I want to have a real conversation about something I see every single day. We live in this era where you can open Instagram or TikTok and see the exact same nose on fifty different people. You know the one I’m talking about—the tiny, upturned, super-sculpted slope. And look, on the right filter, in the right lighting, it looks aesthetically pleasing. But here’s the problem I run into constantly in my practice: that specific nose probably doesn't belong on your face.
I’m a facial plastic surgeon here in Beverly Hills, and if there’s one thing I’ve learned after performing thousands of these surgeries, it’s that there’s no such thing as a "one size fits all" nose. It just doesn't exist. My entire philosophy is built around the idea that facial plastic surgery should whisper, not shout. It should fit you so well that even your best friends can’t quite put their finger on what changed.
So today, I wanna walk you through my thought process. I wanna explain why we’re moving away from that cookie-cutter look and focusing on personalized aesthetic surgery. We’re gonna talk about facial harmony, breathing, and what actually happens when you decide to undergo rhinoplasty with me.
Let’s start with the basics. Back in the day, rhinoplasty surgery was often reductive. That means surgeons would take a nose, remove bone and cartilage, and make it smaller. That was the goal. Small equaled good. But that approach ignores the rest of the face.
If you’ve got strong cheeks, a prominent chin, or a taller forehead, putting a tiny button nose in the middle of your face is gonna look weird. It throws everything off balance. It actually draws more attention to the nose because it looks artificial.
When I analyze a face, I look at the big picture. I look at your other facial features. I look at your upper lip length. I look at the projection of your chin. My job as a rhinoplasty specialist is to create a new nose that respects those features. We want facial harmony. When someone looks at you, I want them to see your eyes. I want them to see your smile. I don’t want them staring at your nasal tip, wondering who your surgeon was.
When you come into the office, the first thing we do is talk. I need to understand your aesthetic goals. Why are we here? Is there a dorsal hump that bothers you in profile photos? Is your tip undefined? Or is it a functional issue, like nasal obstruction or a deviated septum?
I see many patients who bring in wish pictures. I love that. Show me what you like. But then we’ve gotta have a real discussion about your anatomy. I perform a thorough physical examination of the nasal anatomy. I’m feeling the nasal bones. I’m checking the strength of the cartilage.
One massive factor is nasal skin. If you’ve got thick, oily skin, it behaves very differently from thin, transparent skin. If you’ve got thick skin, we can’t make the tip incredibly sharp and tiny because the skin just won’t shrink down that much. It’d result in dead space and scar tissue. If you’ve got thin skin, every little edge shows, so we have to be incredibly smooth with our surgical technique.
Setting realistic expectations is probably the most important part of my job. I’ll tell you exactly what we can achieve. I’m not gonna promise you a result that your anatomy can’t support because that leads to unhappiness. I want patient satisfaction to be high, and that starts with honesty.
Here’s something people forget: the nose is an organ. It’s got a job. It needs to filter and humidify the air you breathe. A cute nose job that leaves you struggling to breathe is a failure in my book.
I’m dual board-certified, meaning I’ve got training in both facial plastic surgery and otolaryngology (ENT). So when I look at your nose, I’m looking inside the nose just as much as the outside. I’m checking the nasal septum—that wall that divides your nostrils. A deviated septum is incredibly common, and it blocks airflow. I’m checking the turbinates. I’m checking the valves.
When we create a surgical plan, we address all of this. If you’ve got trouble breathing, we fix it. We can straighten the septum. We can support the nasal passages. Most patients wake up from surgery and tell me, "Wow, I didn't know I could breathe like this." That functional improvement is huge for your quality of life.
Because every nose is different, I’ve got a toolbox of different techniques. I don’t do the same surgery on everyone.
You might’ve heard these terms. Open rhinoplasty involves making a tiny incision on the columella—that little strip of skin between your nostrils. I lift the skin up, and I can see everything. It gives me total control over the nasal anatomy. I use this for complex reshaping, fixing asymmetrical tips, or revision rhinoplasty. The scar heals incredibly well; it becomes virtually invisible.
Closed rhinoplasty, or endonasal, is where all the incisions are inside the nostrils. No external scar. This is great for patients who need a hump reduction or minor refinement but don't need major structural changes to the tip.
Surgeons prefer different approaches, but an experienced surgeon uses the right approach for the patient. I do both, depending on what we need to achieve.
This is an exciting shift in our field. Traditional rhinoplasty often involves cutting away the roof of the nose (the bridge) to lower it. Preservation rhinoplasty is different. We remove cartilage and bone from underneath the bridge and let the whole structure settle down. It preserves your natural dorsal lines. It often leads to less swelling and a very natural look. It’s not for every nose, but for the right candidate, it’s fantastic.
Sometimes, to get the shape we want, we have to add support. If you’ve got a weak, droopy tip, I can’t just cut cartilage away, or it’ll collapse. I have to build it up. We use cartilage grafting. I usually take cartilage from your nasal septum. If you’ve had surgery before and don’t have any septum left, we might use ear cartilage or a small piece of rib.
This acts like a strut or a beam. It holds the nose in the correct position so it doesn't droop over time. It ensures the nasal tip stays refined and the breathing passages stay open.
If this is your first time having nose surgery, that’s primary rhinoplasty. It’s the best time to get a great result because the tissues are virgin. The blood supply is perfect.
Revision rhinoplasty is when you’ve had a procedure elsewhere and need it fixed. These are much more complex. We’re dealing with scar tissue. The normal anatomy might be gone. The nasal skin might be compromised. I do a lot of revision surgery, and it requires a very specific skillset. We often have to reconstruct the nose using grafts.
If you’re coming in for a revision procedure, patience is key. The healing takes longer. But we can usually make significant improvements to both the shape and the breathing.
Now for the logistics. Rhinoplasty is usually an outpatient procedure. You come in the morning, and you go home that afternoon.
I perform almost all of these under general anesthesia. I know some people get nervous about anesthesia, but it’s actually the safest way to do this. I need your airway protected. I need you completely still so I can be precise with every millimeter. We’ve got amazing anesthesiologists who take great care of you.
The surgery takes anywhere from 2 to 4 hours, depending on what we’re doing. I use very precise tools. I use something called Piezosurgery, which uses ultrasonic vibrations to reshape the nasal bones. It’s much gentler than the old-school hammers and chisels. It causes less trauma to the surrounding tissue, which means less bruising for you.
Once we’re done, I put a splint on the outside of the nose to protect the shape. Now, let’s address the elephant in the room: nasal packing. Everyone’s heard stories about having yards of gauze pulled out of their nose. I rarely do that. It’s uncomfortable. I use soft silicone splints inside the nose if needed, or sometimes just a small drip pad. I want you to be comfortable in the recovery room.
I'll be real about the downtime. You aren’t gonna be bedridden, but you definitely need to take it easy.
When you wake up, you’ll feel congested. It feels like a heavy head cold. You won’t be in sharp pain—most patients tell me the pain is very mild. You’ll have some pressure.
For the first 48 hours, your job is to rest. Keep your head elevated. Put cold compresses on your cheeks (not directly on the nose). This helps reduce bruising and swelling. You might get some bruising under the eyes, especially if we adjusted the bones. It looks worse than it feels, but do not touch your nose. If you do, it very well might feel as bad as it looks.
You need to eat soft, bland foods for a day or two. High fiber foods are great because anesthesia can slow your digestion down. Avoid anything super spicy or salty that’ll make you swell. And absolutely no nose blowing. If you have to sneeze, do it with your mouth open.
We usually take the cast and sutures off on day 6 or 7. This is the big reveal. But—and listen closely—it’s a swollen reveal. You’ll look in the mirror and see that the dorsal hump is gone and the shape is better, but the nose will be puffy. Especially the tip. You're still going to look like you just got into a fist fight, so give yourself some grace.
Rhinoplasty teaches you patience. The nasal skin takes time to shrink wrap down to the new framework we built. You’ll look restaurant-ready after about two weeks. You can go out, wear makeup, and nobody will look at you sideways.
But the fine detail? That takes time. It can take a full year or more. If you’ve got thick skin, it can take up to two years.
We see our patients regularly throughout that first year. We take photos. We monitor the healing. Sometimes we use tiny steroid injections to help the swelling go down in specific spots. It’s a process, and I’m with you the whole way.
I’m a doctor, so we’ve gotta talk about safety. Rhinoplasty is surgery. There are risks. Infection and bleeding are possible, though rare. There’s a risk of septal perforation, which is a small hole in the septum. This is very uncommon in primary rhinoplasty but can be a risk in complex revisions or if you’ve got a history of cocaine use or intranasal trauma.
The biggest risk is usually aesthetic—not liking the result. That’s why the consultation is so important. We need to be on the same page. If you want a result that isn't physically possible, I’ll tell you. I’d rather say no to a surgery than perform a nose job that won't make you happy.
Choosing a board-certified facial plastic surgeon minimizes these risks significantly. You want someone who does this every day, someone who understands the blood supply, the nerve pathways, and the structural support of the nose.
People ask me why I chose faces. It’s because the face is your identity. When you change something on the body, you can cover it with clothes. You can’t hide your face.
I’ve seen patients who’ve spent their whole lives hiding from the camera. They tilt their head down. They avoid certain lighting. When we fix the issue—whether it’s a cosmetic reason or a breathing issue—it changes how they carry themselves.
When I see a patient come back for their follow-up and they’ve got a new haircut, or they’re smiling bigger, that’s the best feeling.
I want to touch on heritage again because it’s so important. Rhinoplasty shouldn't erase your ethnicity.
I do a lot of nose surgery for patients of Middle Eastern, Asian, African, and Hispanic descent. The anatomy is different. The cartilage strength is different. The skin thickness is different.
In the past, many surgeons tried to give everyone a Caucasian nose. That’s wrong. It looks fake and it dishonors the patient's background.
My goal is to refine. If you’ve got a Middle Eastern background and a dorsal hump, we can straighten the profile without making it look scooped and tiny. If you’ve got an Asian background and want more bridge height, we can build that up naturally so your glasses sit better and your eyes look more defined. We want to preserve your facial features while improving the balance.
Let me answer a few things I get asked constantly.
"Dr. Nima, will I look like a different person?" No. That’s my whole point. You should look like you, just refined. People usually ask if you changed your hair or lost weight. They sense you look better, but they can't always tell why.
"Can I combine this with other things?" Absolutely. Many patients combine rhinoplasty with a chin implant (to balance the profile), a lip lift, or eyelid surgery. We can do this all under one anesthesia, which means one recovery period.
"What about non-surgical rhinoplasty?" Liquid rhinoplasty (using fillers) is popular. It’s great for minor camouflage, like hiding a small bump or lifting a tip slightly. But it’s temporary. And it can’t make a nose smaller; it only adds volume. It also carries risks if not done by an expert, because the blood supply in the nose is tricky. It’s a tool, but it doesn't replace surgery for structural changes.
"How much does it cost?" This varies. It depends on the complexity, the time in the OR, and whether it’s a primary or revision procedure. We give you a full quote at the consultation. Remember, this is your face. It’s not the place to look for the lowest bidder. You’re paying for the surgeon's expertise, judgment, and care.
Look, deciding to have plastic surgery is a personal decision. There’s no right or wrong reason, as long as you’re doing it for yourself.
If you’re thinking about rhinoplasty, take your time. Do your research. Look at rhinoplasty medical experience. Find a surgeon whose before-and-after photos resonate with you.
And when you’re ready, come see us at Eos Rejuvenation. We’ll sit down, we’ll talk, and we’ll figure out the best plan for your face. No pressure. No sales pitch. Just honest, expert advice.
We’re all about helping you feel confident. Whether that means fixing a deviated septum so you can sleep better, or refining a nasal tip so you love your profile, we’re here to help.
