The nose is the most central feature of the face and one of the first ones noticed. When a nose is large, unbalanced, or deviated, the nose becomes the focal point. The goal of rhinoplasty as performed by Dr. Bustillo is to remove the focus from the nose and shift it to the eyes. This is achieved by creating a beautiful and balanced nose that blends with the facial features. Having an aesthetically appealing and elegant nose can significantly improve your overall appearance and confidence.
Dr. Andres Bustillo is one of the best rhinoplasty surgeons in Miami. He is a nose job specialist with extensive experience in working with patients of all different ethnic backgrounds, including Caucasian, African American, Asian, and Hispanic patients. With Dr. Bustillo’s expertise and artistry, even minor tweaks to the nose can result in dramatic cosmetic improvements to the entire face.
Rhinoplasty Before and After Photos
Each patient is unique and individual results may vary*.
What is Rhinoplasty?
Rhinoplasty, also known as a nose job, is a surgical procedure that is performed to permanently change the shape and size of the nose, the refine the nasal tip, straighten a deviated septum, or correct other breathing problems. Aesthetic goals may include reducing the size of the nose, eliminating a nasal hump, narrowing or defining the nasal tip, supporting a droopy nasal tip, or narrowing the width of the nostrils. Rhinoplasty surgery can also repair nasal injuries or congenital abnormalities.
Dr. Bustillo’s personal philosophy regarding rhinoplasty is a fusion of the craft he learned from his mentors and his personal evolution after performing over 4500 nasal surgeries. His philosophy continues to evolve as he serves patients and works to provide the best possible rhinoplasty results.
For the last twenty years, there has been a great debate on whether the rhinoplasty operation should be approached in an open or closed fashion. The open rhinoplasty or external approach involves an incision in the column between the nostrils. The closed rhinoplasty or endonasal approach involves a series of incisions made inside the nose.
A “ski slope” nose from the 1970’s
Before and after rhinoplasty result by Dr. Bustillo
One approach is not universally better than the other. Each is used for different types of noses and surgical goals. Dr. Bustillo believes that some noses may be better served with the closed approach and others better treated with the open approach. He uses either approach, depending on the nose.
Closed rhinoplasty. Note the cartilages being delivered.
Open rhinoplasty columellar incision markings by Dr. Bustillo.
Before and After open rhinoplasty incision by Dr. Bustillo.
Dr. Bustillo is an expert in both structural rhinoplasty and preservation rhinoplasty. Structural rhinoplasty is performed by changing the structure of the nasal skeleton using grafts. This is by far the most common type of rhinoplasty performed. Preservation rhinoplasty is performed by reducing the size of the nose by working underneath and altering the septum to achieve the desired result. Not all noses are candidates for preservation rhinoplasty, but when they are Dr. Bustillo prefers this technique.
The piezo ultrasonic machine is a novel instrument that Dr. Bustillo uses to reduce the bony nasal hump and to narrow the nasal bones. It is very precise and its use limits bruising and swelling after the rhinoplasty procedure. Dr. Bustillo utilizes the piezo so that all of the rhinoplasties he performs are ultrasonic rhinoplasty.
Before and After closed rhinoplasty by Dr. Bustillo
Rhinoplasty Benefits
Nose surgery can have many benefits. Here are just a few of the potential benefits of rhinoplasty:
- Improvement in the size of the nose
- Refined nasal tip
- Correction of weak and droopy tip
- Enhanced harmony between the facial features
- Improved nasal function and breathing
- Increased confidence and self-esteem
Bad rhinoplasty result performed by another surgeon
Before and After thin skin rhinoplasty by Dr. Bustillo. Note excellent tip definition
Rhinoplasty Techniques
There are several different rhinoplasty techniques available today. Some surgeons use a combination of these techniques, depending upon the patient’s needs.
Ultrasonic Rhinoplasty
Dr. Bustillo performs all rhinoplasties using the piezo ultrasonic machine. The piezo is used to reduce the bony portion of the hump instead of using rasps. The advantage is less trauma to the soft tissues which leads to less swelling and bruising. The piezo is also used to cut the bones instead of using osteotomes (chisel and hammer). This also helps to prevent or diminish bruising and swelling.
Preservation Rhinoplasty
Preservation rhinoplasty refers to a series of different techniques with the main goal to preserve the cartilaginous framework of the nose. While Dr. Bustillo has always practiced preservation of the nasal tip cartilages, he now performs dorsal (nasal bridge) preservation in certain cases.
Dorsal preservation involves the reduction of the nasal hump by bringing it down from below instead of removing the cartilage from the top of the hump. Think of reducing the height of the building (the nasal hump) by removing a floor underneath (dorsal preservation) instead of removing the top floor (structural rhinoplasty). The advantage is that the dorsum or bridge of the nose is preserved and not destroyed. This typically results in a very natural and soft-appearing bridge. The other significant advantage is that one of the preservation techniques available (low septal strip) is the technique that can maximally straighten a deviated nose. One downside of the dorsal preservation technique is that there is a small percentage of cases where there can be a small 1 mm residual hump. Luckily, this can usually be managed in a small 15-minute retouch done under local anesthesia. The other downside is that there are some patients that may not be candidates for this procedure.
Questions about your procedure?
Schedule a consultation with Dr. Andres Bustillo.
Rhinoplasty Consultation
The decision to undergo a rhinoplasty operation is a very important and personal one. You should consult with your surgeon and family before scheduling any surgical cosmetic procedure. For most patients, the results are life-changing. Many of our rhinoplasty patients wonder why they waited so long.
The ideal candidate for rhinoplasty surgery is a healthy person who is dissatisfied with the appearance of their nose or nasal tip, has a deviated septum, or significant breathing problems and would like to have these issues improved.
Realistic expectations are very important. Although modern rhinoplasty techniques produce better results than ever, there are still limitations. Surgery can never achieve perfection.
The consultation process begins with a discussion about the patient’s specific issues and concerns regarding the appearance of the nose, a deviated septum, or functional breathing problems. The medical history is discussed to make sure the patient can undergo surgery.
A thorough physical exam is then performed. Dr. Bustillo will examine the external nose, nasal cavities, and the septum. Common aesthetic issues issues he looks for are a nasal hump, a bulbous nasal tip, a droopy and weak nasal tip, a deviated septum, and enlarged turbinates causing nasal obstruction. Pictures of the nose are then taken and computer imaging projections are created to get a better understanding of your aesthetic goals and help set your expectations.
Preparation for Rhinoplasty
Patients undergoing cosmetic nasal surgery are required to obtain pre-operative labs before surgery. If the candidate is over the age of forty-five or has certain medical conditions, Dr. Bustillo will request a medical clearance before the rhinoplasty.
Patients should stop taking any products that affect blood clotting at least 10 days before the procedure. These include aspirin, ibuprofen, and naproxen, plus supplements such as vitamin A, Ginkgo Biloba, and St. John’s wort.
Before and After thick skin rhinoplasty by Dr. Bustillo. Note good tip definition
Alcohol should also be avoided for five days before surgery to decrease bleeding and swelling. Patients are required to start taking 2000 mg of vitamin C a day, starting one week before the surgery and then for two weeks after the rhinoplasty. This helps to reduce bleeding during the surgery and swelling after the surgery.
Wide and bulbous tip by Dr. Bustillo.
Overprojected tip
Droopy tip with poor tip support
Left: Nasal hump and droopy tip (Pre-operative).
Center: Rhinoplasty computer morphing.
Right: Rhinoplasty result by Dr. Bustillo. Note similarity to computer image
Left: Bulbous nasal tip (Pre-operative)
Right: Rhinoplasty result by Dr. Bustillo. Note enhanced tip definition
How is Rhinoplasty Surgery Performed
Dr. Bustillo performs rhinoplasty surgery as an outpatient procedure at his certified surgical facility. Anesthesia is provided by board-certified anesthesiologists (MD), who are part of the Baptist Hospital Anesthesiology Department. Rhinoplasty surgery is performed with general anesthesia to help protect the airway during surgery.
Using the latest techniques employed by modern rhinoplasty surgeons, Dr. Bustillo will then reshape the nose according to the patient’s specific needs and goals. This could include using the open or closed rhinoplasty approach, either using structural rhinoplasty techniques or preservation rhinoplasty techniques. Dr. Bustillo utilizes the piezo ultrasonic machine in all rhinoplasty surgeries. The rhinoplasty procedure usually takes between two to three hours.
Recovery from Rhinoplasty
After your surgery, you should keep the head elevated using two pillows and place a small bag with frozen peas over the eyes for ten minutes of every hour spent awake for the first two days to help reduce swelling around the nose and eyes. Maintain a liquid diet for the first twelve hours after anesthesia.
There is a variable amount of swelling that occurs in the nose after the rhinoplasty operation. Most of the swelling resolves in the first four weeks. It is recommended that strenuous physical activity, such as running or lifting, be resumed only after the fourth week. The remainder of the swelling can take from four to twelve months to completely resolve.
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Rhinoplasty Patient
Since I was in my early teenage years, I always wanted to change the shape of my nose. I never thought my nose was horrible nor was my self-esteem affected, but I always thought that it could be better. I finally had the courage to bring to my family. They were very supportive and mentioned that I could do it when I turned seventeen. About a year ago, I began to do my research to find a surgeon that would do my surgery. I searched and read about different surgeons. Dr. Bustillo’s name would always come up when I asked others whom they would recommend for rhinoplasty, so I decided to consult with him.
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Rhinoplasty FAQs
The cost of nasal cosmetic surgery varies depending on your unique needs. Our office will give you an approximate fee schedule when you contact our office. An exact quote will be given once you have consulted with Dr. Bustillo.
The nose must be finished growing before rhinoplasty can be performed. Dr. Bustillo performs rhinoplasty for female patients ranging from age fifteen and over and male patients from sixteen and over.
The average rhinoplasty procedure performed by a board-certified plastic surgeon takes between two and three hours. However, you should also factor in time for pre-operative preparation and post-operative recovery time.
The postoperative period after rhinoplasty is typically not painful. Tylenol is usually enough to control any minor discomfort.
There will be some swelling after rhinoplasty. Because Dr. Bustillo performs ultrasonic rhinoplasty, most of his patients bruise a very small amount. Most patients can return to school or work about six days after the rhinoplasty.
Most patients notice an improvement in nasal appearance and function right when the cast comes off in the immediate postoperative period. There will be some swelling, but you should see about 70% of the swelling go down within about four weeks after surgery. It will take several months to see the final results of the surgery.
Rhinoplasty is not typically covered by insurance. However, you may want to check with your insurance company, as some will cover facial plastic and reconstructive surgery procedures when they are medically necessary.
About Dr. Andres Bustillo
Dr. Andres Bustillo performs over 300 nasal surgeries a year, making him one of the most experienced nasal surgeons in South Florida. In addition to creating a beautiful nose, he is also an expert in nasal function.
Dr. Bustillo has been practicing facial plastic surgery for over 17 years. He is one of the nation’s few double board-certified facial plastic surgeons, and he does not perform any breast or body surgery. Approximately 50% of his practice is devoted to rhinoplasty and revision rhinoplasty.
Dr. Bustillo is well known for providing the most natural and conservative rhinoplasty results. He delivers a look that fits and blends harmoniously with the patient’s other facial features. Dr. Bustillo has extensive experience with different types of noses and ethnic rhinoplasty.
Andres Bustillo teaches students, residents, and other physicians the art and science of rhinoplasty. He has been invited to Asia, South America, and the Caribbean where he has taught other plastic surgeons his rhinoplasty techniques. He has also written and published several chapters on nose surgery.
He holds the following credentials:
- Best Doctor’s 2020-2021
- Castle Connolly Top Doctor for more than 10 years
- Diplomate American Board of Facial Plastic and Reconstructive Surgery
- Diplomate American Board of Otolaryngology-Head and Neck Surgery
- Facial Plastic & Reconstructive Surgery Fellowship at The New York University
- Otolaryngology-Head & Neck Surgery Residency at The University of Miami, Jackson Memorial Hospital
- General Surgery Internship at The University of Miami, Jackson Memorial Hospital
