Information About Rhinoplasty From Top New Jersey Surgeon Dr. Laurence Milgrim

Perfect noses don’t come off-the-rack. And one size doesn’t fit all.

The goal is to give the patient the most beautiful, natural-looking nose for her face and not anyone else’s, says board-certified facial plastic surgeon Dr. Laurence Milgrim of Northern Jersey Facial Plastic Center.

“The greatest long-term patient satisfaction following a rhinoplasty procedure is when patients feel that their nose is not the focus of their face,” he says. “Most want it to look as if nothing has been done, what we call ‘a natural nose.’”

In 2012, nose reshaping was the second most popular cosmetic procedure - behind breast augmentation, according to the American Society of Plastic Surgeons. It’s a surgery that can greatly improve the proportion, appearance and even function of the nose, leading to increased self-esteem and better breathing.

With all of the recent advances surgical procedures, there is no reason a person should go through life unhappy with her nose, Dr. Milgrim says.

Below, he answers some of the most common questions about rhinoplasty.

Q. What makes a good nose?

A. In American popular culture, a natural nose typically follows the European facial model: high cheekbones, a bold chin and a nose that stands away from the face. The look is what most facial plastic surgeons are asked to create. However, long-term patient satisfaction suggests that the ideal nose for any given person, regardless of her heritage, should be natural-looking. So conforming to ethnic norms might actually be more successful than changing the nose to fit an unrealistic ideal.

Q. Who is a good candidate for a nose job?

A. Anyone who is unhappy with their nose. If the appearance of the nose lowers the patient’s self-esteem and makes them feel self-conscious, they are a candidate for rhinoplasty. The procedure is simple – and when done properly – almost painless. The results are completely unnoticeable. I will tell you that I have never had a nose that I couldn’t operate on in my 20 years.

Q. What are the most common reasons someone has a nose job? Is it pure vanity?

A. I usually see patients who have a hooked nose, a bump on their nose - caused by a poorly-set broken nose - or a nose that doesn’t look right because of heredity. Most people have rhinoplasty when they’re in their late teens or early 20s, but I operate on men and women who are much older than that.

Q. I understand you use a “closed approach.” What is that exactly?

A. Closed approach refers to procedures in which all the surgery is performed within the nose, leaving no visible incisions or scarring. The main advantage is that the results are seen almost immediately – even during the surgery. This method can be more complex than an open approach procedure, where the incision is made on the outside of the nose, leaving a scar. But the results are impressive and natural-looking. I estimate that a closed approach can be performed in 90 percent of all cases.

Q. How much discomfort does the procedure cause?

A. Most people are black and blue for a week. I have not had anyone who has not been able to smell. In terms of discomfort, it’s really not that painful. Most people come out feeling like they have a bad cold. Some people swell a lot, but the swelling goes away within 10 days. So the idea that you are going to be holed up in your house for a month - I think are extreme cases, and I have never seen that in my 20 years.

Q. Plastic surgery used to be something that was only for the wealthy. How much does this cost?

A. The average price in New Jersey is between $7,000 and $10,000. If you’re in Beverly Hills and New York, they tend to be more expensive. We have payment plans, so you can pay it off like a credit card if you want. That opens it up to a lot of people who want to have it done but aren’t like the people in Beverly Hills who can pay the whole thing in cash.

Q. What’s the key to performing a successful rhinoplasty?

A. We have to understand that each patient has her own set of “personal guidelines.” Results in the past tended to be unnatural-looking, cookie cutter nose jobs that were visible to even an untrained eye. That’s because we tried to go by the textbook – the distance between the eyes, the distance between the eyes and nose, instead of what is beautiful. It looked great in a textbook, but a lot of times it didn’t look so beautiful on a person’s face. The look of what is natural and symmetric varies from person to person. The real secret of any natural nose is that it fits the person’s face and enhances her beauty.

 Q. What should someone look for in a plastic surgeon?

A. Definitely do your research. Look for someone who is board-certified, which means he or she has gone through residency programs and rigorous training and has passed a number of tests to become a specialist in a particular field. Ask if you can see before and after pictures to get a feel of what type of nose your surgeon will create. And last of all, like him or her! He is going to be your "best friend" for a while so it is always good if you can connect. 

Northern Jersey Facial Plastic Center has locations in Teaneck and Midland Park, N.J. For more information, visit http://www.milgrimplasticsurgery.com/ or call 201-530-5956. All consultations are complimentary.

Physician Bio

After graduation from Johns Hopkins University, Dr. Milgrim attended medical school at UMDNJ-Rutgers University. He completed his Internship and Residency training in Otolaryngology-Head and Neck Surgery at the Albert Einstein/Montefiore Medical Center in New York. Dr. Milgrim was  awarded a Fellowship in Facial Plastic and Reconstructive Surgery at Mount Sinai Medical Center. He was then honored by Frank Kamer, MD with an Externship in Facial Plastic and Reconstructive Surgery at the famed Laskey Clinic in Beverly Hills, California.  Dr. Milgrim was trained by preeminent New York nasal surgeons William Lawson and Sidney Feuerstein, disciples of Irving Goldman, who in his day, was considered one of the most highly sought after nasal surgeons in New York.