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Frequently Asked Questions

Deepak raj Dugar, md

Plastic Surgeon located in Beverly Hills, CA

A lot of surgeons are comfortable with using scarring procedures when it comes to performing Rhinoplasty, but Dr. Dugar goes above and beyond for his patients. At Beverly Hills Rhinoplasty Center™ located in Los Angeles, CA, Dr. Dugar offers closedor scarlessRhinoplasty for his patients.

Most surgeons are more comfortable with the “open” rhinoplasty approach that inflicts a scar at the base of the nose. This could become a motivating factor for them to convert you to an “open” rhinoplasty because it is easier for them to personally perform. But that may not necessarily be in your best interest. Always ask if it can be done scarless.

This may sound irrelevant but it is extremely relevant when you understand the depths and difficulty of scarless rhinoplasty. The average surgeons who perform breast surgery, facelifts, liposuction, noses, and eyelid surgery take much longer to achieve mastery because their concentration and dedication are being split amongst too many endeavors and, in effect, end up spreading themselves thin. They may be very good at one thing or another, but if they claim to be amazing at them all, which just quite frankly, can’t be true, how do you trust what they are actually good at? When surgeons focus 100% of their energy in a single craft, it allows them to grow within the craft to expert levels far faster than their peers ever can. Mastery is not developed by dabblers. To become a Master of One, you must dedicate yourself wholeheartedly to the craft. Always ask if Scarless Rhinoplasty is 100% of their surgical practice.

Most surgeons are trained classically to be scientist surgeons. This means they think mathematically and look at the nose like an engineering project. They use classical formulas and angles to construct the “perfect nose” on every patient. But this leads to repetitive workshop results with every patient getting the same surgery. We agree there is a mechanical component to scarless rhinoplasty, especially with open or reconstructive rhinoplasty, but for a primary nose (that has never been operated on before) it is much more of an art than a science. Artistry is mandatory to perform this type of finesse surgery because when the math doesn’t add up, the surgeon’s eye remains most important. In an operation of micro-millimeters, 1 millimeter can make or break the surgical outcome. Always ask yourself if the surgeon’s artistic vision is in alignment with your own.

This is extremely important. Scarless Rhinoplasty is a surgery of patience. Ask any rhinoplasty surgeon and they will tell you their patience has never been tested like it has been during a difficult nose. Sometimes a difficult nose will require an extra hour or two of a surgeon’s time because of repeat stitching, or repeat maneuvering, or repeat shaving. The key is patience. If your surgeon seems rushed or forceful during your consult, imagine what the surgery itself might feel like when you aren’t even awake for them to answer to. You want to know you are with a surgeon who doesn’t rush and will take the extra time needed especially in the operating room to deliver the optimal outcome for you. Always ask if your consultation felt rushed or forced.

As an Otolaryngology-Ear Nose and Throat trained Plastic Surgeon, Dr. Dugar specializes in internal nasal surgery of the septum, turbinates, and nasal valves. Your breathing from the nose will be assessed right from the beginning of the consultation and if there is an anatomical problem (such as a Deviated Septum, Inferior Turbinate Hypertrophy, or Nasal Valve Collapse), it will be discussed and can be addressed independently as a Scarless Functional Surgery or in conjunction with a Cosmetic nasal surgery at the same time. As always, all of the nasal breathing surgery as well as cosmetic nasal surgery, is done via scarless (closed) approaches only. Always ask about your nasal breathing.

When contemplating surgery to change the shape of your nose, it is extremely important to be able to visualize the changes that will impact the future of your face for the rest of your life. While facial morphing software and image design are important, the most important analysis is studying before and after photos of the surgeon’s work in person in the office. This will show you true realistic results based on real people who underwent the same journey as you are considering. Morphed images of your own nose, while fun and exciting, are ironically less important because technology allows us to morph almost any result, even if it is not surgically realistic. So be dubious of the morphing software and put more trust in real results from before and after images, you can see in the office. Always ask to see before and after images in the office.

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The Five Things I Hate

About Rhinoplasty

1. Unnecessary external cuts and scars (99% of surgeons perform “open” rhinoplasty inflicting a scar at the base of the nose)
2. Pinched Nasal Tip (when too much cartilage is removed and/or no support is provided causing a collapse of the tip)
3. “Ski Slope” Profile (when too much cartilage and bone is removed from the profile causing a severe scooping of the nose)
4. “Miss Piggy” Nose (when the tip is lifted too much)
5. Worsened or Unimproved Breathing (when nasal breathing and structural function of the septum, turbinates and nasal vales are not adequately addressed)

These five things are constantly in my mind during every consultation and every surgery. This is where being the only surgeon in the USA whose entire surgical practice is dedicated to Scarless Rhinoplasty allows a superior advantage of finding the perfect delicate balance of meaningful refinement to a nose without drastic uncomfortable change. Natural noses are mandatory in my practice.