truly have a breathing problem. Unless you have sustained a fairly recent and medically documented injury to your nose that has severely disfigured your nose, your insurance company usually is not concerned about the overall appearance of your nose. They might cover the straightening of your nose within a few weeks of the incident and surgery to improve your breathing, but usually not other changes.
How long will I be in your office for the consultation? About an hour. Dr. Bentkover will ask you what you do not like about your nose, examine your nose, photograph you himself, and do some simulated surgical planning with you on the computer. He will answer all of your questions. You will also spend some time with our aesthetic nurse. You may return for a second, shorter consultation at no charge, if you have more questions.
Like to see some of our patient photos? Click here: http://drbentkover.com/procedures/rhinoplasty_photos-worcester-boston