Expert Doctor

Total Nose Approach

Nathan Nachlas, MD

Boca Raton, FL

Total Nose Approach

People get rhinoplasties—or “nose jobs”—for a whole host of reasons. Though many prospective patients are looking to improve the appearance of their noses, many others are looking to increase functionality. Those patients may be looking for more than just rhinoplasty—what they might need is the Total Nose Approach.



Though rhinoplasty is considered to be the first plastic surgery treatment ever (dating all the way back to Ancient Egypt!), sinus surgery is much more modern. Prior to the development of the endoscope, sinus surgery was considered to be very aggressive and invasive, so unless the patient had a drastically decreased quality of life due to their sinuses, the procedure was often considered not to be worth the risk, and was reserved for only the sickest patients with sinus disease.

In the mid- to late-1980’s, physicians began to utilize the endoscope in sinus surgeries, transforming sinus surgery from an ultra-invasive, risky procedure into a minimally invasive natural addition to standard rhinoplasty surgery. The “total nose approach” is a combination of rhinoplasty and sinus surgery, and it works to improve both the aesthetics and functionality of the patient’s nose.



There are no risks unique to combining rhinoplasty and sinus surgery. Of course, the general risks of surgery that patients should be aware of include anesthesia, bleeding, and infection. One of the biggest risks with rhinoplasty is dissatisfaction with the end result. For sinus surgery, the biggest risk tends to be a continuation of the sinus issues that plagues the patient prior to surgery.



Following the total nose approach, patients are typically able to return to work or school within five or six days. They will experience bruising and facial swelling, which generally heal within a couple weeks (though this will vary from patient to patient). However, patients should be advised that the nose itself will be swollen for roughly four to six months following the procedure.



The general price range for the whole procedure depends greatly on the region. The functional part of the treatment (which is oftentimes covered by insurance) can cost several thousand dollars (or higher). For the rhinoplasty, the price can range anywhere from $5000 to $15,000 or more.



If you are interested in the total nose approach, it is extremely important that you find the right surgeon for the job. Always be sure to do your research when choosing a doctor—look at their previous work, read patient reviews, and choose wisely. Remember: the nose is an extremely delicate, and you will want to find a skilled, board-certified surgeon who has plenty of experience, and with whom you can discuss exactly what it is you want from your treatment.


Written by Cosmetic Town Editorial Team through exclusive interview provided by Dr. Nathan Nachlas in Boca Raton, FL