As the most central and prominent feature of the face, the nose is pivotal to both appearance and personal identity. The goal of any rhinoplasty (nose job) should focus on creating a nose that suits one’s face and personality.
With his extensive experience, Dr. Alexander appreciates the delicate details of reshaping a nose. He is well versed in both endonasal (minimally-invasive) and open rhinoplasty, as well as non-surgical techniques (“liquid rhinoplasty”). Dr. Alexander is able to choose the approach that will give you the best result.
Instead of applying cookie-cutter solutions, Dr. Alexander prides himself on the extensive time and meticulous planning he devotes to every rhinoplasty evaluation. His skill and expertise, coupled with a genuine, compassionate demeanor and true ability to connect with his patients’ wishes, have earned Dr. Alexander the reputation of providing among the best nose jobs Toronto has to offer.
Rhinoplasty is my favourite operation. The joy and satisfaction that comes from giving someone the nose they have always wanted, the nose that reflects their true identity, is a wonderful feeling. While some surgeons might get bogged down by the minute intricacies of a case, this is my happy place. It’s getting caught up in those details, in achieving that perfect, natural result, that I feel most satisfied in my work.
Who is a good candidate for rhinoplasty?
Ideal candidates for nose surgery generally experience issues with the nasal bridge, the tip, the nostrils, or some combination of all three. Additionally, many patients will struggle with functional difficulties such as breathing impairment from a deviated septum. If you have suffered from a poor self-image and low confidence because of your nose, rhinoplasty may be able to improve your quality of life.
Dr. Alexander recommends for younger patients that rhinoplasty is put on hold until the nose has finished growing, which usually happens by age 16. On the opposite end of the spectrum, there is no upper age limit for a nose job; however, all patients must be in good mental and physical health to undergo surgery, with no significant medical issues.
It’s important that rhinoplasty patients have realistic expectations for their surgery. The nose can be greatly improved, but perfection can be elusive. During your consultation, the doctor can provide you with Vectra 3D imaging results that will reflect your results. These can be adjusted to your liking with the doctor’s help so that both surgeon and client arrive on the same page regarding the outcome of the surgery.
Details of the surgery
Rhinoplasty typically takes 3-4 hours to perform as it is a meticulous operation. Surgery will involve the manipulation of nasal cartilage and bone to remodel the shape of the nose. Nasal grafts may be employed for re-contouring when necessary. If the profile is weak, the doctor may recommend chin implant surgery at the same time as your rhinoplasty to provide optimal facial harmony and balance.
Prior to surgery, the doctor will choose either an open or closed rhinoplasty, depending on the type of changes that need to occur. During the open surgery, a small columellar incision is made at the base of the nose to give the doctor the most efficient access to the underlying nasal structures. The scar from this incision typically heals beautifully and becomes imperceptible. A closed rhinoplasty involves incisions made inside the nostrils, resulting in no external scarring. Dr. Alexander is highly experienced in both approaches, and will recommend to you the best approach for your nose during your consultation.
Recovery from rhinoplasty
While each patient will heal at a different rate, most clients will experience expedited healing without complication, thanks to Dr. Alexander’s conservative, expert technique. You may be dressed with a splint, but this will be removed in about 7 days along with your sutures. Swelling and discomfort are all normal and to be expected in the early stages.
Patients can usually resume most regular activities within 7-10 days. Swelling and bruising will be much improved by 2 weeks. If you have any questions during your recovery period, do not hesitate to contact Dr. Alexander’s office. You will also be able to check in with him during regularly scheduled follow up appointments to ensure that healing is going according to plan.
Understanding revision rhinoplasty
If you have previously undergone nasal surgery, but the outcome was unsatisfactory, you may require a secondary rhinoplasty (aka revision rhinoplasty). An undesirable outcome can occur for a variety of reasons, whether it be persistent difficulty with nasal breathing, or an untoward aesthetic result. This can sometimes be due to over or under-resection of the nasal structures and supports. Often, it’s a consequence of unpredictable healing which cannot be controlled by you or your surgeon. However, in the unfortunate circumstance of a patient requiring a revision procedure, you want to ensure that your surgeon has the skill and experience necessary to improve your nose with a subsequent operation.
Revision rhinoplasty is a highly complex and delicate procedure. While the goal of revision rhinoplasty (and primary rhinoplasty) is improvement, not perfection, if done well it can have a significant positive impact on an individual’s life.
Determining your candidacy for revision rhinoplasty
An ideal candidate for revision rhinoplasty surgery is in excellent general health, and has realistic expectations for the correction of their nasal concerns. Dr. Alexander will help determine your candidacy during your in-depth initial consultation. Dr. Alexander will be very honest with you in terms of his assessment of your nose, and what he thinks he can improve (or not improve). He will not offer you surgery unless he truly believes he can make a difference for you.
Revision rhinoplasty checklist
If you suffer from any of the following after your initial rhinoplasty, revision rhinoplasty may be right for you:
Nasal breathing difficulties
A persistently crooked nose
An over-projected nasal tip
Asymmetrical nasal tip
- A bridge that lacks sufficient cartilage
A bridge that is still too prominent
- An uncorrected bump or irregular shape to the nose
- A nose that does not suit your face
Selecting the right doctor for the procedure
Choosing the best plastic surgeon for your revision rhinoplasty in Toronto can be a daunting task. Dr. Alexander is compassionate towards those that feel apprehension, and he understands that trust is earned gradually based on transparency, integrity and reputation.
Dr. Alexander has completed many prestigious residencies and fellowships, including a facial plastic surgery fellowship at New York University in Manhattan, where he honed the art of rhinoplasty, performing sophisticated, intricate surgeries under the tutelage of the most respected surgeons in the world. Dr. Alexander brings this consummate skill and seasoned technique to his Toronto patients.
As with your initial rhinoplasty, there are two general approaches during revision surgery: the closed rhinoplasty, and the open rhinoplasty. The closed approach consists of incisions made within the nostrils, thus hiding any scarring from view. The open approach favors a single minor incision at the base of the nostrils, which does leave a scar, but Dr. Alexander does his best to minimize this through careful placement.
Tissue grafting is often a major component of revision rhinoplasty. Cartilage from other parts of the body must be harvested and transferred to the nose to compensate for nasal deformities. If a cartilage graft is required, Dr. Alexander will borrow cartilage from the ears or ribs to augment the nasal structure to provide improved form and function. Additionally, the doctor may opt to employ dermal fillers such as Restylane, Juvederm or Radiesse, all of which can be instrumental in addressing asymmetry and other aesthetic imbalances.
The consultation process
Dr. Alexander provides an in-depth, personalized consultation in the privacy and comfort of his Toronto offices during which he will help determine the best course of action regarding your revision rhinoplasty. This involves a careful review of your nose, examination of previous surgeries, and a frank discussion of your needs and wishes. Dr. Alexander will explain the revision process to you, mapping out a clear plan for improvement and success.
To best prepare for the consultation, it’s a good idea to jot down all your questions and concerns in advance. You may also want to collect images from magazines and websites that reflect your ideal nose. These can help Dr. Alexander understand your aesthetic preferences. The doctor may also employ our advanced Vectra 3D imaging software to help you visualize the changes.
Dr. Alexander is passionate about patient education and awareness. For those undergoing rhinoplasty for the second time, this is especially relevant, as the patient may be justifiably cautious after a bad surgical experience. Dr. Alexander does his best to provide you with all the facts, risks, details and surgical information so that you may move forward with confidence and peace of mind. The doctor can also discuss combining treatments, such as revision rhinoplasty and a chin implant or a facelift, for example, which may result in greater cost effectiveness.
The recuperation process
Thanks to Dr. Alexander’s conservative and meticulous approach, his patients generally experience a smooth and speedy recovery. As with primary rhinoplasty, swelling, bruising, soreness and discomfort are to be expected. Dr. Alexander will do his best to ensure you are comfortable throughout the entire process.
Results with revision rhinoplasty take a little longer to settle in since the revision process may involve more tissue grafting or cartilage repair. Manipulating the nasal structure for the second time may cause extra swelling, and this may take time to abate. Rest assured, Dr. Alexander will be there for you every step of the way.
What is ethnic rhinoplasty?
For many years, a traditional Westernized approach to rhinoplasty was the cookie-cutter
approach applied to all noses, even non-Caucasian noses. Today, ethnic rhinoplasty
offers clients a chance to preserve and respect those characteristics that they most cherish
in their appearance, while minimizing flaws, enhancing balance and increasing
attractiveness. Generic, one-nose- fits-all strategies have been replaced with a sensitivity
and attentiveness to the ways in which different cultures perceive beauty.
Dr. Alexander has extensive training and expertise focused exclusively on the face and
the nose; as such, he is deeply attuned to the nuances of ethnic rhinoplasty procedures.
He has worked with patients from a broad array of nationalities, backgrounds and
cultures that span the globe.
Choosing the right surgeon for your Toronto ethnic rhinoplasty
While skill, training and experience are extremely important in selecting the right doctor,
it’s also important to search for someone who is approachable, compassionate and who
truly listens. Dr. Alexander possesses this entire spectrum of winning attributes, earning
him a reputation as among the most sought out surgeons in Toronto. He is meticulously
detailed and laser-focused when it comes to analyzing your nose and constructing a
surgical plan, and takes the time to listen to your questions and concerns, and understand
Dr. Alexander is board certified in facial plastic surgery and has devoted his career to
providing outstanding results for the face. By limiting his focus to this exclusive area of
the body, he has been able to hone his artistry to the highest degree. As ethnic rhinoplasty
requires exacting knowledge of the human anatomy and all its diverse manifestations, Dr.
Alexander is poised to deliver the unique, life-changing outcomes you desire.
African American rhinoplasty
It is not uncommon for African American patients to seek corrective rhinoplasty for a
variety of nasal issues, both aesthetic and functional. Often a wide bridge is the cause for
change, although prominent nostrils and a broad tip may also present obstacles to feeling
and looking one’s best. Dr. Alexander has extensive experience in all aspects of African
American rhinoplasty, from tip-plasty to performing cartilage grafting in order to
augment the profile. Dr. Alexander works to honour the natural features of the nose and
face while improving overall attractiveness.
Middle Eastern rhinoplasty
Toronto rhinoplasty patients of Arab, Persian or Armenian ancestry will find Dr.
Alexander is finely attuned to their unique preferences and needs, delivering nuanced
results that work to diminish flaws while preserving cultural uniqueness. Whether it is a
prominent nasal hump that needs to be reduced, or a drooping tip that needs to be
elevated and refined, Dr. Alexander creates facial harmony, seamlessly providing a more
attractive aesthetic. If you are interested in pursuing Middle Eastern rhinoplasty, please
schedule your confidential consultation at our Toronto office.
Dr. Alexander has assisted many Hispanic patients with achieving their ideal nose,
carefully working to protect each patient’s cultural identity and heritage while reducing
both structural and aesthetic issues. Dr. Alexander is skilled at addressing challenges of
the nasal bridge (both reducing and augmenting), and refining the nasal tip. In the
doctor’s capable hands, all manner of imperfections are improved, along with quality of
Dr. Alexander’s delicate artistic sensibility combined with masterful skill and training
ensure he is ideally qualified to perform Asian rhinoplasty for his Toronto patients. In
general, where other groups may favor nasal hump reduction, many Asian patients
require nasal enhancement to give the nose greater definition and sculpting. Flat, wide or
sunken bridges may be augmented using cartilage grafting, taken from another area of the
body such as the ear or ribs. Another issue facing Asian patients relates to broad nasal
tips and enlarged nostrils. Dr. Alexander can adjust the Asian nose so that it complements
and supports the overall nasal shape, improving the facial aesthetic and increasing self-
confidence in the process. Many patients of Asian background also wish to undergo
facial slimming procedures at the same time that they address issues with their noses.
Details of these procedures can be found HERE.
Liquid rhinoplasty” is an ever-expanding technique, with very impressive results. Using neuromodulators (e.g. BOTOX Cosmetic®) and injectable fillers, Dr. Alexander is able to reshape the nose with immediate results, minimal discomfort and no downtime. Using his mastery of nonsurgical techniques, Dr. Alexander can straighten a crooked nose, augment a flattened bridge, camouflage a dorsal hump or alter the shape and angulation of the nasal tip to provide the most natural, youthful, harmonious appearance to your nose. Unlike many injectors who do not perform rhinoplasty surgery, Dr. Alexander can use his extensive expertise as a nasal surgeon to guide you toward the best nonsurgical options for your nose.
Moving forward with your Toronto rhinoplasty
If you would like to learn more about whether rhinoplasty is right for your aesthetic goals, please contact our office today to set up your initial confidential consultation with Dr. Alexander. During this private session, he will be able to answer all your questions and concerns in detail.
Your consultation will begin with an examination of your nose, a review of your previous surgical procedures, if any, and a survey of your medical history. The doctor will then begin to offer a general outline of his treatment plan to address your nasal issues and imperfections.
You are welcome to bring photographs from magazines or the internet that reflect your ideal nose. In addition, the doctor may also choose to employ our advanced Vectra 3D imaging software to help you better visualize your results.
Benefits of a non-surgical nose job at a glance:
- Minimal downtime
- No incisions
- No pain or discomfort
- Safe, proven and effective
- Cost efficient
- Lower risk than surgery
- No general anesthesia
- Patients can return to work immediately
- Great alternative to revision rhinoplasty
- Reversible results
- Perfect for those unsure about committing to primary rhinoplasty
- Short treatment time
- Can improve self-confidence
Am I a good candidate for non-surgical rhinoplasty?
Clients pursue non-surgical rhinoplasty for a variety of reasons. Many are not ready to commit to the invasiveness and recovery time associated with surgery. Others require minor revisions to a previous nose job. Still others are looking for subtle, natural changes that can be accomplished best with dermal fillers. If you are seeking refinement of the bridge, nostrils or tip, or are looking to address nasal asymmetry, a non-surgical rhinoplasty in Toronto might be right for your needs.
Understanding the procedure
A non-surgical rhinoplasty will last anywhere from 30 minutes to 1 hour, depending on the complexities of the changes required. Topical anesthesia is first applied to eliminate pain and discomfort.
Dr. Alexander works with a variety of dermal fillers, including Voluma and Radiesse to seamlessly improve the nasal shape, reduce sharpness, alter the angle of the tip, achieve better symmetry, and produce more attractive contours. Although no cartilage or bone is manipulated, softening irregularities with filler can actually cause the nose to appear less prominent.
The dermal fillers Dr. Alexander uses are extremely safe. Voluma’s key ingredient is hyaluronic acid, a compound found naturally in the human body. The filler is slowly broken down by the body’s metabolism over time, leaving no by-products or toxins behind. Dermal fillers are completely reversible, and therefore ideal for those who are unsure about permanent nasal surgery.
What happens after treatment?
There is very little downtime with the non-surgical rhinoplasty, and most clients find they can return to their jobs or normal routines immediately. Occasionally clients will experience some bruising, swelling, or redness of the nose. These side effects are normal, and will resolve within a few days.
Dr. Alexander suggests that patients abstain from aerobic exercise and weight lifting for at least 24 hours after the procedure. It is also recommended that you avoid drinking alcohol for the same period of time in order facilitate optimal healing. Sunglasses should not be worn for about two weeks to take pressure off the nasal bridge as it recuperates. Patients should avoid taking any blood thinners such as aspirin, Advil, Motrin or Aleve, for 5 days before and 5 days after treatment. Like any medical procedure, there are risks with injectable rhinoplasty, and Dr. Alexander will review these with you in detail during your consultation.
Results for the non-surgical nose job typically last anywhere from 9 months to two years, depending on the type of dermal fillers used by the doctor. You are encouraged to attend follow up appointments so Dr. Alexander can monitor your results over time. It is easy to repeat the non-surgical rhinoplasty process if touch-ups are required.
How can I learn more?
If you are considering a non-surgical rhinoplasty, do not hesitate to contact Dr. Alexander today to get started. Your initial confidential consultation is a great time for you to ask questions, and have your concerns addressed in detail. The doctor will examine your nose, enquire about previous surgeries, review your medical history, and create your own individualized treatment plan that addresses your concerns.
What is the next step?
Getting started with ethnic rhinoplasty is easy. Simply call and schedule your confidential
consultation with Dr. Alexander in the privacy of his Toronto office. There he will meet
with you to discuss your needs and wishes, collecting your medical information, noting
prior surgeries and treatments, and formulating your customized treatment plan.
The doctor may make use of advanced Vectra 3D imaging in order to provide you with
more accurate expectations for your results.
The consultation is also a good time to ask Dr. Alexander about any additional
procedures which you might be interested in. In some cases, he may recommend facial
implants for the chin or cheeks to complement your nose surgery. He may also suggest
non-surgical treatments such as dermal fillers or injectables, which can help to reverse the
signs of aging. Procedures performed in tandem minimize downtime and discomfort. It
can also be more cost effective to pursue several procedures at once, so don’t hesitate to
speak with the doctor at length about your aesthetic goals.