Primary Rhinoplasty

Dr. Toriumi understands that as your rhinoplasty surgeon, it is his mission to improve your facial appearance and nasal function. His many years of training and experience make him one of the top rhinoplasty surgeons in the world.

Because every nose differs, and its anatomy varies from patient to patient, rhinoplasty is one of the most difficult operations in the field of facial plastic surgery. The techniques used in a nasal surgery therefore must vary based on each patient's unique nasal anatomy -- both to fulfill the patient's aesthetic/functional goals and to ensure long-term health while minimizing the need for additional surgery.

Successful rhinoplasties require:

  • Performing a nasal analysis that is both complete and highly precise.

  • Using the nasal analysis to spot all deformities, aesthetic and functional.

  • Creating a surgical plan to correct any identified deformities and provide long-term function

It takes years of experience to accomplish these steps successfully, a process Dr. Toriumi has mastered and continues to refine over more than 30 years of practice with hundreds of satisfied patients. Based on this experience and expertise, Dr. Toriumi is able to manage a wide range of deformities including complex primaries, deviated asymmetric noses, ethnic noses, noses with extreme deficiencies in projection, congenital deformities and patients with severe nasal obstruction.

Some problems - such as a bulbous nasal tip or small dorsal hump -  are less complicated than other more complex conditions. However, even the "simplest" or less complicated nasal surgeries require attention to detail and precision.

Dr. Toriumi knows that rhinoplasty is an extremely difficult operation and does everything possible and spends the necessary time to give you the best outcome. He typically spends 3 to 4 hours to complete a typical primary rhinoplasty (a moderately complex secondary case may take 5 to 6 hours). One of the reasons it takes Dr. Toriumi longer to perform your rhinoplasty is that he anticipates problems that could occur long term based on your anatomy and performs special maneuvers to try to prevent these problems. He also spends a lot of time attending to the nasal airway to ensure good long term nasal function. This is a top priority for Dr. Toriumi whenever he performs a rhinoplasty. Dr. Toriumi does his absolute best to give you the optimal outcome you seek. He intends to make it your last rhinoplasty operation.

Dr. Toriumi follows all patients over many years post-surgery and works to maximize your long-term result. Regular post-surgical follow-up is critical in ensuring a good result and Dr. Toriumi encourages follow-ups for as long as needed, even several years, to ensure long-term aesthetic and structural function, as well as your long-term satisfaction.

He works with you personally both to customize his treatment to your needs and make you aware of treatment milestones.  For example, at one-year post-op, your nose is only about 30% healed with the remainder of the healing occurring over your lifetime, so he and our team work with you to understand what to expect from your recovery post-surgery, including to resist the forces of scar contracture that can occur over time.

To this end, Dr. Toriumi may frequently ask you to do nasal exercises, tape your nose to decrease swelling, and occasionally receive steroid injections. Postoperative care can have a major impact on your long-term outcome and satisfaction.

Secondary Rhinoplasty

A significant portion of Dr. Toriumi's practice is devoted to secondary rhinoplasty (correcting problems from a previous rhinoplasty). Secondary rhinoplasty (or “revision rhinoplasty”) is needed when a primary rhinoplasty does not adequately resolve cosmetic or functional issues, or when specific imbalances arise post-surgery or worsen.  If the nose, for example, is not in balance with other facial features due to problems from previous surgery or unanticipated issues associated with poor healing, secondary rhinoplasty may be indicated. With the typical reductive rhinoplasty techniques, is not unusual for the patient to have an improvement in the appearance of their nose early postoperative and then deform over time. Dr. Toriumi's structure techniques are designed to provide a good long-term outcome. The patient must understand that their nose will look swollen and possibly wider early on, only to improve with time.

For these reasons, secondary rhinoplasty can be more complex than a first surgery.  That is why a surgeon specialized in revision/correction is critical. Successful secondary rhinoplasty surgeons typically have – and should have – experience with more complex issues around structure and function that may have been compromised or incompletely addressed by primary surgery.  For you the patient, your personal treatment, appearance, and structural/functional goals are even more critical to address and fulfill via secondary rhinoplasty, for obvious reasons.

To this end, Dr. Toriumi’s experience and expertise with secondary rhinoplasty are unmatched – as he performs more than 200 such procedures each year.  He believes that every detail of secondary rhinoplasty is more complex than with primary rhinoplasty, and is magnified by the hesitancy many patients express around additional surgery.  The revision rhinoplasty surgeon, then, should be committed to an even higher level of sensitivity to the patient’s concerns and commitment to the patient’s needs, wishes, and desired results.

Over his 30+ years of practice, he has mastered and refined – and continues to refine – his technique.  This has included replacing ear cartilage used in secondary cases with rib (costal) cartilage, for example.  This critical adaptation of technique – detailed in many of Dr. Toriumi’s peer-reviewed papers and other writings – reflected his recognition that the use of ear cartilage, a less complex procedure, sometimes did not produced the long-term results patients demand, with some instances of ear cartilage being pinched, leading to somewhat compromised nasal function.

Rib cartilage, on the other hand, is high-quality and strong, producing resilient and durable grafting material.  Dr. Toriumi adapted and refined a revolutionary technique that allows for very thin costal cartilage grafts that are strong to support long-term function – a technique that requires a smaller initial incision that, combined with reduced dissection, minimizes recovery discomfort and time.

For a majority of secondary rhinoplasty patients, Dr. Toriumi must construct a new supporting nasal structure to provide a proper shape. These major reconstructions are extremely difficult and necessitate an accurate understanding of three-dimensional nasal contours.

When a patient undergoes a secondary rhinoplasty procedure, scar tissue can develop that can complicate subsequent reconstructions. Dr. Toriumi understands that there is a large degree of variability in secondary rhinoplasty deformities. Some patients have problems that are difficult to correct. For this reason, some noses can be effectively corrected while others have a higher risk of problems or persistent deformity that may require an additional surgery (revision).

Dr. Toriumi emphasizes preservation with minimal excision.

Dr. Toriumi’s techniques enhance the preservation of your nasal structures while limiting the need for excision of supporting tissues. He avoids removing too much of the supporting structures because it can result in a pinched, upturned tip with nasal obstruction – an “operated look”.  The use of cartilage grafts -- from the ear or the rib -- is undertaken to increase the strength of the nose. This minimizes undesirable changes that could otherwise occur.

Dr. Toriumi maximizes your nasal function.

Dr. Toriumi believes compromising your nasal function for a better-looking nose is unnecessary. Your nasal function is vital, and he considers it as important as your aesthetic outcome. Without both, no surgery can be considered successful. He will ensure that, after your surgery, you will breathe better and have improved nasal function over the long term. Even if you do not complain of nasal obstruction, Dr. Toriumi will maximize your nasal airway to avoid nasal obstruction as you age.


All photographs shown on this website have been consented for publication by the patient.

Dean Toriumi
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How does a Dr. Toriumi determine if I am a good candidate for surgery?  

If you are in good health, typically you are a good candidate for plastic surgery. Of course, Dr. Dean Toriumi will give you a thorough health evaluation to ensure you are fit to undergo surgery. During your consultation, it’s important that you honestly go over your medical history. Dr. Toriumi also wants you to communicate your expectations, plastic surgery goals, and concerns. He will go over what you can realistically expect and how you can best prepare for surgery. 

What is the difference between facial plastic surgeons performing cosmetic and reconstructive surgery?

Dr. Toriumi, performs a variety of procedures for a variety of reasons. Cosmetic surgery reshapes normal structures of the body to improve appearance and confidence. It’s usually not covered by insurance because it is elective. Reconstructive surgery, on the other hand, is performed because the natural structures of the body are negatively affected by defects, disease, infection, or other reasons. Reconstructive surgery is usually covered by insurance, though the level of your coverage may vary based on your policy. Dr. Toriumi treats both kinds of patients, but the result is always the same: they love the way they look. Toriumi Facial Plastics can help you love the way you look, too. Call now for a consultation and to start on the road to confidence and self-esteem today. 

What is the recovery from facial plastic surgery like?

As with all medical procedures, your recovery from surgery depends on your body and how closely you follow the Dr. Toriumi's instructions. As far as pain is concerned, each patient will handle and tolerate the pain in different ways. But you don’t have to worry about pain levels becoming unbearable. Dr. Toriumi will prescribe the appropriate types and quantities of pain medication so that you can recover both safely and comfortably. Most of our patients report minimal discomfort in the post-op period. 


Why should I trust Dr. Toriumi to be my facial plastic surgeon? 

You won’t find a more qualified or respected plastic surgeon. Dr. Toriumi has more than three decades of experience in facial plastic surgery, is board-certified in Otolaryngology and Facial Plastic and Reconstructive Surgery, and has co-authored more than 125 peer-reviewed papers and books during his career as a facial plastic surgeon. On paper, he is the absolute best plastic surgeon you can get. But Dr. Toriumi and his team go above and beyond what’s expected of them as far as bedside manner and patient care are concerned. They know that your face is the most personal part of who you are. When people think of you, they think of what your face looks like. Your face is a huge part of your identity as an individual. For that reason, Dr. Toriumi takes the utmost care to listen to your needs, wants, and concerns. He listens to what you love—and what you don’t love—about yourself, and then he provides solutions that help you love every part of your face. His world-renowned surgical techniques combined with his unmatched patient care and compassion make him your top choice for facial plastic surgeons. If you’re ready for a change and want the best surgeon in the industry, call now.   


Is facial plastic surgery safe? 

Like any medical procedure, there are risks associated with facial plastic surgery. To reduce your risks, Toriumi Facial Plastics employs highly professional medical staff to give you the best possible outcome. The best way you can prepare for a safe and successful surgery is to follow Dr. Toriumi's instructions. Follow all pre- and post-operative guidelines and be totally transparent about your medical history, physical and emotional well-being, and anything else you think might affect your surgery or your results. One of the ways you can work toward a safe procedure is to take every precaution to prepare your body for surgery and then take care of your body afterward.


What are my payment options with Dr. Toriumi?

Plastic surgery is an investment, and in some cases, your insurance won’t cover it. Here at Toriumi Facial Plastics, we know how your life can be completely changed when you love yourself. For that reason, we do our very best to make sure all of our patients knows their options and what to expect financially when they come to us for care. Our friendly staff will walk you through the payment process so nothing will take you by surprise. Please give our offices a call and we can walk you through your options.


How can my facial plastic surgeon help me minimize swelling and bruising? 

Because facial plastic surgery is just that—surgery—you can expect your body to bruise and swell as it heals. However, there are steps you can take to ensure the healing process is as smooth as possible. Before surgery, you’ll have consultations with your plastic surgeon where he will tell you the best ways to care for your body up to the surgery date. How you prepare your body will greatly affect your recovery, including bruising and swelling. After surgery, you’ll receive more post-op instructions. The most common mistake patients make in the recovery process is rushing along their healing, often because of unreasonable expectations. Your body has just undergone a major operation. It needs time to rest and heal. If you don’t give yourself time, you will increase bruising and swelling and put yourself at risk for hurting yourself even further. 

What does post-operative care look like with Dr. Toriumi? 

Every patient is different, as is post-op care and the healing process. For most of our procedures and patients, you undergo an outpatient procedure and are home the same day. While with us, you will be cared for by a team of expert and compassionate staff. If you are able to go home and have someone there to care for you, Dr. Toriumi will send detailed instructions on how to clean the procedure site and what you need to do to heal best according to your specific situation.