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Rhinoplasty & Preservation Rhinoplasty in Atlanta

Important factors in facial aesthetics include symmetry and harmony between the facial features.  For some men and women, an overly large, long, crooked, or ball-like nose may detract from their appearance and affect self-confidence.  For this reason, rhinoplasty (or nose surgery) has been and remains among the most popular procedures to which patients turn to enhance their appearance.  Rhinoplasty typically lands in the top 5 most popular plastic surgery procedures year after year, and on average, 220,000 Americans undergo rhinoplasty annually.

At Aviva Plastic Surgery, we believe that looking beautiful can be done without compromising the features that make you unique.  A facial plastic surgery specialist, Dr. Fishman is among the few plastic surgeons in the United States to offer both traditional and “preservation” rhinoplasty – a modern approach to the ever-popular nose job that offers less invasive surgery, faster recovery, and more natural-looking results. Learn how either the traditional nose job or preservation rhinoplasty can help you feel more confident. Call 678-974-8435 today and schedule your consultation with Dr. Fishman.

What Is Preservation Rhinoplasty?

Like traditional rhinoplasty, preservation nose surgery is a highly personalized treatment designed to improve the overall shape and size of the nose while ultimately improving overall facial aesthetics. However, the methodology and technique behind traditional and preservation rhinoplasty differ.

Traditional Rhinoplasty

Traditional rhinoplasty relies on reducing undesirable volume of the nose by removing excess cartilage and/ or bone.  Excess cartilage is typically resected with scissors or a scalpel, while excess bone is typically “filed down” with rasps.  These reductive techniques can disrupt critical connections between the structures of the nose, leading to less support and even some degree of nose collapse over time.  While it is a very effective solution to reshaping the nose, traditional rhinoplasty can have complications—such as prolonged swelling and undesirable scarring—which can adversely affect the shape of the nose.

Preservation Rhinoplasty

Preservation rhinoplasty, on the other hand, offers patients a less invasive approach to nose jobs. Popular in the middle East and many European countries, preservation rhinoplasty relies on reshaping tissues more than removing them.  Rather than filing down the dorsal hump like during traditional rhinoplasty, this conservative approach uses incisions into the nasal bone to lower the entire bridge as a single unit.  During preservation rhinoplasty, our facial plastic surgeon, Dr. Inessa Fishman, selectively removes a thin strip of bone and cartilage from under the bridge of the nose, thus keeping intact important connections between the structures of the nose.  The dissection techniques used in preservation rhinoplasty are also unique, aiming to preserve the ligament structures of the nose—specifically Pitanguy’s ligament, important for nasal tip support—and the natural planes between the underlying structures and soft tissues of the nose.  In practicing preservation rhinoplasty techniques, Dr. Fishman preserves more of the cartilage and bone, leading to less swelling and a more natural-appearing nose contour.   


Because preservation rhinoplasty minimizes the need for nasal filing and minimizes swelling, the procedure is considerably more difficult than traditional rhinoplasty. In the United States, only a select few surgeons are trained to offer the procedure. Atlanta surgeon Dr. Fishman is among these select experts.



Benefits of Preservation Rhinoplasty

Preservation rhinoplasty has some significant benefits that help hesitant patients feel more comfortable with the rhinoplasty. These include:

While rhinoplasty is consistently among the top requested plastic surgeries, its recovery can last up to two weeks, with swelling taking many months to resolve completely. Because preservation rhinoplasty preserves the patient’s original nasal anatomy, it reduces how much swelling or bruising patients experience during recovery and thus shortens the recovery process.  Preservation rhinoplasty is typically associated with less bruising and swelling than traditional rhinoplasty (see patient shown before and immediately after preservation rhinoplasty below).

Preservation rhinoplasty techniques help Dr. Fishman preserve the natural support structures of the nose, which are important both for nose aesthetics and function, specifically breathing.  Nasal preservation techniques can even enhance airflow by widening the internal air passage.

Preserving the nasal bridge can yield more natural-looking results with greater longevity. When too much tissue is removed, the nose can become structurally unsound and lose its support over time. Aesthetically, this can leave patients with an “operated” and unnatural appearance post-surgery, including a poorly supported nasal bridge and potentially misshapen tip. Medically, changes in the shape of nasal passages required by more invasive surgery put airflow passages at risk. In contrast, preservation rhinoplasty removes excess tissue from the base of the nasal bridge, lowering the entire bridge as a single piece, thus allowing the nose to retain its structural integrity.

Preservation rhinoplasty Atlanta

Candidates for Preservation Nose Jobs

For the best results, preservation rhinoplasty is recommended for the following individuals:

  • First-time rhinoplasty patients
  • Patients with dorsal humps
  • Patients with crooked noses
  • Patients without a history of septal trauma

While preservation rhinoplasty can be an excellent option for some individuals, not all patients may enjoy the same results.

Benefits of Traditional Rhinoplasty

Rhinoplasty finds it place in the top five plastic surgery procedures year after year for good reason. When carried out by a qualified surgeon with facial plastic surgery expertise, rhinoplasty can treat multiple structural and aesthetic concerns. With traditional rhinoplasty, Dr. Fishman can:

  • reduce the overall size of the nose
  • address breathing problems
  • improve the angle between the nose and your upper lip
  • remove bumps and bends within the nose
  • straighten a crooked nose
  • narrow flaring nostrils 
  • narrow the “bulb” of “ball-like” appearance of the tip of the nose
  • change the shape of the nose bridge

Like traditional rhinoplasty, preservation rhinoplasty can rectify these challenges as well. Whether you choose traditional or preservation rhinoplasty will depend on what you want to achieve as well as the physiology and structure of your nose and skin. Dr. Fishman will guide you in your treatment options as part of your consultation. 

Best Candidates for Traditional Rhinoplasty

Patients with:

  • large noses looking to significantly reduce the nose size 
  • problems related to a previous rhinoplasty
  • significant septal deviation or septal scarring

Ethnic Rhinoplasty: Both Traditional Rhinoplasty & Preservation Rhinoplasty Can Align with Your Heritage

While rhinoplasty has long been a popular procedure for decades, the treatment has at times drawn criticism for erasing ethnic features in favor of more Caucasian features.  In recent years, ethnic rhinoplasty has become a popular approach to creating personalized, natural-looking results that are inclusive of diverse patient backgrounds.  Dr. Fishman uses both traditional and preservation rhinoplasty techniques to get best results in ethnic rhinoplasty.

Ethnic rhinoplasty is tailored to help patients retain and even emphasize their ethnic heritage while adding symmetry and harmony to their appearance.  Correctly performing this procedure involves not only in-depth anatomical knowledge of the nose, but also an understanding and appreciation for different standards of beauty found across different cultures and ethnicities.

Dr. Fishman brings unique experience and international training to the rhinoplasty treatment development process.  She has traveled across the globe to train with renowned rhinoplasty surgeons, attend specialized surgical conferences, and learn about the different standards of beauty unique to different parts of the world.  Dr. Fishman’s aesthetic sense and training offer unparalleled ethnic rhinoplasty expertise to her patients.

To learn more about traditional and preservation rhinoplasty, call and schedule your consultation with Dr. Fishman today!