Rhinoplasty in the Bay Area Including San Francisco

Rhinoplasty for Patients in the Bay Area, including San Francisco, San Jose and Palo Alto

*Individual patient results may vary

Surgery on the nose (also known as a rhinoplasty, or a "nose job") is often referred to as the most difficult cosmetic surgery to do well. Since the procedure is offered by many, a patient must be extremely careful when choosing a doctor, as achieving consistent and harmonizing facial results in rhinoplasty is not possible for every surgeon. A nose should blend into the rest of a face, not drawing attention to it, but allowing an observer's gaze to be drawn to the eyes, the lips, and the contour of the jaw.

So many patients have written to us after receiving a rhinoplasty in our Bay Area office, describing how difficult it was before their nose surgery to always use the same pose for each picture to minimize attention to their nose. "Thank you so much for my new nose! I no longer feel self-conscious when someone takes a photograph from the side. I love the way it looks in pictures!" A good rhinoplasty addresses these concerns, leaving a nose that draws no particular attention to itself but allows all of the beautiful features of the face to shine in harmony.

The beauty of the nose comes from its complex appearance. If you look closely at a nose you think "fits" a face, take note of why. A "good" nose is proportional to the surrounding features. It is a blend of shadows and highlights, angles and contours. Making a bad nose look good is often a change of millimeters, sometimes even just reducing an unnatural shadow.

The Ideal Nose
The Ideal Nose: To create a balanced nose, Drs. Lieberman and Parikh take numerous proportions and angles into account, all of which have been developed by aesthetic medical experts over hundreds of years. The idealized nose includes a straight nasal dorsum, a moderately projecting nasal tip, and a small dip in the nasal vault. The doctors' carefully planned rhinoplasty will produce a nose that harmonizes with surrounding facial features and its own elements.

We understand how important it is to create harmony in the face and know how much work it takes to affect even a subtle change in the nose. We have a combined 15 years of surgical and advanced fellowship training dedicated to the face and neck. Our experience and partnership model allows us to deliver a consistent and reliable result. Correction of even minor nasal deformities via rhinoplasty, using techniques that may shift tissues by a matter of mere millimeters, can nonetheless have profound benefits to appearance and self-esteem.

Rhinoplasty Pre-Operative Process

Am I a Candidate for Rhinoplasty Surgery? Who Gets a Nose Job?

Rhinoplasty is one of the most common cosmetic operations performed on the face. There are many reasons why an individual seeks out this type of nasal surgery. Common reasons patients cite for choosing rhinoplasty include:

  • To reduce a high dorsum (take down the hump)
  • Reduce the overall size of a nose
  • Straighten a crooked nose
  • Lift a droopy tip
  • Bring a tip closer to the face
  • Refine a rounded tip
  • Narrow a wide nose
  • Lengthen a short nose

This does not even include the large number of patients who also want to breathe better through one or both sides of their nose. Nasal airway management is a crucial component of rhinoplasty. Only a surgeon who is experienced in nasal airway surgery can maintain or improve a nasal airway while making changes to the external appearance of the nose. Selecting the right candidate for any surgery, not just rhinoplasty, is an important part of every consultation. The overall goal is to create an aesthetic facial balance and bring about natural harmony.

*Individual patient results may vary

Patients considering rhinoplasty surgery should avoid smoking in the weeks prior to their scheduled appointment, as smoking impedes proper oxygen flow throughout the body, and such flow is important for healing and recovery.

What Happens During a Rhinoplasty Consultation?

A consultation for rhinoplasty includes a comprehensive overview of your medical history and an examination of the external and internal anatomy of the nose. Time will be spent discussing your desires and expectations about such a change, and cutting-edge software will be used to help communicate your goals. Detailed pictures will be taken of your nose from several different angles.

We feel that digital morphing software is crucial in understanding how rhinoplasty patients want their nose to look so that the nose surgery is customized to each patient. The digital morphing is important because it gives patients an opportunity to communicate their aesthetic desires and allows us to develop a customized treatment plan. The morphed images are used as a guide during rhinoplasty surgery.

Will I Get the Nose I Want With Rhinoplasty?

Patients are free to bring in photos of examples of noses they like in terms or size, shape, or proportion for reference. This can be helpful in communicating an idea of an end goal, but we emphasize that what looks good on one face might not work aesthetically on another. The key with rhinoplasty is to remember that we work with each person so that the nose harmonizes with all of the other features and "works" for the individual.

As facial specialists, we take a variety of elements into account, including how well the nose fits in the middle third of the face when viewed from top to bottom, its width, the angle where the nose meets the forehead, the angle and shape of the nasal tip, the size and shape of the nostrils, the presence or absence of a "nasal hump," how all of these interact with each other, how all of these interact with other parts of the face, and more.

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Rhinoplasty Technique

How is Rhinoplasty Surgery Performed?

There is no single, "one-size-fits-all" approach to rhinoplasty. Each patient's needs are unique, so the surgical methods we use will depend on the size and shape of the existing nose, as well as other factors, including the proportions of the rest of the face and the desired final outcome.

We use either the external ("open") or endonasal ("closed") approach when performing rhinoplasty. During the "open" technique, a small external incision is made on the columella (tissue between the right and left nostrils) to gain access to the interior of the nose. The incision placement allows us to expose the nasal framework and offers a clear line of sight directly into the targeted structures. This can be very beneficial, particularly in complex or involved rhinoplasty surgeries, as everything is available at once. Every effort is made to keep the healed incision line as inconspicuous as possible, and many patients find that the line is barely noticeable, even if you know where to look.

The open approach is in contrast to a "closed" rhinoplasty, in which all incisions are made entirely within the nasal interior. Most obviously, this method avoids any potential of a visible scar, though it also limits viewing options into the nasal framework.

At the initial consultation, we'll discuss which technique will be used. This will be determined based on which approach will allow us to best reshape the nasal cartilage, bones, and soft tissue to obtain the most precise and predictable result.

Typically the septum is the source for all grafting material needed to create contour and definition in the nose. For revision rhinoplasty, occasionally grafting material is developed from either ear or rib cartilage. If there is even a chance of using this material, it will be reviewed with you in detail during the initial consultation. We always want patients to feel comfortable with the plan, so we aim to avoid surprises.

"A Partnership for the Face": Rhinoplasty by Dr. Lieberman and Dr. Parikh

Dr. Lieberman and Dr. Parikh strive to create a natural, refined result for their rhinoplasty patients, and believe in making subtle changes which deliver significant improvements in the contour, projection and rotation of the nose. The unique partnership between Dr. Lieberman and Dr. Parikh provides unparalleled service to each and every patient. Collaboration affords them the opportunity to act as a sounding board for one another when determining the best possible treatment plan for each patient. You benefit from their combined skills as board certified and fellowship trained surgeons specializing exclusively in facial plastic and reconstructive surgery.

Why choose Lieberman & Parikh Facial Plastic Surgery?

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What Should I Expect on the Day of My Rhinoplasty Surgery?

Rhinoplasty (nose job surgery) is performed either under deep sedation or general anesthesia, depending on the procedure's specifics. We are extremely selective in which anesthesia group we choose, as patient safety is the most important component of the entire process. We only work with board-certified anesthesiologists who specialize in cosmetic surgery. The procedure can take two to four hours, depending on the complexity of the case and whether a revision rhinoplasty is being performed.

Is Revision Rhinoplasty Different?

When people talk about getting a "nose job," they are typically referring to a rhinoplasty, as work done during the surgery changes the appearance of their natural nose. This procedure can reduce its size, alter its shape, and balance its proportions.

All of these benefits can also be a part of revision rhinoplasty, but that term is most often used to describe a surgery being done to correct a nose that has been aesthetically changed by prior surgery or trauma. Physical damage can disrupt symmetry, create bulges where there weren't any before, and more, all of which can be corrected by experienced, facial-focused plastic surgeons who understand how a nose should look in the context of the rest of the face.

Patients who have had lesions removed due to skin cancer treatment, leading to an undesired visual impact on their nose, can also talk to us about skin cancer reconstruction. This is not uncommon, since skin cancer is most likely to appear on the face, and the nose is a prominent feature where cancers can develop. Some skin cancer treatment specialists can also make aesthetic repairs during the removal process, but involved cases are often referred to facial experts who have considerable knowledge of the most current surgical and minimally invasive techniques available.

Rhinoplasty Post-Operative Recovery Process

What Should I Expect After My Rhinoplasty?


Suture Removal

3 days (If present)

Cast Removal

7 days

Return to Work

1-2 weeks


3-6 months


1 year

Our philosophy is to see you early and often after surgery. So many questions arise in the first two weeks following any surgery that we believe setting up a series of appointments for that time period should ease any anxiety a patient may have about the recovery process. If sutures are present, they are removed three days after surgery. Finally the cast is removed seven days after surgery.

During that first week of rhinoplasty recovery, you will be encouraged to keep your head higher than your chest, even when you're settling in to rest. This will reduce swelling.

Our core objective is to provide a safe, comfortable surgical experience that aspires to restore your appearance and aims to produce natural results. We have provided rhinoplasty before and after photos of our patients to help you visualize the possibilities. Keep in mind, though, that each patient's rhinoplasty is his or her own. We do not re-create other people's noses, but instead shape our patients' own noses to best suit their faces.

What Can Complement Rhinoplasty?

Since a key element in a successful rhinoplasty is balance, the surgery often prompts patients to think more about their facial aesthetics as a whole.

Once their nose has healed properly, some people choose to get an aesthetic treatment, such as skin resurfacing via lasers, chemical peels, or dermabrasion to reduce their pore size and sun spots, and even out their skin tone.

On a more involved level, some rhinoplasty patients want other facial features to structurally change as well. A chin augmentation, for instance, can help create a more dramatic difference by reshaping that area for a bolder, rejuvenated look. This can be a long lasting, surgical choice, or can be handled with minimally invasive and temporary dermal fillers, such as Juvéderm® Voluma or Radiesse®.

Other available procedures include otoplasty (also known as ear shaping), surgical or non-surgical lip enhancement, neck liposuction, and more.

Finally, as noted above, some patients are seeking both external and internal changes to their nose, making their procedure as much about function as is it about aesthetics. A surgery to improve someone’s ability to breathe through their nose via nasal airway surgery can also involve changes to its appearance.