FAQs

Dr. Lam performs open (or external) rhinoplasty, which involves a tiny incision along the columella. The other method that is used is known as closed in which there are no external incisions. Dr. Lam does not perform closed rhinoplasty in general unless it is to rasp a small residual hump following rhinoplasty for many reasons. First, the scarring heals very well and is virtually undetectable in most cases even close up. Second, the technique that Dr. Lam uses as described in this website allows for optimal preservation and enhancement of the nose, which is simply not possible with a closed rhinoplasty technique. Third, the closed rhinoplasty method is a relatively “blind” approach and in the art of rhinoplasty, Dr. Lam believes that he must be able to see every minor flaw to ensure that everything is adequately corrected. He would be happy to discuss his methods more or answer more specific questions should you have them regarding his technique and why he prefers his method over that used by some other surgeons.

Dr. Lam has been performing rhinoplasty for 20 years and is an expert in performing safe, aesthetically attractive, ethnically sensitive, and functionally strong rhinoplasty procedures. He is board certified in both by the American Board of Otolaryngology-Head & Neck Surgery serving the specialty of ear, nose, and throat as well as by the American Board of Facial Plastic & Reconstructive Surgery, for which he is both an oral examiner and on the board of directors. He has lectured and written extensively about rhinoplasty and is considered an expert in nose surgery.

Nasal incisions in Dr. Lam’s hands heal exceptionally well. Using dissolvable sutures has been a game changer, which he has been doing since 2015. Even before that time, Dr. Lam had excellently healing incisions but since he has been using dissolvable sutures the incisions he makes during a nose job have healed even better. Besides the convenience and avoidance of pain of not having to have sutures removed, the special type of dissolvable suture Dr. Lam uses allows incisions to heal very well. First, under high magnification, Dr. Lam carefully evaluates the incision during closure to make sure that every fraction of a millimeter is perfectly closed. Since he uses a dissolvable suture and does not worry about the discomfort from having to remove extra sutures, he typically now places 3 to 4 times the number of tiny sutures in his closure than he did in the past making sure every tiny part of the incision is perfectly aligned and tension-free. Fortunately, these tiny sutures are also flesh colored and even difficult to see in African-American patients. The longer hold time on the suture further enhances improved healing. Careful closure and using the right suture are the two methods that Dr. Lam has at his disposal to achieve superior and seamless wound closures in rhinoplasty.

In short, no. If you are looking to have a simple septoplasty, then Dr. Lam can refer you to a qualified ENT doctor. However, Dr. Lam typically performs a septoplasty as part of every rhinoplasty without additional charge since the septum provides wonderful grafting material that he prefers you not have removed by an ENT surgeon during surgery if at all possible. Also, at times, nasal breathing problems are far more complicated than an ENT surgeon can usually handle and may involve multiple anatomic points that need correcting, which you can explore in the section of this website on functional rhinoplasty.

Traditionally, nasal packing is considered very uncomfortable and is the most dreaded thing following a rhinoplasty. Dr. Lam only applies very small nasal cotton pieces into the nose for one night that is not only comfortable but also so small that you should in most cases be able to breathe around them. He only uses these cotton pieces when he performs osteotomies. These are nothing like nasal packs used by other surgeons. They are meant to stabilize the bones for one night and can be removed by yourself at home the following morning after rhinoplasty. In rare cases, Dr. Lam may have you keep them in for a few more days but they are not painful in almost all cases.