The Piazza Center for Plastic Surgery and Advanced Skin Care
7900 Farm to Market Road 1826, Bldg 2, Suite 206
Austin, TX 78737
Phone: (512) 288-8200
Monday–Thursday: 9 a.m.–3 p.m.
Friday: 9 a.m.–2 p.m.
If you, like our many patients from San Antonio and nearby communities, feel self-conscious about the size or shape of your nose, rhinoplasty at our practice in Austin, Texas, can produce a nose that looks natural and harmonizes with the rest of your facial features. Performed by facial plastic surgeon and rhinoplasty specialist Dr. Marcelo Antunes, rhinoplasty can enhance your natural beauty, bringing focus to other attractive features without sacrificing the unique character of your face.
Dr. Antunes takes a lot of pride in his rhinoplasty work. He understands the importance of harmony between the nose and the face and how much work it takes to create even a subtle change in the nasal contour. His advanced surgical training and commitment to excellence will clearly delineate why he is uniquely qualified to perform your rhinoplasty. The results speak for themselves.
Why Choose a Rhinoplasty Specialist?
Rhinoplasty is complicated and widely considered to be the most difficult plastic surgery procedure to perform. No other cosmetic procedure combines art and science like rhinoplasty. It takes dedication and skill to master the techniques involved in this surgery. The difference between a great result and one that’s unacceptable can be 2 millimeters. That’s why it’s so important to choose an experienced, double board-certified facial plastic surgeon such as Dr. Antunes, who has a thorough knowledge of the nasal structures and understands that modifying 1 aspect of the nose will create changes in other portions of the nose.
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Can You Benefit From Rhinoplasty?
As the nose is the centerpiece of your face, even small changes through rhinoplasty can significantly enhance your appearance and confidence. With that in mind, the decision to undergo rhinoplasty is very personal and one that only you can make. People who can benefit from rhinoplasty may want to:
- Reduce the size of the nose
- Reduce the hump of the nasal dorsum
- Refine the tip of the nose if it’s too rounded or broad
- Straighten a crooked nose
- Lift a nasal tip that is droopy
- Narrow a wide nose
- Lengthen a nose that is too short or small compared to the rest of the face
- Improve the appearance of an ethnic nose
Rhinoplasty can be truly life-changing when performed by an experienced surgeon. It can restore form and function and be a gratifying experience for the patient and the surgeon. Rhinoplasty can be purely cosmetic (for patients who have no difficulty breathing through their noses) or functional (when structural abnormalities make breathing difficult through one or both sides of the nose). In some cases, Dr. Antunes can combine functional and cosmetic rhinoplasty.
The procedure is consistently one of the most popular cosmetic surgeries performed. Also called nose reshaping or a nose job, it is often sought by younger Austin residents—even older teens—but can be performed on women and men of any age. People who are unsure about or not ready for surgery may have the option of a liquid rhinoplasty. This nonsurgical procedure is used to refine the shape of the nose with injectable fillers. While results can last for 1 to 2 years, they are temporary.
Meet Dr. Antunes
Board-certified facial plastic surgeon Dr. Marcelo Antunes dedicates his practice exclusively to aesthetic procedures for the face. He can help you look your best and be confident in your appearance.About Dr. Antunes
Going into your initial consultation unsure what to expect can sometimes be intimidating. But once you find out about the consultation process, you will realize that there is little reason for concern. The primary goal of your initial rhinoplasty consultation is for you to meet Dr. Antunes and spend time with him discussing your aesthetic goals and desires. You will typically meet with him for a thorough examination and learn about rhinoplasty and his approach.
Getting to know your surgeon is extremely important. You need to ensure that your surgeon is not only skilled, practiced, and board certified, but that you also feel comfortable around him or her. Your surgeon should carefully listen to you, discuss your goals, give you realistic and honest feedback, and answer any questions that you have. After discussing your concerns with Dr. Antunes, he will perform a computer simulation of the expected results.
Computer imaging is an exceptional tool to enhance communication between you and Dr. Antunes. Most patients have a clear picture in their minds of what they would like to achieve in their rhinoplasty, but accurately expressing this image to the surgeon can be challenging. Other patients have a broader idea of what they are looking for and want to discuss Dr. Antunes’ suggestions.
Dr. Antunes uses his experience to explain–with the aid of computer imaging–what rhinoplasty can realistically accomplish based on your anatomy. He is careful to show you a very realistic image morphing that represents the possibilities and limitations of your procedure. Your input is extremely important. We encourage you to give your opinion regarding the designed shape. This is the time to voice aesthetic preferences and ask all the questions.
Every treatment is customized with your needs in mind to make sure the result you get is what you were looking for.
There are 2 primary incision techniques used to perform rhinoplasty: open and closed.
In some cases, Dr. Antunes makes a small incision on the columella—the small strip of skin between the nostrils. He then gently lifts the skin to expose the nasal structures, such as cartilage and bone, which he sculpts to create the desired shape and size. The tiny incision results in a scar that is nearly imperceptible.
Dr. Antunes hides incisions within the nose in a closed rhinoplasty procedure. A plastic surgeon with the expertise of Dr. Antunes can use this technique and create exceptional facial balance and harmony.
Whether Dr. Antunes recommends a closed or open procedure, he tailors the surgery based upon your goals, specific nasal anatomy, facial structure, and unique features.
Rhinoplasty can take between 2 to 4 hours and Dr. Antunes uses either general anesthesia or local anesthesia with sedation, depending on the circumstances and your preference.
Recovery & Results
Because Dr. Antunes doesn’t use nasal packing for rhinoplasty, discomfort during the recovery process is minimized. He places a cast on the nose and uses dissolvable stitches on the nose’s interior. For an open rhinoplasty he will use stitches on the columella.
Expect to experience some nasal congestion and pressure during the first few days following the surgery. That said, many of our patients feel remarkably well immediately after the procedure, despite some swelling. Pain medication is very effective for managing any discomfort. We schedule several follow-up appointments with Dr. Antunes during the initial couple of weeks after surgery, so he can make sure your recovery is proceeding as expected. He removes the nasal cast 7 days after your procedure.
Plan to return to work after a week and to resume physical activities 2 weeks after the surgery. You may still have bruising around the eyes. It typically takes up to a year before the nose is fully healed after rhinoplasty, although you’ll notice the new look of your nose long before that.
Rhinoplasty at a Glance
Goal: Refining the size and shape of the nose to create an attractive, natural-looking contour that improves the facial balance. In addition, it can improve nasal function helping the patient to breathe better.
Procedure: Incisions are hidden inside the nose, and in some cases a small incision is made in the columella (skin between the nostrils) underneath the nose. The incisions typically heal extremely well and over time become nearly invisible. The nasal cartilages and bones are sculpted to create the new shape. The procedure will be tailored based upon your goals, specific nasal anatomy, facial structure, and unique features.
Anesthesia: General anesthesia or local anesthesia with sedation, depending on the case and patient preference.
Procedure length: 2 to 4 hours
Aftercare: There will be a cast over the nose, dissolvable stitches inside the nose, and in some cases stitches on the skin between the nostrils. Dr. Antunes does not pack the nose after surgery, which minimizes discomfort during the recovery process.
Recovery: During the first few days after rhinoplasty, the patient will experience some nasal congestion and pressure. Most patients feel remarkably well immediately after the procedure in spite of swelling. Most patients have mild pain after rhinoplasty that can be controlled with pain medications. Dr. Antunes will see the patient several times over the first couple of weeks. The nasal cast will be removed at the day 7 appointment. Most patients will return to work at that time and are back to full activities after 2 weeks. Patients may have bruising around the eyes, but this can be easily camouflaged with makeup.
- Day 5 to 7: Suture removal
- Day 7: Cast and splint removal
- Within 7 days: Return to work and social activities
- 8 to 12 weeks: 50% healed
- 1+ year: 100% healed
My Philosophy On Rhinoplasty
Rhinoplasty, also known as nose job, is a plastic surgery procedure performed to reshape, reduce or augment the nose. It is often regarded as the most difficult cosmetic procedure to perform. This is such a difficult operation because every patient is different in the way they heal and every nose has a different anatomy. As the anatomy changes, the surgical techniques used for correction will also change. I perform a thorough and precise analysis of the nose to properly determine the deformities in the anatomy. After that, I formulate a surgical plan to correct the specific deformities. It takes a great deal of experience and dedication to be able to accomplish these steps accurately.
Patients seek rhinoplasty due to several different reasons. Understanding your goals is perhaps the most important part of the procedure. During the rhinoplasty consultation, your photographs are taken and you and I will carefully review them and discuss which features you want to have changed.
A beautiful nose is a natural one. It fits harmoniously with a patient’s face, complimenting the other facial features. It should allow the observer’s attention to be drawn to the patient’s eyes. I do not believe in a universal aesthetic standard or an “ideal nose.” There is no “one-size-fits-all” for rhinoplasty surgery, only an ideal nose for a particular face. I believe the nose is one of the most important parts of one’s face and cultural and ethnic differences should be respected when changing a nose. The nose should appear natural. It should not be excessively upturned, scooped out or have an overly pointy tip. Every nose that I do is different as every face is different. And a customized, individualized technique describes best my approach to rhinoplasty.
Another important and uncompromising portion of rhinoplasty is maintaining or improving the function of the nose. Good nasal function is critical and I consider it as important as the aesthetic outcome. In fact, most of his patients breathe better after surgery and have improved nasal function over the long term. Even if the patient does not have symptoms of nasal obstruction, I will maximize the nasal airway to avoid nasal obstruction in the future. There is absolutely no need to compromise nasal function during cosmetic rhinoplasty.
I perform both closed and open rhinoplasty and use a technique of rhinoplasty that highlights preservation of nasal structural components. Excessive removal of supporting structures may result in an “operated-on look” that frequently looks like a pinched, upturned tip, with nasal obstruction. These problems can be avoided by minimizing excision of supportive cartilages of the nose. In addition, I will often use cartilage grafts taken from the patient’s own nasal septum (from inside of the nose) to increase the support of the nose and minimize the undesirable changes that can otherwise would occur over time. In more complex and revision cases, I may use ear cartilage or rib cartilage for the structural grafts.
I take a lot of pride in my work with rhinoplasty. I do not do tummy tucks, breast surgery or body liposuction. Rather, I dedicate my practice entirely to the face, the nose in particular. This highlights my commitment to excellence in surgery of the nose.
To learn more about Dr. Antunes’ approach to rhinoplasty surgery, read his blog post on the 7 Things Dr. Antunes Does to Get the Best Rhinoplasty Results.
Things You Should Know About Rhinoplasty
- Rhinoplasty is considered the most difficult of all cosmetic surgeries.
- Onesize definitely DOES NOT fit all. The nose should fit your face. Every face is different, and every nose should be different. A nose that looks great on someone else may not be the best suited for you.
- A good rhinoplasty should look natural.
- A great surgeon cannot always guarantee a great result. One factor is what the surgeon does at the procedure and another factor is what your body does when heals from surgery. Good healing is a critical portion of a successful rhinoplasty.
- No rhinoplasty result is absolutely perfect, but an accomplished rhinoplasty surgeon will frequently come very close. If a surgeon is promising perfection, beware.
- Rhinoplasty can create profound transformations in the shape of the nose, but some of the basic architecture can only change so much. Be realistic.
- Most patients will be swollen for several weeks to months after surgery. Be patient. The nose starts to get into its final shape in about 6 months after surgery, even though the healing is not complete before 1 year.
- Today’s rhinoplasty is more accurate, predictable and effective than any other time in history.
The Use of Rib Cartilage in Rhinoplasty
One of the most important principles of modern rhinoplasty is to maintain or create good structural support for the nasal framework so the shape of the nose can endure the changes that will happen during the healing process. The structural strength is nearly always provided by the use of cartilage grafts. Cartilage will often be obtained from the nasal septum or the ear cartilage.
However, sometimes the nasal septum is missing cartilage due to a previous trauma to the nose, or the patient has been submitted to a previous nasal surgery. Another source of cartilage would be ear cartilage, which is a great cartilage for some portions of the nose but usually is not good for structural grafts, particularly grafts that are responsible for supporting the nasal tip and nasal dorsum. In situations where septal cartilage is not available or insufficient and structural support is needed, Dr. Antunes will use rib cartilage.
Rib cartilage can be obtained from the patient’s chest or from a tissue bank. Obtaining rib cartilage from the patient’s chest has their advantage of using the patient’s own tissue. However, this comes with associated issues such as a new surgical scar on the chest, presence of increased postoperative pain and a risk (albeit small) of injury to the chest wall’s inner lining causing pneumothorax (air leak) or hemothorax (bleeding). An alternative is the use of cadaveric rib that is obtained from a tissue bank. This is called “irradiated homologous rib graft” and carries the advantage of availability, ease of use and lack of comorbidities associated with chest surgery. The use of irradiated homologous cartilage for graft in rhinoplasty has been extensively studied and determined to be safe and effective.
The main risks associated with the use of rib cartilage in rhinoplasty are: warping, resorption, mobility, extrusion and infection.
The anatomy of the nose is so important because it is what determines the appearance of your nose. Therefore, it’s fundamental that the nose’s anatomy be accurately assessed in order to develop a realistic and rational surgical plan.
Dr. Antunes takes great pride in the natural-looking results he creates for rhinoplasty patients. Request a consultation using the online form to meet personally with Dr. Antunes to discuss your concerns. You can also call The Piazza Center at (512) 288-8200 to schedule an appointment.