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Facial Plastic Surgery


"Facial harmony is developed as the appearance of the nose reflects your facial proportions."

A side profile of a woman's faceRhinoplasty or nose reshaping surgery, sometimes called a “nose job,” is a cosmetic surgical procedure designed to change the size and shape of the nose while balancing the proportions and aesthetic angles of the nose. We offer rhinoplasty at our Edina office for residents throughout the Minneapolis-St. Paul area.

State-of-the-art rhinoplasty does not result in an “operated” look. The nose appears to be aesthetically balanced to the face. The most common rhinoplasty performed is to reduce the volume of the nose and define the shape of the underlying bone and cartilage. In a closed rhinoplasty, all the incisions are made inside the nostrils. An open rhinoplasty includes an external incision and is usually done for more involved changes, such as a revisional (second surgery) rhinoplasty where the shape of the nose may have asymmetries.

The goal of artistic rhinoplasty is to bring your nose into harmony with your face - not someone else’s face. Pictures of other people's noses give you an overall sense of what proportions are pleasing to you, but the best rhinoplasty is the one that looks like you were born that way. Because rhinoplasty is so aligned with proportion, a chin implant may be recommended when needed, to balance the entire profile of the face.

Candidates for Rhinoplasty

The most important consideration for anyone considering rhinoplasty is to understand that the overarching goal of surgery on the nose is improvement, not perfection. The nose has many inherent asymmetries that must be taken into account that will not change with surgery. For example, where the nostril attaches to the face may be higher on one side, the right profile may be different than the left, and one tip of the cartilage may be more prominent than the other. Important considerations are:

  • The contours and shape of your face, including your chin prominence
  • The texture and thickness of your skin
  • The strength and position of the underlying cartilages, including the midline septum
  • The angles of the junction of your forehead/nose and base of nose/upper lip
  • Even your height and whether you had orthodontia (braces) in the past

Value of Computerized Video Imaging

Computerized video-imaging is an invaluable tool when considering rhinoplasty. This imaging tool allows for a detailed examination of the shape of the nose with different views. Video-imaging enables you to visualize the profile with the addition of a chin implant, or with several degrees of rotation of the tip, or with different amounts of lowering of the bridge. Most often, people will come to their own aesthetic of what looks good for them, and this can be visually communicated to Dr. Szachowicz as your facial plastic surgeon. Dr. Szachowicz takes this computerized video-image to the operating room to act as a road-map for the goals of the surgery.

The Rhinoplasty Procedure

The most common rhinoplasty procedure offered at our Edina practice involves reducing the volume of the nasal hump (the dorsum), defining cartilages of the tip, and narrowing the nasal bones. A closed approach to rhinoplasty limits all the incisions to the inside of the nose, and an "open" approach adds a small incision across the base for access to perform more advanced work, such as the placement of grafts of cartilage.

The most common rhinoplasty is the reduction rhinoplasty where the overall 3-D volume and shape of the nose is reduced. This procedure can be performed under either sedation or a brief general anesthetic. Advanced methods of rhinoplasty remove only precise amounts of the structural bone and cartilage to cause a change in shape, with every attempt to preserve as much of the natural shape and anatomy of the nose.

  • Using either the closed or open approach, the skin is separated from the underlying bone and cartilage structures.
  • The cartilages of the tip are then shaped; then most often are trimmed to make them smaller and more defined.
  • The hump (nasal dorsum or nasal bridge) is then lowered to match the tip.
  • If needed, the nasal bones are narrowed together to reduce the width of the nose.
  • The incisions are precisely closed, and the nose is supported inside (with a stent) and outside (with a nasal splint). No nasal packing is generally required.

The goals of the procedure may include the placement of cartilage grafts, usually taken from the inside of the nose. Nostril-reducing surgery and chin implant surgery can also be performed at the same time. Augmentation of the chin, when needed, is usually done first in the sequence of procedures so that Dr. Szachowicz can use the new profile to balance the nasal surgery. For younger patients, the nose must become fully developed (usually by ages15-16 in women, and slightly older for young men).

Revisional (Secondary) Rhinoplasty

Revisional or secondary rhinoplasty is done when there is some size, shape, angle or proportion that may need to be corrected after the original surgery. Any secondary surgery (revision) should wait 6 months to a year after surgery to complete the healing. Again, video- imaging is useful to understand what specific changes can be made to improve the overall result. Dr. Szachowicz has over 25 years’ experience in rhinoplasty and has a wealth of knowledge. In revisional surgery, often small changes can enhance your result.

Recovery and Aftercare

At the end of the procedure, long-acting anesthesia is injected at the sites of surgery so there is little discomfort after surgery. Ice and normal pain medications are usually all that is required. Most of the subsequent swelling and bruising is usually removed within one week. The inside stent and outside splint are easily removed at one week. Although you can return to usual activities thereafter, Dr. Szachowicz recommends no strenuous activity for another week. Homeopathic arnica Montana is given by pellets to reduce any swelling and bruising.

No Insurance Billing

Dr. Szachowicz is a non-participating physician with insurance carriers, and does not submit insurance claims from his office. You can check with your insurance plan to see if you can submit claims as a member of your insurance plan, but Dr. Szachowicz is not an insurance provider with any carrier.

Risks of Rhinoplasty Surgery

Infrequent complications of rhinoplasty surgery include bleeding, infection, asymmetries and delayed difficulties in breathing.

Learn More about Rhinoplasty (Nose Shaping Surgery)

If you are considering rhinoplasty, it is important that you go to an experienced and artistic surgeon. Dr. Szachowicz has been doing rhinoplasty for over 25 years, and is a facial plastic surgeon. To learn more about rhinoplasty, and to have your own computerized video simulation, contact our Edina, Minnesota office today. We serve the Minneapolis-St. Paul area.

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Centennial Lakes Medical Building

7373 France Ave S
Ste 508
Edina, MN 55435

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