Houston Rhinoplasty Surgeon
Every patient may have a different goal when considering rhinoplasty (nose job) or nose surgery. You may be seeking to reduce a nasal hump or bump, make a crooked nose straight, narrow a wide nose, refine a bulbous tip, or rotate a tip that hangs down to much. You might also have breathing problems due to a deviated septum, large turbinates, or valve collapse. Rhinoplasty or nose surgery is one of the most commonly performed surgeries by Houston facial plastic surgeon, Dr. Etai Funk. Other common nose procedures include septoplasty and revision rhinoplasty. Dr. Funk focuses not only on improving the appearance and proportion of your nose but also enhancing facial harmony and self-confidence. The American Society of Plastic Surgeons states that most plastic surgeons perform on average 11 rhinoplasties per year. As one of of Houston's top rhinoplasty surgeons, Dr. Etai Funk performs over 200 rhinoplasties in Houston per year for both cosmetic and functional purposes as he is Double Board Certified in both Facial Plastic Surgery and Otolaryngology (ENT) Surgery. View Testimonials Here.
Rhinoplasty, though a common procedure these days, requires exacting knowledge of the structure and the function of the nose. Some believe that rhinoplasty is the most difficult type of plastic surgery simply because every nose is different. In addition, there are close to 200 types of maneuvers, grafts, and suturing techniques described to change the shape of the nose. This organ possesses three-dimensional qualities that must be respected and maintained. The intricacies and nuances of rhinoplasty can be overwhelming and a surgeon must be well trained in this specialty.
Rhinoplasty Surgery Process
Dr. Funk takes pride in his extensive consultation with each patient. He makes sure to understand his patients’ concerns and desires for their ideal aesthetic result. Dr. Funk believes that the goal with rhinoplasty is not to create a nose that HE feels is aesthetically pleasing but to give YOU the nose that YOU want. This is what makes a happy patient. If you want to keep a straight bridge without a gentle curve or slope or do not want your tip rotated with nose surgery, he makes sure to honor these requests and wishes.
Dr. Funk will provide a thorough examination of the external and internal aspects of your nose. If there is a deviated septum or enlarged turbinates, he will discuss this with you, what it means, and what can be done to address these issues. Photographs will be taken and Dr. Funk personally will sit with you and loved ones while making digital changes to your photos. He feels that this allows both surgeon and patient to be on the same page regarding the desired outcome. Dr. Funk will personally review actual before and after images of patients who have similar features to your nose and have undergone rhinoplasty with him.
Your consultation will end with our patient care coordinator discussing your quote for surgery and insurance benefits if you have breathing issues. She will assist with scheduling your surgery and accommodating your needs up to the date of the procedure.
Your preoperative appointment, or preop, typically occurs the day prior to your procedure. On this day, you will spend a considerable amount of time with our patient care coordinator who will provide prescriptions and detailed instructions on what to expect after your rhinoplasty and how to care for the nose after your surgery. You will also meet with Dr. Funk once more to assure the two of you are in agreement regarding the goals for the surgery. Images may be reviewed once more during your preop with Dr. Funk.
Day of Surgery
On your day of surgery, it is important to note that Dr. Funk has performed your rhinoplasty in his mind 3-4 times already - on the day of your consultation, at your preop, and the morning of surgery. Dr. Funk will perform your rhinoplasty at an accredited surgery center with an anesthesiologist, nurse anesthetist, nurse, and surgical technician. Dr. Funk insists on having the same team for your surgery. This way, they understand his routine and things run much more smoothly. Rhinoplasty duration varies but usually takes 2-3 hours. You will be in recovery for about one hour and then be discharged home.
Recovery after rhinoplasty is typically about 8 days until you are feeling social. Dr. Funk will provide you with medications to take orally and certain medications will also be given in the operating room through your IV to minimize your bruising and swelling. Dr. Funk does not use any packing or splints that may cause pain and headaches. He uses a gentle technique and maximizes hemostasis, avoiding bleeding, to make for a more comfortable and easier recovery with minimal bruising. Dr. Funk sees patients for their first postoperative visit 5-6 days after surgery. The nose is then retaped for 2-3 days.
This is a question that many patients likely ask themselves. Is rhinoplasty worth the one week recovery? Is it worth the discomfort postoperatively? Is it worth the cost? Is it worth the risk of undergoing surgery? Ultimately, this is a question you must answer yourself. However, many of Dr. Funk's patients have stated that they had wished they had the surgery long earlier after realizing how much they loved their new nose and how tolerable the postop period was. When shown their result, may of Dr. Funk's patients have said, "In my mind, this is the nose I always thought I had". Dr. Funk has had many patients cry and shed tears of joy at 8 days after their tape is removed as their nose had caused them such angst and insecurity throughout their lives. He has seen teenage girls develop significantly more confidence postoperatively and other patients have stated they never feel shy in front of the camera or are afraid of getting a profile photo taken. Rhinoplasty or nose reshaping is a surgery that has changed the lives of many of Dr. Funk's patients.
Dr. Funk will sit down and thoroughly discuss your cosmetic concerns and goals for rhinoplasty. He will ask questions regarding any breathing or internal nose issues you may have. Dr. Funk will then examine your nose (both inside and out!) and explain why you may be having breathing issues due to a deviated septum, enlarged turbinates, or valve collapse. Photographs will then be taken and you will review these with Dr. Funk extensively. Digital rendering of what your nose may look like after surgery will be performed to your liking. This will allow you to get an idea of what rhinoplasty can do for you and of Dr. Funk's aesthetic sense. Rest assured, you will have plenty of time to sit down, discuss things at length, and feel comfortable with Dr. Funk.
Non-surgical rhinoplasty or reshaping the nose using a facial filler such as Restylane, Juvederm, or Radiesse has gained popularity but is not highly recommended by Dr. Funk. Unlike other areas of the face where we lose volume (cheeks, temples, etc.), the nose is not an area where this occurs. Fillers can lead to irregularities and permanent scarring that make surgery quite difficult. Fillers in the nose will not improve any of the airway issues patients may have. The only time Dr. Funk may recommend fillers is if the patient is not a good surgical candidate due to medical reasons or if a very minor touch up or depression is needed to be filled after surgery.
Choosing the right surgeon may be difficult for any procedure you are considering. However, rhinoplasty or cosmetic nose surgery can be one of the most complex types of plastic surgery. You are dealing with a facial structure that clothing cannot hide after surgery. The nose is not just composed of soft tissue and skin like the breast, abdomen or eyes. There is also cartilage and bone that needs to be addressed. Not to mention the functional or breathing aspect of the nose that must be respected if not improved. It is important to seek a surgeon who not only understands how to attain an aesthetically pleasing nose, but maintain a good nasal airway and breathing. It is important to ask your surgeon how many nose jobs they perform per year and how comfortable they are with YOUR nose. You should see eye to eye with your surgeon regarding expectations for your outcome and review digital imaging with him or her. You should be able to review their before and after photographs, appreciate the changes made, and find a nose similar to your own. In the end, this is your face and you should feel most comfortable with the surgeon that is taking it in his/her hands.
A crooked nose is one of the hardest types of noses to fix with surgery or rhinoplasty. Cartilage has memory and wants to move back to its original position. A nose job for a crooked nose needs to incorporate grafts, suture maneuvers, controlled fractures of the nasal bones, and most important - a good surgical plan. Most noses will remain straight after surgery, however, the healing process is never predictable. Dr. Funk always promises his patients that their nose will be perfectly straight on the operating room table, but can only promise a "straighter" nose long term.
Rhinoplasty can address breathing issues that you may have. Dr. Funk is board certified in Ear, Nose, and Throat Surgery as well so is fully capable of identifying and treating nasal breathing problems. Cosmetic rhinoplasty alone will not improve your breathing, but nasal airway obstruction can be treated while making changes to the appearance of the nose.
The septum is the wall that separates the two sides of the nose and is composed of cartilage and bone. Deviated septum surgery is commonly combined with rhinoplasty or a nose job. You may have breathing problems due to a deviated septum that can be corrected with septoplasty. The downtime or recovery after deviated septum surgery is the same as rhinoplasty and septoplasty should not cause any more pain, bleeding, or issues than rhinoplasty alone.
This is a common question asked by many of our patients. Depending on your benefits (deductible, etc.), insurance will pay for a certain portion of the functional components of your rhinoplasty such as septoplasty or turbinate reduction if you have breathing problems. Insurance will not pay for any cosmetic changes made to the shape of the nose. However, utilizing insurance for the functional part of your surgery will fray a good portion of your cosmetic costs for Dr. Funk's fees, the facility, and anesthesia.
Rhinoplasty or a nose job is a very intricate type of surgery performed either by facial plastic surgeons or plastic surgeons. With rhinoplasty, the bone and cartilage under the skin is carved, contoured, grafted, and shaped to an aesthetically pleasing appearance. The nose is refined and frequently, the airway is opened to improve breathing. The skin is then allowed to heal and contract after nose surgery over the new bony and cartilaginous framework.
Rarely do we hear comments like, "She has a beautiful nose!". We are meant to notice people's eyes, lips, and hair. These are the features we continuously focus our attention to with models, actors, and actresses. Those of us who do focus on others' noses may be unahppy with our own nose. This self conscious feeling about our nose may come and go throughout our life, but ultimately will prevail. Patients seeking rhinoplasty will frequently state during their consultation, "I have never liked my nose".
Although the nose may sit in the middle of the face, it should really be invisible. Our attention should not be drawn to the nose. A nose that is crooked, has a bump or hump, is too long or too wide, or even one that looks operated, can distract from the features we want people to notice like our eyes. It is said that a a good rhinoplasty is not seen in the nose but in the eyes. It is important to obtain a natural and unoperated result with rhinoplasty which is something Dr. Funk prides himself on.
Rhinoplasty or nose surgery can be performed once the nose has stopped growing and pubescent growth is completed. This can vary in males and females but is typically between 15-17 years of age. Rhinoplasty can be performed at any time after that. As long as you have no medical reasons that would prevent you from undergoing surgery, a nose job or nose surgery can be done at all ages of adulthood.
Rhinoplasty or nose surgery should not change your smile significantly. There are many muscles around the mouth and some interdigitate with the muscles of the nose. At times, when you smile, the tip of the nose may droop or the nostrils may flare, or they may widen. Rhinoplasty surgery can address these nasal issues with smiling. The upper lip may be more apparent after rhinoplasty with smiling if the tip is rotated. Your smile may feel very tight during the first few weeks after surgery. This will soften and loosen up over time.
Rhinoplasty or nose surgery is NOT a painful procedure. Patients will describe it as being uncomfortable for the first two days and by day three they start feeling better. Many of Dr. Funk's patients will only take one prescribed pain pill and some require none!
Dr. Funk DOES NOT USE PACKING after rhinoplasty. Dr. Funk feels that by using good surgical technique and controlling the blood pressure during and after surgery, packing is not needed. Packing can lead to more pain and discomfort for patients and is frequently unnecessary.
You may have a small amount of bruising and swelling around the eyes after surgery. Dr. Funk's regimen of herbal remedies and cold Swiss therapy gel masks helps decrease this after nose surgery.
Recovery is eight days. On day six after surgery, Dr. Funk will remove your cast and some stitches. He will retape your nose and on day eight after surgery, he will remove that tape and all the stitches. You are social at this point! Most if not all of your bruising is gone by then. The nose will be swollen at this point but not noticeable to others. As the months pass by, your swelling will decline. At 3 weeks, 20-30% of the swelling is down. At 6 weeks 50-60% of swelling has abated. It will take a full year for all the swelling to subside. However, most of Dr. Funk's patients are thrilled with the appearance of their once the tape comes off and know it will only get smaller over time.
You will check in at the facility where Dr. Funk performs rhinoplasty and they will start an IV. Rhinoplasty is done under general anesthesia and takes about 2 hours depending on the complexity of the nose. Dr. Funk will make a small incision between your nostrils and the rest of the incisions are on the inside of the nose. When you awaken after your rhinoplasty, you will have a small cast on your nose, a Swiss therapy gel mask over your eyes and a guaze drip pad under your nose to catch any drainage. Expect discomfort but not a lot of pain after nose surgery. You may have some bruising under and around your eyes which should resolve within the week. Once the cast and tape come off, expect to have some swelling. This will last for weeks, but you WILL see a dramatic improvement after surgery. As the swelling resolves, your nose will look better and better. It simply takes time for the skin to readhere and redrape over the new cartilage and bony framework.
A bulbous tip or wide base of the nose with wide nostrils is typically due to the shape of the cartilage in the tip. This nose cartilage can be refined using many techniques. The nostrils can be narrowed by excising a small amount of triangular skin just inside the nostril in a shadowed area where the scars heal well. Read more on rhinoplasty for bulbous tips.
The cost of rhinoplasty is a common question amongst many patients. If you have breathing problems due to a deviated septum, allergies, or repeated sinus infections that require surgery, this portion of your surgery will be paid by your insurance (depending on the extent of your benefits). This will fray the cost of cosmetic fees for the facility where Dr. Funk performs surgery and the anesthesia fees. The majority of their bill will be paid by your insurance company (again, depending on your insurance benefits).
However, if you are interested in making cosmetic changes to the appearance of your nose such as addressing a hump or bump, refining the tip, making the nostrils smaller, or narrowing the nose, this will not be covered by insurance. There will be surgeon's, anesthesia, and facility fees for these aesthetic changes that you may desire.
Choosing the right plastic surgeon is a personal decision. The first step is to confirm that surgeon's credentials and assure that they are board certified. Dr. Funk is double board certified in ear, nose, and throat surgery, and facial plastic surgery. He can therefore address your breathing issues and any cosmetic concerns you may have. Next, it is important to read that surgeon's website. Understand that surgeon's philosophy on rhinoplasty and aesthetics. In addition, assure that the surgeon has been trained appropriately at the proper institutions. Lastly, it is important to review that surgeon's work. If the photo gallery has 20 before and after photos of breast augmentation and 2 rhinoplasties, they may not be as experienced with rhinoplasty as they are with other procedures. Assure you like the before and after results for in the rhinoplasty photo gallery.
The next step is the consultation. Did you get enough time with the plastic surgeon? Did you feel comfortable with the surgeon? Were you confident of their skills and plan for your nose surgery? Did you like his/her digital enhancement of your nose and did the surgeon do it themselves or a staff member? Did you feel at ease with the staff and did they explain the quote and your benefits effectively? Did you leave the surgeon's office excited for your rhinoplasty? Were all your questions answered?
It is also important to know how many rhinoplasties per year your surgeon performs. The average plastic surgeon performs under 20 nose surgeries per year. Dr. Funk performs close to 150 rhinoplasties per year. The majority of these are combined functional or breathing with cosmetic surgery. Nose surgery is Dr. Funk's specialty and he receives many referrals from other plastic surgeons in Houston for difficult rhinoplasty surgeries or complex noses.
Dr. Funk performs both open and closed rhinoplasty in Houston. He does feel that the open approach allows for better visualization of the bony and cartilaginous framework and allows for more precise graft and suture placement. This ultimately leads to a more predictable and improved result. Although there is a little more initial swelling with the open approach, Dr. Funk feels that the final result is well worth the wait to be able to assure you get the outcome you desire from you nose surgery. The external approach does leave a very small scar between the nostrils, but Dr. Funk has yet to have a patient complaint abou this scar. He closes this incision meticulously and it is almost completely unnoticeable at one month after rhinoplasty.
Dr. Funk does not use packing after rhinoplasty or nose surgery. Packing can lead to unnecessary discomfort and pain. Dr. Funk feels that by using careful surgical technique along with controlling the blood pressure and heart rate effectively, packing can be avoided in almost all cases.
Many plastic surgery procedures will require repeat surgeries in the future. A facelift does not stop the aging process and will last 10-15 years. Another facelift will likely be needed at that point. Breast augmentation may require implant exchange every 10 years. However, the results of a rhinoplasty are permanent. Once the swelling has completely subsided, the grafts that are placed and scarring that has occurred will be subject to the effects of aging and gravity like the rest of the face and body. Unless you are unahppy with your result and are desiring revision rhinoplasty, repeat nose surgery is quite rare after a successful primary rhinoplasty.
Dr. Funk's prides himself on creating a natural appearing nose after nose surgery. One that fits your face and blends in easily with your face allowing attention to be drawn to your eyes, hair, and lips. A nose can distract attention away from these features when it is a crooked nose, has a hump, AND if it looks operated. The last thing you want is someone looking at you and the first thing they think is "nose job!".
Dr. Funk does perform digital enhancement of your photographs during your consultation. This will provide you with an idea of what your nose may look like after surgery. At this time, you can have input as to how you might want your nose to look like. Dr. Funk will aslo provide his aesthetic opinion and explain what he would be capable of with rhinoplasty.
Dr. Funk is a revision rhinoplasty expert in Houston. 20-30% of his rhinoplasties are revisions due to an undesired result from a previous surgery with a different surgeon. Please go to our revision rhinoplasty page and read about some of our patients issues and results.
A crooked nose due to trauma, pubescent growth, a deviated septum, or misplaced cartilage can distract significant attention from the features of your face you want people to notice. You do not want people staring at your nose, but want them to concentrate on your eyes, lips, or hair. A deviated nose or canted nose can be fixed with controlled fractures of the bone and cartilage grafting.