Dr. Michael Decherd and Dr. Matthew Isakson perform rhinoplasty surgery for women and men who desire a more aesthetically pleasing nose. The most common reason to have rhinoplasty is for cosmetic purposes. Whether caused by trauma or heredity, we can correct asymmetries and imperfections and create a balanced, natural look. Using a subtle approach to nose reshaping, he can help improve the appearance of noses that are too big, too wide, crooked, or have a deformity such as a visible bump on the top or at the tip. Dr. Decherd and Dr. Isakson also offer revision rhinoplasty procedures to patients in the San Antonio area.

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Surgical Considerations

Dr. Decherd and Dr. Isakson are skilled in performing both open and closed rhinoplasty. The approach taken during surgery will be based on the aesthetic goals of the patient, as well as the complexity of the surgical case. Open rhinoplasty is used for more complex cases and allows the surgeon greater access to the nose to manipulate cartilage and bones. The incisions are made on the tissue between the nostrils or on the natural crease of the nose just above the lips. Closed rhinoplasty is used for cases that require mild reshaping and are not as severe. The incisions are made to the inside of the nose through the nostrils.

FULL RHINOPLASTY REVISION

Secondary rhinoplasty can be challenging as the surgeon works to correct or fix a problem stemming from the first surgery. During this procedure, the majority of surgeons will use an open approach. This entails separating the skin from the support framework of cartilage and bone, which offers the surgeon full access to the structures within the nose. The surgeon will re-sculpt the nose to a more desired shape depending on the problem being addressed. If additional tissue is needed, an autologous approach is typically taken, which uses cartilage and bone from the patient.

TOUCH-UP RHINOPLASTY

Some patients may be happy with the look and feel of their nose following surgery, but need a slight touch-up. This may include a visible bump or edge on the tip of the nose. The imperfection is usually found and discussed during a post-operative appointment and it is common for the original surgeon to address the issue. This surgery is less complex than the original surgery and may only involve slight shaving of the bone. It usually produces results both the patient and surgeon are content with.

DURING/AFTER SURGERY

Secondary rhinoplasty is performed under general anesthesia in an accredited surgical facility. The duration of this surgery depends on whether the nose is being reconstructed or a minor alteration is being made. After surgery, patients will wear a nose splint and will experience bruising and swelling. For patients undergoing revision surgery, the process can be somewhat unnerving. The goal is for the nose to return to a natural, non-surgical appearance. If an experienced surgeon is performing the procedure, the results are often positive.

Before & Afters

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Rhinoplasty Results
Rhinoplasty Results
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Board Certified, MD

Dr. Decherd

Dr. Decherd is a fourth-generation doctor who chose plastic surgery because he enjoys helping people look and feel their best.

Meet Dr. Decherd

04 – Meet The Doctors

Meet Your Experienced surgeons

Michael E. Decherd, MD, and Matthew H. Isakson, MD, our board-certified plastic surgeons at San Antonio Plastic Surgery Institute, prioritize your comfort and safety throughout your surgical journey. Their extensive training and experience promote personalized attention and the highest standard of care possible.

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Board Certified, MD

Dr. Isakson

Dr. Isakson is a board-certified plastic surgeon with specialized fellowship training and extensive experience in aesthetic surgery.

Meet Dr. Isakson

Rhinoplasty FAQs

Rhinoplasty is performed under general anesthesia and can take up to about 2 hours to complete. Once the incisions are closed, the nose will be placed in a splint for additional support. There will be swelling, soreness, and bruising around the nose and possibly even under the eyes. It takes about 7-10 days for these side effects to disappear. Patients will be able to see their results immediately, however, it may take 3-4 months for the results to become optimal.

All cosmetic and restorative surgeries carry some form of risk, especially those that involve the face because that is what people see first. It’s important to find a qualified and skilled nose surgeon so that any risks can be minimized during surgery. Rhinoplasty is one of the most commonly performed procedures in the U.S., and a good surgeon will create a satisfactory outcome that is natural, subtle, and pleasing.

An experienced nose surgeon who is trained and skilled in revision surgery will understand the dynamics behind what went wrong during the first operation and how to correct the problems with a secondary procedure. While the procedure itself can be quite complex, the results are often pleasing for the patient. It is extremely important to do your research when looking for a revision specialist.

After rhinoplasty, some patients will require nasal packing. This includes gauze or cotton packs to be inserted into the nasal chamber to help control bleeding. This can cause some discomfort, but the packing is short-term and is usually only for the first 24 hours after surgery.

In some cases, cartilage grafting will be needed in order to produce the desired results. This can be done by taking cartilage and bone from another part of the body, such as the ribs, and using it to correct a certain nasal structure. Cartilage and bone grafting are usually only needed in more severe cases, including framework reconstruction.

Revision rhinoplasty is actually somewhat common. It varies by practice and by rhinoplasty surgeon, but some experts put minor revision rates between 5-15%. A large majority of these patients desire tweaking and minor adjustments only. True reconstruction and major revision cases are on the lower end of the spectrum.