Rhinoplasty With Dr. Brian Rotenberg: Expert Answers to Your Top Questions

1) How do I pick the right surgeon for my rhinoplasty?

Choosing the right rhinoplasty surgeon is the most important decision in your cosmetic or functional nasal surgery journey. Rhinoplasty is widely recognized as one of the most technically demanding procedures in facial plastic surgery, so selecting a highly qualified specialist directly impacts your final outcome.

Dr Brian with patient

Look for board-certified training with ENT expertise

For optimal safety and results, your surgeon should have board certification and an Otolaryngology (ENT) background. An ENT-trained rhinoplasty surgeon—like Dr. Brian Rotenberg—has advanced knowledge of both nasal aesthetics and the airway. This ensures your nose will not only look balanced and natural but also breathe properly after surgery. Every rhinoplasty, whether cosmetic, functional, or a combination (septorhinoplasty), must address both form and function.

Choose a surgeon who specializes in rhinoplasty—not a generalist

Rhinoplasty requires precision, aesthetic judgment, and a deep understanding of nasal anatomy. Look for a surgeon who performs rhinoplasty regularly and has a high case volume. This ensures they maintain the fine-tuned skills necessary for consistently excellent outcomes. Hospital privileges for rhinoplasty are also an important indicator of peer-reviewed safety and competence.

Evaluate before-and-after photos for alignment with your goals

A surgeon’s portfolio reveals their aesthetic sensibility. When reviewing photos:

  • Look specifically for patients whose “before” nose resembles yours
  • Examine multiple angles—not just the profile
  • Assess the straightness, symmetry, and natural appearance of the results
  • Be cautious of photos with heavy makeup, filters, or strategically dramatic lighting

 

A skilled rhinoplasty surgeon prioritizes structural integrity. If a gallery shows noses that appear overly pinched, scooped, or collapsed, this may signal aggressive techniques that compromise function.

before-after14
before-after27

Evaluate before-and-after photos for alignment with your goals

Your in-person consultation is essential to determine whether you feel comfortable with the surgeon’s communication style and approach. A qualified surgeon will:

  • Listen to your goals
  • Evaluate your nasal airway thoroughly
  • Use tools such as computer imaging/morphing to align expectations
  • Explain what is and is not achievable based on your anatomy

 

Be wary of anyone who promises perfection, downplays recovery, or offers limited-time discounts. Your rhinoplasty should be tailored, thoughtful, and grounded in realism—not sales pressure.

2) Can rhinoplasty improve both breathing and nasal appearance?

Yes. In fact, the best rhinoplasty results seamlessly combine cosmetic refinement with improved nasal function. In Dr. Rotenberg’s practice, the structural and aesthetic aspects of the nose are always addressed together, because the nose must breathe well and look balanced long-term.

Straightening the septum improves airflow and appearance

Many patients seeking cosmetic improvement—such as a straighter bridge or more refined tip—also have a deviated septum. A crooked septum can cause:

  • Nasal obstruction
  • Difficulty breathing through one or both sides
  • External nasal deviation or twisting

 

A septorhinoplasty corrects the deviated septum to restore airflow while using that straightened internal structure as the foundation for a symmetrical, natural-looking result.

Modern rhinoplasty techniques protect and enhance nasal breathing

Reducing a dorsal hump or refining the nasal tip can narrow internal airflow if performed without structural reinforcement. Dr. Rotenberg uses advanced techniques such as spreader grafts to support the internal nasal valves—the narrowest part of the airway. These small cartilage grafts help keep the nostrils open during deep breaths and prevent collapse when inhaling.

This ensures your breathing stays strong even as the outer nose becomes more refined and harmonious with your face.

Patients often experience life-changing functional benefits

Most patients report significant improvements in daily breathing, exercise, and sleep quality after surgery. While they love the cosmetic transformation, many describe enhanced airflow as the most meaningful change.

The goal is always to create a nose that functions as beautifully as it looks.

3) What if I don’t like the results of my rhinoplasty, or think I might need revision rhinoplasty?

Concerns about outcomes are very common, but it’s important to understand the natural healing timeline of rhinoplasty before assuming something is “wrong.”

Early results are not final—swelling takes months to settle

When the cast is removed, the nose is swollen, firm, and sometimes slightly upturned. This is normal. Rhinoplasty swelling can take 12–18 months to fully settle, especially at the tip. At the three-month mark, most dissatisfaction is due to temporary swelling or asymmetry that will even out with time.

If needed, a steroid injection can be performed around three months to help reduce localized swelling.

Revision rhinoplasty is available, but only once healing is complete

At one year, if there is a true structural or cosmetic concern, we can evaluate whether a minor touch-up or revision is appropriate. In many cases, small contour irregularities or asymmetries can be addressed non-surgically with:

  • Steroid injections
  • Dermal fillers for camouflage (non-surgical rhinoplasty)

 

Surgical revision is reserved for issues that meaningfully affect appearance or breathing.

If needed, a steroid injection can be performed around three months to help reduce localized swelling.

Realistic expectations protect long-term results

Because cartilage and skin are living tissues, millimeter-perfect symmetry is impossible—and trying to achieve it through repeated surgery can weaken support, increasing the risk of functional issues. The goal is always meaningful improvement, balance, and harmony—not mathematical perfection.

A long-term partnership with your surgeon

Dr. Rotenberg’s philosophy is that rhinoplasty patients are patients for life. If concerns arise, you will never be dismissed or left without guidance. Together, we can determine the best path forward, whether that involves reassurance, non-surgical adjustment, a small revision, or a second opinion if additional insight would be helpful.