Structure first. Aesthetics follow.
Dr. Kim sees Rochester-area rhinoplasty patients at the historic Oliver Culver House on East Boulevard. His dual board certification in otolaryngology and facial plastic surgery means the nasal airway and the nasal appearance are evaluated together, at the same consultation.
The nose is divided into thirds by the anatomy of its framework. The upper third is bony: the paired nasal bones sit atop the maxilla and create the ridge of the nose. The middle third is cartilaginous: the upper lateral cartilages support the middle vault and, together with the nasal septum, form the internal nasal valve — the narrowest point of the airway in most people. The lower third is defined by the lower lateral cartilages, which form the tip and the alar rims, giving the nose its final shape.
Rhinoplasty works on this framework directly. A dorsal hump is addressed at the bony and cartilaginous junction. A wide or bulbous tip reflects the size, shape and spacing of the lower lateral cartilages. Nasal valve collapse — which causes breathing obstruction — reflects inadequate support at the internal or external valve, a structural problem with a structural solution.
For the full range of rhinoplasty techniques, including preservation rhinoplasty, structural rhinoplasty and revision approaches, see our full rhinoplasty overview. The Rochester consultation establishes which approach the anatomy warrants.
The most common source of disappointment in rhinoplasty is an expectation the procedure cannot meet. The consultation is where those limits are named.
Structural changes to the bony and cartilaginous framework are durable and real: reduction of a dorsal hump; refinement of a tip that is wide, asymmetric or under-projected; improvement of a drooping or over-projected tip; correction of a deviated dorsum; repair of nasal valve collapse that narrows the airway. A combined functional and cosmetic approach addresses breathing and appearance in the same session.
Patients coming from Rochester, Buffalo, the Finger Lakes and Canandaigua frequently raise questions about revision after a prior rhinoplasty. The consultation for revision is longer, the anatomy more complex, and the expectations must be calibrated accordingly — but the assessment begins in Rochester just as a primary consultation does.
Skin thickness is determined by genetics and is not changed by rhinoplasty. The skin drapes over whatever framework is created beneath it; in a patient with thick, sebaceous skin, even a well-executed tip refinement will be less visible than in a patient with thin skin, because the overlying tissue does not adapt as closely. This is discussed explicitly at the consultation, and the plan is calibrated to what is realistic for that patient's skin.
Asymmetry that exists before surgery is likely to persist in some form after it, because the healing process introduces its own variation. Perfect symmetry is not an achievable surgical goal. The aim is a nose that is balanced, proportionate and functional, not identical on both sides to the millimeter.
The approach — open or closed — is determined by what the anatomy requires, not by a single preferred technique.
In a closed rhinoplasty, all incisions are placed inside the nostrils; no external scar results. In an open rhinoplasty, a small incision is added across the columella, the tissue between the nostrils, allowing the tip skin to be elevated and the lower lateral cartilages to be visualized directly. The open approach offers better visualization for complex tip work and for revision cases; the closed approach limits scarring and operating time when the anatomy allows.
Regardless of approach, the operative steps follow the anatomy from upper to lower: the dorsum is addressed first if a hump is present, then the middle vault, then the tip. When functional work is needed — septal straightening, valve repair — it is integrated into the same operative session. The nose is splinted at the end of surgery; the splint comes off at the first post-operative visit, approximately seven to ten days later.
Surgery takes place at the practice's accredited office-based suite in Syracuse, not at a hospital. Patients check in the morning of surgery and are discharged the same day. The first follow-up visit is the morning after surgery.
Rhinoplasty recovery is measured in weeks for the acute phase and in months for the final result. Both timelines are real and should be planned for.
Head elevated, minimal activity, cold compresses around the eyes and cheeks rather than on the nose itself. The splint and any internal packing are in place. Congestion is expected. Swelling and bruising around the eyes develop in the first day. A responsible adult must be present.
Bruising peaks around days two to four and begins to fade. Breathing through the nose is restricted until the splint comes off. No glasses on the nose during this period; contacts are the alternative. No blowing the nose. Sleep with the head elevated. Gentle face washing around the splint. No strenuous activity.
The splint is removed at the post-operative visit. Most of the initial swelling is present at this point; the result seen immediately after splint removal is not the final result. Bruising is usually resolving. Many patients feel comfortable going out in public shortly after this visit, though significant swelling remains.
Bruising resolves completely in most patients by the end of week two. Tip swelling is the dominant remaining finding. Return to light aerobic activity typically begins around three to four weeks. Avoid contact sports for six weeks or longer. Sun protection on any exposed scars during the first year.
The tip continues to refine over this period. In patients with thicker skin, the full result may not be apparent until twelve to eighteen months. Interim photographs at three and six months track the progression. The published literature consistently describes nasal tip healing as the longest phase of rhinoplasty recovery.
Any sudden increase in swelling on one side, significant one-sided pain, fever, or spreading redness around the incision sites after the first week warrants a call. The office number is 315-471-8404; an on-call physician covers after hours for surgery-related concerns.
Questions about the Rochester consultation, travel logistics, and what the procedure can and cannot achieve.
Yes. Rhinoplasty consultations and long-term follow-up take place at the Rochester office on East Boulevard. The consultation includes a hands-on anatomic evaluation, photographic analysis and a discussion of what the individual nasal framework can and cannot realistically achieve. Surgery is performed at the practice's AAAHC-accredited office-based suite in Syracuse.
The drive from Rochester to the Syracuse surgical suite is roughly ninety minutes. Pre-operative appointments are scheduled in Rochester so that patients make that drive only once, on the day of surgery. We advise on lodging near the practice for patients staying overnight before returning home.
Yes. The Rochester office is about seventy-five minutes from Buffalo and ninety minutes from the Finger Lakes region. Many patients traveling from the western part of upstate New York find the Rochester location more practical than driving directly to Syracuse. The consultation typically runs sixty to ninety minutes.
Rhinoplasty corrects structural problems of the nasal framework: the bony upper third, the cartilaginous middle third including the upper lateral cartilages, and the tip anatomy formed by the lower lateral cartilages. It can reduce a dorsal hump, refine a bulbous or asymmetric tip, improve a drooping columella, and address nasal valve collapse that causes breathing obstruction.
Skin thickness is not changed by rhinoplasty, only the framework beneath it. A patient with thick nasal skin who wants a very refined, narrow tip needs to understand that the skin will drape over a reshaped framework but not become thinner. Results in thick-skinned patients are real but less dramatic than in patients with thinner skin. This is discussed at the consultation.
Not necessarily. Rhinoplasty can be performed under local anesthesia with IV sedation, which is how it is done at this practice, at the AAAHC-accredited office-based suite in Syracuse. This avoids the risks of intubation and general anesthesia and shortens the recovery from the operative day itself.
The nasal splint is removed at about seven to ten days, and much of the bruising resolves in the second week. Tip swelling, however, is the slowest part: the tip continues to refine over twelve months, and in patients with thicker skin, the final shape may not be fully apparent until eighteen months. This is not a complication; it is the known biology of nasal healing.
The most discussed risk is revision: published revision rates range from approximately 5% to 15% across large series, reflecting how demanding the operation is technically and how carefully the original plan must account for what healing will produce. Other risks include asymmetry, breathing changes, prolonged swelling, infection, scarring at the columella incision and a result that settles differently than planned.
In most patients, the columella incision, placed in the natural step of the tissue between the nostrils, heals to a fine line that is not visible in normal social interaction. The scar is visible on close inspection for the first several months and fades over the following year. In patients who form hypertrophic scars elsewhere, additional management may be needed.
Yes, when the cause of obstruction is structural. Nasal valve collapse, septal deviation and turbinate hypertrophy are the most common structural causes. A surgeon board-certified in otolaryngology is trained specifically in the anatomy and physiology of nasal airflow; the consultation includes a systematic evaluation of the airway alongside the cosmetic assessment.
We ask patients to remain accessible to the practice for at least the first week, which includes the splint removal visit. Most patients from Rochester plan to stay near Syracuse for five to seven days before returning home. Follow-up appointments after that point are coordinated at the Rochester office.
Rhinoplasty is commonly combined with septoplasty for functional correction and with chin implant placement to improve facial proportion. Combination with a facelift is also done when the anatomy and the patient's goals warrant it. The consultation determines what is appropriate for the individual and what can be accomplished safely in a single session.
The Rochester office at 70 East Boulevard serves patients from Rochester, Buffalo, the Finger Lakes and across western upstate New York. See our Rochester office page for directions and what to expect at the visit, or explore our Syracuse surgical home.
4939 Brittonfield Pkwy, Bldg B, Ste 208
East Syracuse, NY 13057
Surgery and main office
347 E 53rd St, Suite Lobby A
New York, NY 10022
Consultations and follow-up
"Dr. Kim is absolutely wonderful. His attention to detail and understanding of what I was looking for with my rhinoplasty made the whole process much less daunting. The results are natural and exactly what I hoped for."
"Dr. Kim took the time to explain everything clearly and made me feel confident going into my procedure. The result is exactly what I wanted. I couldn't be happier with my decision to come to Natural Face Clinic."
"From the first consultation through my recovery, the level of care was consistent and thorough. Dr. Kim answered every question and I always felt like a priority. My breathing is better and so is how I look."