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Rhinoplasty (Nose Surgery)

Every week I see a few patients who are seeking to reshape his or her nose. This procedure, rhinoplasty, has its modern roots in Europe at the beginning of the last century. It was one of the first cosmetic procedures done in the history of medicine. Until that time, few people would dare undergo a surgical procedure unless it was to alleviate substantial pain or preserve life. Jacques Joseph, however, an orthopedic surgeon by training, saw the opportunity to alleviate a different type of suffering, the psychic pain caused by a nose of ill proportion. Young men and women flocked to this man in Berlin and his disciples who were able to reduce the size of their noses.

Video: Dr. Berkowitz Discusses His Advanced Rhinoplasty Technique


Dr. Berkowitz discusses the latest advancements in rhinoplasty surgery that can greatly reduce recovery time and yield beautiful, natural-looking results.

People who felt ostracized by the highly developed but conforming Western Civilization now could better assimilate into their societies. Over the years this procedure has gained wide acceptance as a way of easing a person’s discomfort over even smaller imperfections in his or her appearance thereby boosting self-esteem. In the entire world of plastic surgery there are few procedures that compare to the power of a well-performed nose job!

Herein lies the rub-“well-performed” Even so there is no greater challenge in aesthetic surgery than learning to evaluate, plan and execute this daunting procedure. There is a Latin proverb, “ars longus, vita brevis” which loosely translated means “life is short but the craft takes a long time to learn” This is true of plastic surgery in general but especially for rhinoplasty.

It is an architectural project requiring an intimate understanding of complex anatomy and physiology. The underlying bone and cartilaginous framework must be meticulously reshaped or constructed for the overlying skin to reflect the desired outcome.

Obtaining good results in this operation requires sound training in a plastic surgery or ear nose and throat residency, a commitment to constant self evaluation and criticism and years of practice. The technique has changed considerably from the last century. Originally designed primarily as a reductive procedure whereby a great deal of the boney infrastructure was removed with saws, chisels and rasps done from inside the nose by feel rather than visualization, results were often unpredictable and the entire process just a recipe repeated on all comers. Primarily, (but not always) an open approach is now used where with fibreoptic lighting, magnification and greatly refined instrumentation, a constructive approach can be individualized to each patient’s needs. Even so, to achieve the Hollywood idealized results that we all have come to expect it is not unusual for a patient to require a secondary or touch-up procedure. Fortunately, down time has been reduced from what was once as long as a 6 week recovery to one week. It is done as an outpatient procedure under general or local anesthesia with sedation. It is my preference to utilize the services of board-certified anesthesiologists to afford greater safety and comfort to our patients.

After more than 27 years of being a board certified plastic surgeon, as an associate member of the prestigious Rhinoplasty Society and more than a thousand rhinoplasties to hone my craft, I strive to ever perfect this valuable and challenging surgical procedure.

rhinoplastyView Rhinoplasty Before and After Photos

To assist you with any arrangements that you may need please contact us at 408.559.7177