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Rhinoplasty in Miami, FL

Daniel Careaga, MD
Paul Durand, MD

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Rhinoplasty In Miami

Sometimes, the smallest adjustments and modifications in nasal proportions can result in the most significant changes to a patient’s facial appearance.

A rhinoplasty (nose surgery) can address several concerns in one’s nose based on what is needed and desired. In some patients, this can be to improve nasal shape, proportions, and overall facial harmony. In others, it can be to correct impaired breathing caused by structural defects in the nose and septum. It is not uncommon for a patient seeking rhinoplasty to have both cosmetic and functional concerns. A well-trained rhinoplasty surgeon should be well-versed in what is needed to address both of these issues.

An accident or injury can change the shape of your nose to an undesirable outcome. Sometimes, patients are simply unhappy with the nose they were born with due to genetics or a facial imbalance. Regardless of the cause, rhinoplasty (nose surgery) aims to correct imperfections in the nose to achieve the desired shape and size for improved facial harmony.

Revision (or secondary) rhinoplasty is performed in patients who already underwent prior rhinoplasty surgery. Revision rhinoplasty is often considered the most difficult cosmetic surgery procedure. It is a much more involved procedure than a primary rhinoplasty that is done to restore both nasal shape and function. Unfortunately, we often see patients seeking revisionary surgery after undergoing primary rhinoplasty with a surgeon who was not well-trained in rhinoplasty surgery.

Dr. Paul Durand with rhinoplasty patient during a consultation.

After his plastic surgery training at the world-renowned Cleveland Clinic, Dr. Paul Durand became one of the few to undergo a subspecialized fellowship with world experts in primary and revision rhinoplasty. He is a firm believer that rhinoplasty is a surgery of millimeters and should be treated as such in helping every patient achieve their unique aesthetic goals. Dr. Durand is board certified by the American Board of Plastic Surgery (ABPS).

At Careaga Plastic Surgery, we offer the professional expertise, safety, and cutting-edge technology required to help patients achieve their cosmetic surgery needs. Our dedicated staff of professionals has extensive experience in the cosmetic industry.

Rhinoplasty Can Correct:

Bulbous Or Boxy Nasal Tip

Whether your nose has always had a boxy or bulbous tip that lacks definition or you’ve experienced an incident that rendered your nose crooked or misshapen, rhinoplasty can correct bumps, crooks, unevenness, and other imperfections for a more flattering nose shape and size.

Large “Hump” Or A Wide And Crooked Nose

Large and elongated noses can be reduced for a shorter, thinner nasal appearance.

A large dorsal hump can also be reduced for a much more pleasing side view.

Obstructed Breathing

A deviated septum or impeded nasal structure can reduce your ability to breathe freely, which is uncomfortable and can cause other health issues.

Septoplasty, which is often combined with rhinoplasty, addresses these concerns by correcting deviation and fixing sinus issues to reduce snoring.

What Does A Rhinoplasty Entail?


Rhinoplasty is a nuanced surgery of millimeters that requires extensive planning and measurements. This is part of the reason why your rhinoplasty consultation with Dr. Durand is so important. During this meeting, Dr. Durand will:

  • Determine if you are a candidate for the procedure
  • Evaluate your nose for structural and functional concerns
  • Take measurements of your face
  • Discuss your goals and expectations for your rhinoplasty
  • Show you before and after photos of his previous patients
  • Explain what you can expect from your surgery and recovery
  • Give you a list of ways to prepare, including when to stop smoking, drinking, and taking blood-thinning medication


Anesthesia medication is administered prior to your procedure so you do not feel any discomfort during the surgery.

Surgical Technique

Incisions are made to access the nasal tissue in key areas. Regardless of the approach used, incisions are placed in locations that minimize scarring and make them imperceptible to the naked eye.

Closed Rhinoplasty

The closed approach is designed and ideal for patients with mild nasal concerns. This technique only uses internal incisions to manipulate and sculpt the tissues, cartilage, bone, and skin. If additional strength is needed, grafts will be taken from the patient’s ears, septum, or ribs using a rib cartilage allograft.

Since there are no external incisions, there will be no external scars.

Open Rhinoplasty

The open approach allows Dr. Durand to make more extensive corrections to the nasal structure. A small, hidden incision will be made in the tissues between your nostrils (columella), and the skin will be pulled back to allow for full visualization of the cartilage, bone, and muscles. For patients who require additional structure, grafts may be taken from the ears, septum, or ribs using a rib cartilage allograft to avoid incisions and pain at the harvesting site.

Since there is an external incision, you may develop scarring; however, this scar will be hardly noticeable once healed.

Combination Procedures

Because rhinoplasty is not an anti-aging procedure, many men and women interested in this surgery only require or desire adjustments made to the nose. Occasionally, rhinoplasty can be performed in conjunction with additional facial plastic surgery or non-surgical treatments to maintain balance and improve facial contours.

Potential Combinations

Some potential combinations include:

  • Facelift surgery, to restore youthful contours to the midface, lower face, and neck. This procedure tightens underlying tissues, repositions fat, and trims excess skin.
  • Eyelid surgery, to address aging eyes, such as upper-eyelid hooding and lower-eyelid puffiness.
  • Facial injectables, to address wrinkles or volume loss. As this is a non-surgical procedure, it will not be performed at the same time as your rhinoplasty; however, when performed at an earlier or later date, it can enhance the quality of your rhinoplasty results.

Rhinoplasty Concerns

Rhinoplasty Frequently Asked Questions

  • If your nose has completed growing and you are dissatisfied with your nasal appearance, then rhinoplasty may benefit you. Patients should maintain realistic expectations for their outcome and be in good overall health.

  • Your procedure can take between one and three hours to perform depending on what needs to be corrected. Revision (secondary) rhinoplasty, which is when the patient has already had previous nasal surgery, can take longer.

  • The reason for your rhinoplasty will determine whether your procedure is covered or if insurance can help pay for it. Typically, insurance does not cover elective procedures, which includes aesthetic rhinoplasty. If you are considering rhinoplasty to correct functional limitations and you can prove to your insurance company that your nasal condition is impacting your life and health, there is a chance that insurance will help cover the cost—even if an aesthetic change is being made. Please contact your insurance provider for further details.

  • Most rhinoplasty procedures require a nasal splint and packing to maintain and protect your new nasal structure while draining excess blood and fluid after your surgery. This packing may make breathing difficult during the initial days of your recovery. This challenge is very typical and not a sign that anything has gone wrong with your procedure. Most patients have no functional breathing problems once the packing has been removed.

  • Rhinoplasty results are generally permanent. It can take a year for your outcome to become fully evident due to residual swelling, and your nose will continue to improve as you heal. Your rhinoplasty results are not expected to be altered by the aging process, unlike many other facial cosmetic surgeries. While you may see some minor changes due to gravity and time, they are not expected to be significant.

  • Revision rhinoplasty is a secondary procedure used to correct or enhance the form and function of a previous rhinoplasty. It is very challenging to predict the way a patient’s nose will heal from prior surgery.

    If you are displeased with your rhinoplasty results following your initial surgery, you will be advised to wait for at least one to two years before considering a revision rhinoplasty procedure. This waiting period is necessary to allow the internal tissues, cartilage, bone, and skin to heal completely and for all of the residual swelling to subside.

    Candidates for revision rhinoplasty need to have realistic expectations if they are looking to achieve more fulfilling results than those of their initial rhinoplasty surgery. Dr. Durand will evaluate your nasal structure during your revision rhinoplasty consultation to determine if any swelling or internal healing is going on that could affect your results.

  • Rhinoplasty is one of the few cosmetic surgeries that you can safely undergo as a teenager. To be a candidate for rhinoplasty, it is required to have a fully developed nose. This commonly occurs around age 14 for girls and 15 or 16 for boys. If you are a teenager considering rhinoplasty or are the parent of a teenager considering rhinoplasty, it is necessary to have a complete understanding of the complexity of facial surgery and what it means for your physical appearance. Teenage patients need to have the emotional maturity to handle the rhinoplasty process.

  • Yes. Dr. Durand is a nasal surgery expert who does a large volume of ethnic rhinoplasty. He is a firm believer that a rhinoplasty procedure needs to be tailored to each face and to a patient’s ethnicity. Dr. Durand will discuss your goals and review your options during your consultation to ensure that your results match your aesthetic or functional desires, as well as maintain your cultural beauty ideals.

  • Ethnic rhinoplasty is a variation of rhinoplasty that is performed on patients of various backgrounds (non-Caucasian patients). Ethnic rhinoplasty is performed for several reasons, taking into account both structural differences and cultural ideals. Ethnic rhinoplasty is not a Westernization procedure. It is performed to enhance nasal structures while keeping in mind the aesthetic ideals of particular cultures. Additionally, variations in skin, bone, and cartilage thickness between different ethnicities require specific techniques. What may work for one ethnicity may not be appropriate for another. This specific form of nose surgery helps ensure that the right techniques will be applied during your procedure.

  • Generally speaking, patients of the same ethnicity tend to have similar concerns. For example, many African American patients desire narrower nostrils, whereas many Asian patients desire a stronger and more pronounced nasal bridge. Whatever the concern, ethnic rhinoplasty has a solution.

  • If you are a non-Caucasian patient it is very important that you seek a surgeon who is skilled in ethnic rhinoplasties, such as Dr. Durand. Not only will this ensure that your results stay true to your culture and heritage, but it will make sure that the appropriate techniques are applied for a safe and successful rhinoplasty result.

  • Some broken noses heal well and do not require any additional surgery to repair form or function. Unfortunately, not all broken noses fall into this category, and some nasal damage requires surgical correction to maintain the above. Occasionally, uncorrected broken noses develop an infection or internal bleeding that can result in collapsed or heavily damaged nasal structures. Rhinoplasty after an injury can help ensure that these concerns will not develop.

  • Most rhinoplasty patients choose only to undergo rhinoplasty surgery to correct their nasal concerns, such as an overly rotated nasal tip, large humps or bumps on the nasal bridge, or overly large or wide bridges or nostrils. Some older patients take this opportunity to reverse signs of aging; however, this is not required nor always advised. If you are considering multiple procedures, Dr. Durand will evaluate your needs to describe whether a combination procedure is right.