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Surgical Rhinoplasty

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About Surgical Rhinoplasty

A rhinoplasty, or “nose job”, can bring overall balance to your face, and in many cases, also make you look younger. The art of rhinoplasty involves more than merely making your nose smaller. Your nose needs to look natural and complement all of your facial features with the right size, width and angles. The procedure is highly individualized because both the left and right sides of the nose need to match as much as possible, so it looks smooth and natural from all angles.

What is Rhinoplasty?

There is a reason why rhinoplasty (or “nose job”) is consistently ranked among the top three most popular cosmetic procedures each year. When performed by someone with the proper training, talent and skill, a rhinoplasty can bring overall balance to your face, and in many cases, also make you look younger.

The art of rhinoplasty involves more than merely making your nose smaller. Your nose needs to look natural and complement all of your facial features with the right size, width and angles. The procedure is highly individualized because both the left and right sides of the nose need to match as much as possible, so it looks smooth and natural from all angles.

The face is comprised of three equal sections: the upper, middle and lower face. In a good profile, all features are in proportion with one another.

Upperface: A forehead that isn’t entirely round or flat.
Middleface: A straight nose that has some concavity to it.
Lowerface: A slim and defined neck and soft jawline.

What is Rhinoplasty?

There is a reason why rhinoplasty (or “nose job”) is consistently ranked among the top three most popular cosmetic procedures each year. When performed by someone with the proper training, talent and skill, a rhinoplasty can bring overall balance to your face, and in many cases, also make you look younger.

The art of rhinoplasty involves more than merely making your nose smaller. Your nose needs to look natural and complement all of your facial features with the right size, width and angles. The procedure is highly individualized because both the left and right sides of the nose need to match as much as possible, so it looks smooth and natural from all angles.

The face is comprised of three equal sections: the upper, middle and lower face. In a good profile, all features are in proportion with one another.

Upperface: A forehead that isn’t entirely round or flat.
Middleface: A straight nose that has some concavity to it.
Lowerface: A slim and defined neck and soft jawline.

The Timeline

  1. The Consult

    We start with a consult where Dr. Esmail or his assistant will take detailed medical history and a complete nasal exam often including an endoscopic exam of the nose. We will discuss what you don’t like or want to change about your nose, and any breathing issues. We then take a set of 3D VECTRA photos as well as high definition 2D photos. Using the latest technology we are able to take precise measurements and analysis of your nose and provide morphing to show you what an expected outcome may look like.

  2. Surgery

    We have three options for surgery. For those cases where there is a medical component, the operation can be done under general anesthesia at the Victoria General Hospital. For purely cosmetic cases the surgery can be done under general anesthesia at the Western Surgical Center across the street from our clinic or under deep sedation inside our state-of-the-art operating theatre.
  3. Post-Op

    We see you post-op on visits at one week, one month, three months, six months and one year. At each visit we will take photos and will monitor your progress at the one month visit we can discuss any concerns and can start injections of steroids to help reduce scar tissue and swelling in areas that need more definition.

The Timeline

  1. The Consult

    We start with a consult where Dr. Esmail or his assistant will take detailed medical history and a complete nasal exam often including an endoscopic exam of the nose. We will discuss what you don’t like or want to change about your nose, and any breathing issues. We then take a set of 3D VECTRA photos as well as high definition 2D photos. Using the latest technology we are able to take precise measurements and analysis of your nose and provide morphing to show you what an expected outcome may look like.

  2. Surgery

    We have three options for surgery. For those cases where there is a medical component, the operation can be done under general anesthesia at the Victoria General Hospital. For purely cosmetic cases the surgery can be done under general anesthesia at the Western Surgical Center across the street from our clinic or under deep sedation inside our state-of-the-art operating theatre.
  3. Post-Op

    We see you post-op on visits at one week, one month, three months, six months and one year. At each visit we will take photos and will monitor your progress at the one month visit we can discuss any concerns and can start injections of steroids to help reduce scar tissue and swelling in areas that need more definition.

Benefits of A Nose Job

Even a small adjustment or tweak can make a world of difference in how your nose blends with the rest of your face, drawing less attention to it and putting more focus on other features like the eyes.

Most patients who choose to undergo rhinoplasty do so because they feel embarrassed or inhibited by the size, shape, or projection of the nose. As it is the central feature of the face, there is no hiding a flaw, whether it is a hump on the bridge, droopy, large, or bulbous tip, or an aesthetic problem related to overlarge, wide nostrils, or a flat bridge or asymmetrical shape.

Benefits of A Nose Job

Even a small adjustment or tweak can make a world of difference in how your nose blends with the rest of your face, drawing less attention to it and putting more focus on other features like the eyes.

Most patients who choose to undergo rhinoplasty do so because they feel embarrassed or inhibited by the size, shape, or projection of the nose. As it is the central feature of the face, there is no hiding a flaw, whether it is a hump on the bridge, droopy, large, or bulbous tip, or an aesthetic problem related to overlarge, wide nostrils, or a flat bridge or asymmetrical shape.

Types of Rhinoplasty

  1. Primary (Surgical) Rhinoplasty

    If this is your first surgery, you fit under primary rhinoplasty. Depending on what is required, what type of anesthesia is chosen and if any of the procedure is covered by insurance, the price will vary.
  2. Ethnic Rhinoplasty

    In the past ethnic rhinoplasty was done to give patients a more Western-looking nose, but today the surgery is performed in a way that enhances the appearance of the nose while maintaining ethnic features. You are able to change the way your nose looks to become more attractive according to your standards without losing any ethnic distinction.
  3. Revision Rhinoplasty

    Revision rhinoplasty is a difficult surgery to master and unfortunately it is often performed with poor results by surgeons who are not rhinoplasty specialists. If you have previously undergone a rhinoplasty and are unhappy with your results, schedule a consult with Dr. Esmail and see how we can achieve your goals.
  4. Micro-Rhinoplasty

    Often we see patients who have a small bump or imperfection they would like fixed. This includes some revision cases with ridges or bumps or that may require narrowing of the nostrils. Dr. Esmail uses specialized 2mm micro rasps to shave the nasal bones through tiny incisions, so small they don’t even require stitches. We can perform these procedures often with freezing and no sedation at all. Some patients may prefer to take a short acting oral sedative. Micro Rhinoplasty is often combined with liquid non-surgical rhinoplasty.
  5. Alar Reduction

    Alar reduction is a component of Rhinoplasty; a specific technique that addresses the width of the nostrils only. The Alar is the area of the nose that extends from the tip of the nose and rounds outwards towards the cheek. An incision is made on either the exterior or interior of the Alar region in order to remove excess tissue.
  6. Liquid Rhinoplasty

    Liquid or Non-Surgical Rhinoplasty is a powerful procedure that involves the use of dermal Fillers and Botox to re-shape the nose. Not everyone is a good candidate for nonsurgical rhinoplasty so a consult with Dr. Esmail essential prior to treatment. This procedure is good for camouflaging bumps on the nose as well as fixing a droopy tip and providing more tip definition. This procedure is not good for fixing crooked noses. non-surgical rhinoplasty should only be performed by surgeons with a knowledge of rhinoplasty. It is one of the most dangerous areas to inject. Because of this, Dr Esmail is the only injector allowed to perform this procedure at his Visage.
  7. Ultrasonic Rhinoplasty

    A mini Ultrasonic Rhinoplasty is performed through a closed approach with a tiny incision inside the nose so there are no external scars. The special instrument used, called a Piezotome, enables the surgeon greater precision and less soft tissue damage.

Types of Rhinoplasty

  1. Primary (Surgical) Rhinoplasty

    If this is your first surgery, you fit under primary rhinoplasty. Depending on what is required, what type of anesthesia is chosen and if any of the procedure is covered by insurance, the price will vary.
  2. Ethnic Rhinoplasty

    In the past ethnic rhinoplasty was done to give patients a more Western-looking nose, but today the surgery is performed in a way that enhances the appearance of the nose while maintaining ethnic features. You are able to change the way your nose looks to become more attractive according to your standards without losing any ethnic distinction.
  3. Revision Rhinoplasty

    Revision rhinoplasty is a difficult surgery to master and unfortunately it is often performed with poor results by surgeons who are not rhinoplasty specialists. If you have previously undergone a rhinoplasty and are unhappy with your results, schedule a consult with Dr. Esmail and see how we can achieve your goals.
  4. Micro-Rhinoplasty

    Often we see patients who have a small bump or imperfection they would like fixed. This includes some revision cases with ridges or bumps or that may require narrowing of the nostrils. Dr. Esmail uses specialized 2mm micro rasps to shave the nasal bones through tiny incisions, so small they don't even require stitches. We can perform these procedures often with freezing and no sedation at all. Some patients may prefer to take a short acting oral sedative. Micro Rhinoplasty is often combined with liquid non-surgical rhinoplasty.
  5. Alar Reduction

    Alar reduction is a component of Rhinoplasty; a specific technique that addresses the width of the nostrils only. The Alar is the area of the nose that extends from the tip of the nose and rounds outwards towards the cheek. An incision is made on either the exterior or interior of the Alar region in order to remove excess tissue.
  6. Liquid Rhinoplasty

    Liquid or Non-Surgical Rhinoplasty is a powerful procedure that involves the use of dermal Fillers and Botox to re-shape the nose. Not everyone is a good candidate for nonsurgical rhinoplasty so a consult with Dr. Esmail essential prior to treatment. This procedure is good for camouflaging bumps on the nose as well as fixing a droopy tip and providing more tip definition. This procedure is not good for fixing crooked noses. non-surgical rhinoplasty should only be performed by surgeons with a knowledge of rhinoplasty. It is one of the most dangerous areas to inject. Because of this, Dr Esmail is the only injector allowed to perform this procedure at his Visage.
  7. Ultrasonic Rhinoplasty

    A mini Ultrasonic Rhinoplasty is performed through a closed approach with a tiny incision inside the nose so there are no external scars. The special instrument used, called a Piezotome, enables the surgeon greater precision and less soft tissue damage.

Risks of Surgical Rhinoplasty

As with any procedure, there are risks associated with rhinoplasty. Given the unpredictability of the way the nose heals a change of a few mm can create an undesirable result. Because of this given in the most experienced hands rate of revision rhinoplasty is 10-15%.

Any patient undergoing a rhinoplasty should be mentally prepared to have to require a second, most often much smaller, procedure to correct any irregularities. Other risks include prolonged bleeding, infection, and prolonged stuffiness. Most of these are minor and resolve with time.

The art of rhinoplasty is more than merely making noses smaller. Your nose needs to look natural and complement all your facial features, balancing size, width and angles.

Cosmetic surgery on the nose is a highly individualized procedure that focuses on one or more of the features that contribute to your overall appearance. Those seeking a well-balanced and youthful face should aim for a nose that’s symmetrical within itself, as well as overall facial symmetry.

Risks of Surgical Rhinoplasty

As with any procedure, there are risks associated with rhinoplasty. Given the unpredictability of the way the nose heals a change of a few mm can create an undesirable result. Because of this given in the most experienced hands rate of revision rhinoplasty is 10-15%.

Any patient undergoing a rhinoplasty should be mentally prepared to have to require a second, most often much smaller, procedure to correct any irregularities. Other risks include prolonged bleeding, infection, and prolonged stuffiness. Most of these are minor and resolve with time.

The art of rhinoplasty is more than merely making noses smaller. Your nose needs to look natural and complement all your facial features, balancing size, width and angles.

Cosmetic surgery on the nose is a highly individualized procedure that focuses on one or more of the features that contribute to your overall appearance. Those seeking a well-balanced and youthful face should aim for a nose that’s symmetrical within itself, as well as overall facial symmetry.

Recovery

Rhinoplasty is generally an outpatient procedure performed in a hospital, ambulatory surgical facility or in-office surgical suite. To determine the areas of your nose that will be addressed, your overall facial appearance, proportion and structure, as well as your goals, medical history and ethnicity will be taken into account.

With rhinoplasty, your profile complements your other facial features. Otherwise, your nose can appear too big or too short and draw too much attention. No face is perfectly symmetrical, but certain asymmetrical features, like the nose, tend to be more evident. The nose is a bilateral structure, you want both the left and right sides to match as much as possible, so the nose looks the same from the front and side views. Symmetry is crucial.

Patients generally wear a splint for the first week. There will be bruising and swelling under the eyes and nose that will be there for a few days to a few weeks following surgery. Patients should avoid strenuous activity for 2–3 weeks.

Recovery

Rhinoplasty is generally an outpatient procedure performed in a hospital, ambulatory surgical facility or in-office surgical suite. To determine the areas of your nose that will be addressed, your overall facial appearance, proportion and structure, as well as your goals, medical history and ethnicity will be taken into account.

With rhinoplasty, your profile complements your other facial features. Otherwise, your nose can appear too big or too short and draw too much attention. No face is perfectly symmetrical, but certain asymmetrical features, like the nose, tend to be more evident. The nose is a bilateral structure, you want both the left and right sides to match as much as possible, so the nose looks the same from the front and side views. Symmetry is crucial.

Patients generally wear a splint for the first week. There will be bruising and swelling under the eyes and nose that will be there for a few days to a few weeks following surgery. Patients should avoid strenuous activity for 2–3 weeks.

What to Expect from a Rhinoplasty Procedure

Upon waking up after surgery, your nose will be covered with a splint (which you may need to wear for up to a week). You may have gauze and padding in certain areas, but will be advised of all your post-op care with detailed instructions, so you’ll feel confident when you leave. Expect to be swollen and bruised around the eyes and cheek area. You may also feel like you have a cold, which is very typical.

Post-Op

Most patients only need pain killers for the first 48 hours. It is not a terribly painful surgery. Get some rest.

Week One

At the end of this week your splints come off and you get the first glimpse of your nose. The profile will look great but the tip will look fat and the nose will look wide. This will continue to improve over the coming months. If there is bruising, the majority of it should have resolved within 10-14 days. Dr. Esmail is unique in that he uses only dissolvable sutures during rhinoplasty. No suture removal is required at this appointment.

Month One

After one month, 80% of the swelling has come down. The tip starts to show more refinement. Breathing starts to significantly improve around this time. Think of this time frame with the analogy of loose fitting clothing. The initial swelling has resolved and the nasal skin is sitting loosely over the structure created below. Over the next 11 months the skin well shrink wrap over this structure to reveal the work of your rhinoplasty.

One Year

It takes approximately one year for the final shape of the nose to reveal itself. Rhinoplasty requires patience and trust in your surgeon.

What to Expect from a Rhinoplasty Procedure

Upon waking up after surgery, your nose will be covered with a splint (which you may need to wear for up to a week). You may have gauze and padding in certain areas, but will be advised of all your post-op care with detailed instructions, so you’ll feel confident when you leave. Expect to be swollen and bruised around the eyes and cheek area. You may also feel like you have a cold, which is very typical.

Post-Op

Most patients only need pain killers for the first 48 hours. It is not a terribly painful surgery. Get some rest.

Week One

At the end of this week your splints come off and you get the first glimpse of your nose. The profile will look great but the tip will look fat and the nose will look wide. This will continue to improve over the coming months. If there is bruising, the majority of it should have resolved within 10-14 days. Dr. Esmail is unique in that he uses only dissolvable sutures during rhinoplasty. No suture removal is required at this appointment.

Month One

After one month, 80% of the swelling has come down. The tip starts to show more refinement. Breathing starts to significantly improve around this time. Think of this time frame with the analogy of loose fitting clothing. The initial swelling has resolved and the nasal skin is sitting loosely over the structure created below. Over the next 11 months the skin well shrink wrap over this structure to reveal the work of your rhinoplasty.

One Year

It takes approximately one year for the final shape of the nose to reveal itself. Rhinoplasty requires patience and trust in your surgeon.

Choosing a Surgeon for Rhinoplasty

The most important thing you could do to insure a good outcome for your rhinoplasty is to choose the right surgeon. Rhinoplasty is widely considered one of the most difficult cosmetic procedures to perform well. This is why you want to choose a surgeon that does a lot of rhinoplasty and specializes in the procedure. Dr. Esmail is Winnipeg’s only fellowship trained facial plastic surgeon. This means he focuses only on the face. Rhinoplasty is the most common procedure performed by Dr. Esmail who performs over 100 rhinoplasty surgeries each year.

Choosing a Surgeon for Rhinoplasty

The most important thing you could do to insure a good outcome for your rhinoplasty is to choose the right surgeon. Rhinoplasty is widely considered one of the most difficult cosmetic procedures to perform well. This is why you want to choose a surgeon that does a lot of rhinoplasty and specializes in the procedure. Dr. Esmail is Winnipeg’s only fellowship trained facial plastic surgeon. This means he focuses only on the face. Rhinoplasty is the most common procedure performed by Dr. Esmail who performs over 100 rhinoplasty surgeries each year.

Cost of Rhinoplasty in Winnipeg

Primary

Ranges from $13,500 – $16,500 + GST (Pricing includes facility and anesthetic fees.)

Revision

Ranges from $15,500 – $19,500 + GST

Micro

Ranges based on consultation

Non-Surgical

$1,150 + GST

Cost of Rhinoplasty in Winnipeg

Primary

Ranges from $13,500 - $16,500 + GST (Pricing includes facility and anesthetic fees.)

Revision

Ranges from $15,500 - $19,500 + GST

Micro

Ranges based on consultation

Non-Surgical

$1,150 + GST

Is rhinoplasty painful?

Most patients described mild and 48 hours and the majority of patients do not need control after this. More often patient’s describes a feeling of pressure and congestion. Dr. Esmail very rarely uses packing which is often considered the most uncomfortable part of the procedure.

Will I have black eyes?

We always tell people to expect black eyes but Dr. Esmail takes many steps to both reduce recurrence bruising and and the duration. 1 - Pre and intraoperatively the use of tranexamic acid reduces intraoperative bleeding postoperative bruising. 2 - Often Dr. Esmail will perform micro external osteotomies(breaking the bone) which also reduce bruising versus the traditional method. 3 - Postoperatively we offer a complimentary laser service to help dissolve any excess bruising

How long before can wear makeup?

10 days

How long before I can exercise?

14 days

Will my breathing be improved after surgery?

Yes the goal for any surgery has 2 parts. The 1st being functional that is improving her breathing and the 2nd being cosmetic. Without both the surgery is considered a failure.

Will Manitoba Health or private insurance cover my surgery?

If you have breathing issues and had been referred by her family doctor often Manitoba Health will cover up to 1000 dollars of your procedure. Autopac or WCB will often cover related surgeries. We will require payment upfront and reimburse any payment by insurance.

What type of anesthesia is used? Will I be completely asleep?

Unless there is a medical reason to keep you overnight, like documented sleep apnea, your surgery will be done under deep IV sedation which is very similar to a general anesthetic but there is no intubation tube. You will not remember any part of the surgery or be awake. We prefer this type of anesthesia because it improves recovery time and risk. If you are not a candidate for this type of anesthetic arrangements will be made to have the procedure done in hospital.

Will my nose be broken?

You may have heard that the nose is broken during a rhinoplasty, but it’s not like breaking an arm or leg, and it is not necessary in every case. This is a misconception from decades ago. In nasal surgery today, the smallest possible instruments are used to cut and shape structures of the nose, including the bone. If it’s necessary to adjust or move your nasal bones during surgery, rest assured that this is a controlled part of the procedure that can make a positive impact on your results. Although it can create significant under-eye swelling and some bruising, most patients find that the results are more than worth it.

Will Rhinoplasty affect my sense of smell?

Your sense of smell won’t be affected in the long term, but occasionally some patients have swelling that can impair it temporarily. If this occurs, the swelling should subside after about a week or two.

How can Rhinoplasty make me look younger?

Throughout the aging process, our noses and chins continue to grow, unlike other body parts. So if you feel like your nose has gotten bigger, it might have. Rhinoplasty can make your nose look younger like it once did. Also, just like your breasts and earlobes, the pull of gravity can cause your nose to droop. Fortunately, if you are an older patient suffering from a droopy nose, rhinoplasty can restore your nasal tip back to its original position, and adding a more youthful balance to your face.

Which procedure do patients often combine with rhinoplasty for the best overall rejuvenation?

We often perform chin augmentation at the same time as rhinoplasty; sometimes, it is necessary to use a chin implant to balance the way a nose looks on the face. Chin implants are extremely powerful in achieving facial harmony, and they are relatively simple to perform, low risk and can always be removed if you don’t like them.

Before And After Plastic Surgery Of The Nose
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About Dr. Ali Esmail, MD

Dr. Ali Esmail Visage

Owner/Doctor

Dr. Ali Esmail is Winnipeg’s first and only fellowship trained Facial Plastic Surgeon. Unlike a ‘general plastic surgeon’, Dr. Esmail has 6 years of specialized training that focuses primarily on procedures from the neck up. Facial plastic surgery requires extreme attention to detail, an eye for symmetry and a drive for perfection. When it comes to someone’s face there is no room for error, and at Visage, this is the very work ethic that drives our entire team. It is those attributes that originally attracted Dr. Esmail to the field of facial plastic surgery. His obsessive attention to detail and keen eye for aesthetic symmetry is what makes him one of the most exciting and top young surgeons in the field.
Read Full Biography

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Other Treatments That Might Interest You

Ultrasonic Rhinoplasty

An Ultrasonic Rhinoplasty uses specialized tools to reshape the nasal bones for a more refined nose shape. It is considered by many to be a

Learn More »

Non-Surgical Rhinoplasty

Liquid or Non-Surgical Rhinoplasty is a powerful procedure that involves the use of dermal fillers and Botox to re-shape the nose. The results are immediate

Learn More »

Revision Rhinoplasty

Revision Rhinoplasty is required when you have previously undergone a rhinoplasty and are unhappy with your results or are experience breathing problems as a result.

Learn More »

Mini Rhinoplasty

Often we see patients who have a small bump or imperfection they would like fixed. This includes some revision cases with ridges or bumps or

Learn More »

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Visage-Cosmetic Skin, Botox, Laser & Facial Plastic Surgery & Dermatology Clinic Winnipeg
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Winnipeg, MB, R3P 1G1

204 817-9190
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