Rhinoplasty with Dr. Hubbard
Nose surgery, also called rhinoplasty, in Virginia Beach requires a high degree of sophisticated precision and is one of the most demanding of all plastic surgery procedures. Dr. Thomas Hubbard is a nationally recognized speaker and presenter and has published multiple journal and book chapters on innovative rhinoplasty techniques. Additionally, Dr. Hubbard has taught surgeons nationally and internationally on the latest techniques in rhinoplasty and has performed this procedure in 6 countries.
Dr. Hubbard "Wrote the Book" on Rhinoplasty
Dr. Hubbard is an authority on rhinoplasty, and has authored textbooks, articles, and presented extensively on the subject.
A Virginia Beach rhinoplasty consultation with Dr. Hubbard involves a careful analysis to assess your facial anatomy and breathing. When appropriate, Dr. Hubbard will use photo imaging to demonstrate the physical changes possible with surgery. His goal is to educate you about the most advanced techniques available in modern rhinoplasty and to achieve natural and aesthetically balanced results.
Request a consultation online or contact our office by calling (757) 687-1900 to discuss your options.
Is Rhinoplasty for Me?
Rhinoplasty can be helpful for people who would like a more attractive shape or size to their nose. Those with breathing problems can also benefit from rhinoplasty, and some insurance policies may cover this procedure for those with a true medical condition.
During Your Procedure
Either general or local anesthesia is used on an outpatient basis. Incisions are made inside the nose except one that may cross the skin between the nostrils. If nostril reshaping is elected, another incision may be made at the edge of the nostril.
The specifics of this procedure vary greatly depending on the patient's needs. Commonly, work is done on the septum (septoplasty). Breathing can also be improved by performing surgery on the turbinates (swellings on the sidewalls of the airway).
Dr. Hubbard performs many revision rhinoplasty cases for people who have had surgery elsewhere. These procedures are highly individualized and vary from small touch-ups to complete rhinoplasty procedures.
Healing after Surgery
An external splint is in place for 1 week. If packing is placed inside the nostrils, it is small and light and removed the next day. Initial discomfort is easily controlled with oral medication. Sutures on the inside of the nose dissolve and those on the outside are removed in 4 to 6 days. Patients can return to work in about a week, although some bruising and swelling may persist. Almost all bruising subsides within 2 weeks but 20% of swelling usually persists for 4 to 6 months. An even smaller percentage resolves in up to a year.
A Complete Makeover
Since the apparent nose size is relative to facial proportions, cheek or chin implants can enhance the results of rhinoplasty surgery. Many people also choose a face lift for anti-aging benefits.
You May Also Need to Know
Revision rhinoplasty refers to redoing cosmetic and/or functional nose surgery after previous unfavorable results. This is a category of nose surgery that is best handled by surgeons with special expertise and considerable experience in rhinoplasty. Dr. Hubbard is referred patients from surgeons in other cities and states for such nose problems. These patients can now benefit from more advanced techniques.
Why is revision rhinoplasty often more difficult? There are a number of reasons. These noses all have considerable scar tissue in multiple areas, changing the character of the structures. Further, there has almost always been both cartilage and bone removed in an attempt to improve the appearance. Often, cartilage must be replaced to overcome the weakness and possible collapse that may have resulted from older, more aggressive rhinoplasty techniques. Modern techniques involve less removal of tissues so results are more predictable and actually more natural in appearance. The goal is a more attractive nose that does not reveal any signs of prior surgery.
Revision rhinoplasty begins with freeing up the old scar tissue and then repositioning the skeleton of the nose – both cartilage and bone. This almost always is accompanied by adding grafts usually of cartilage from the nose, or if necessary, ear or rib. Fortunately, cartilage can be removed from either site with no change in appearance. Grafts strengthen weakened areas, straighten crooked regions, and fill in sites that are too low. They even greatly improve breathing in some cases. Grafts are the ultimate sculpturing surgical procedure in all of medicine.
Rhinoplasty General Information
Rhinoplasty is the surgical sculpting or shaping of the nose that simultaneously maintains or improves breathing. The nose is the most complex structure that is addressed in plastic surgery and the variations in the shape of a patient's nose are some of the most extreme in the body. Further, each patient's desires, goals, and needs are unique.
The process of rhinoplasty begins with a thorough discussion of both the patient's motivations and their internal and external nose anatomy. A discussion then follows about what can be reasonably and realistically accomplished. Computer video imaging assists in decision-making and communication. Drawing all this information together, a unique plan for the patient's needs is developed using a number of the many hundreds of surgical maneuvers available for the nose.
The demand for precision with this surgery is great as the structures manipulated are among the most delicate tissues of the face. Dr. Hubbard's great interest in rhinoplasty results from time spent as an Ear, Nose, and Throat specialist in the 1980's. It has led to teaching advanced rhinoplasty techniques to other surgeons, multiple journal articles, and presentations in the 1990's. Since 2000, Dr. Hubbard has given national presentations on nose surgery and has published textbook chapters on rhinoplasty. The art of rhinoplasty has become a passion of Dr. Hubbard's and has earned him the respect of his colleagues nationwide.
Computer Imaging
Computer imaging is the application of sophisticated computer software on a patient's digital photo to demonstrate potential surgical changes. It is an extremely valuable communication tool between Dr. Hubbard and his patients. He personally demonstrates surgical changes so there can be feedback from the patient, and together plans can be finalized. Not all views can be seen on the computer and the computer cannot show the exact surgical result, but the vast majority of patients find this exercise reassuring that Dr. Hubbard has a good idea of what they desire in this surgery.
Nasal Stuffiness & Rhinoplasty
Although any rhinoplasty can affect breathing, this is unusual. In fact, rhinoplasty generally produces an improvement in nasal function. Dr. Hubbard frequently carries out special maneuvers during surgery to maintain normal breathing or improve breathing considerably. Some rhinoplasty maneuvers can double or even triple airflow! It is also important whenever a hump is removed from the bridge to consider adding small pieces of cartilage to maintain good breathing and also make for better long-term appearance.
Turbinate (a structure that projects from the lateral wall of the nose into the nasal cavity) surgery is easily performed at the same time as rhinoplasty and can permanently cure chronic nasal congestion in many individuals. Dr Hubbard always discusses breathing with his patients.
Tip Rhinoplasty
Tip rhinoplasty is an outdated term and concept from over 20 years ago. At that time, surgeons did not recognize 2 very important tenants of modern rhinoplasty:
- Any surgery on the tip of the nose is likely to affect other aspects of the nose. Thus, committing oneself to working on the tip alone risks unwanted changes to other parts of the nose.
- Most "tip rhinoplasty" techniques of the past used destructive techniques that cut, removed, or weakened excess cartilage of the tip. Surgeons found these techniques attractive as they were rapid, but years later these surgeries resulted in irregularities, distortion, collapse, and even breathing problems. Tip rhinoplasty is rarely indicated anymore.
The Problem of the Nasal Tip Drooping on Smile
In recent years we have greatly increased our knowledge of what controls nasal tip position and why it moves. The nasal tip often moves when we smile but can also shift as a result of aging. Many say the nose grows with age, however, in actuality the tip drops thereby making the length of nose greater. The tip drops because supporting structures of it weaken with time. The nose has a powerful muscle called the depressor septi that pulls down on the tip, especially when we smile. Some individuals with a strong depressor septi muscle will avoid a full smile or cover their nose and mouth when smiling.
As outlined in Dr. Hubbard's chapters on controlling the tip and the long nose, we now have good surgical options to improve tip dropping. Some of these techniques are outlined in his chapter on controlling nasal tip position and movement. These are ways of holding the tip in a good, reliable position after surgery.
Further improvement with those individuals that have a strong lip muscle that pulls the tip down is a procedure that specifically weakens only that tiny muscle and leaves the other lip muscle fully intact. This small muscle weakening procedure is easily performed with a rhinoplasty.
Latest Publications
Over the past 6 years, Dr. Hubbard has developed a surgical technique that leads to significantly better cosmetic results with certain nose reconstructions. The details and results of his surgical technique were published in Plastic and Reconstructive Surgery, the most prestigious national and international journal of his specialty.
Dr. Hubbard has completed updated chapters for the second edition of Dallas Rhinoplasty: Nasal Surgery by the Masters, one of the most authoritative texts in modern rhinoplasty.
Please visit our photo gallery page to see examples of rhinoplasty surgery.
