Del Mar






Rhinoplasty enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose


  • Nose size in relation to facial balance
  • Nose width at the bridge or in the size and position of the nostrils
  • Nose profile with visible humps or depressions on the bridge
  • Nasal tip that is enlarged or bulbous, drooping, upturned or hooked
  • Nostrils that are large, wide, or upturned
  • Nasal asymmetry


  • Change the size
  • Correct birth defects and injuries
  • Change the shape
  • Correct breathing problems

If you’re considering a Rhinoplasty procedure, schedule a consultation with Dr. Kouli. He will be happy to discuss all your options with you.





Made famous by the entertainment industry with the term “nose job”, it is one of the most popular cosmetic procedures performed in the U.S. A nose job can give your nose a new size or shape. By performing a nose job, we can narrow or widen the width of your nose, increase or reduce the size or length of your nose, correct bumps and other issues at the bridge of the nose, or change the shape of the nostrils.

When cosmetic surgery is performed only to change the shape of the nose, age is a consideration. It is usually not done until the nasal bone growth is complete. This is about age 14 or 15 for girls, and a little later for boys.

To ensure the best result, stop smoking at least four weeks before surgery. Smoking impairs wound healing. This is an excellent time to get help with a smoking cessation program from your caregiver or surgeon and stop smoking forever.


Rhinoplasty can be performed under a general anesthetic or with local anesthetic. When local anesthesia is used, your nose and the surrounding area is numbed with a medication like Novocaine. You are usually lightly sedated for the surgery. This keeps you relaxed while the Novocaine keeps you pain free. General anesthesia allows you to sleep through the operation. This is commonly used in children. This is usually done as an outpatient procedure but may require a brief hospital stay if the surgery is more complex.

Incisions are hidden inside the nostrils and sometimes are made on skin between the nostrils. Through these incisions, Dr Kouli is able to reshape the cartilage and bone.

Sometimes a piece of your own cartilage or bone is used to strengthen or improve the build of the nose. This is also done for cosmetic reasons or to improve breathing.

Rarely man-made (synthetic) implants are used to reconstruct the nose when the normal structure is badly damaged or weakened. This is sometimes associated with long-term complications such as movement or your body trying to get rid of the foreign body. Using cartilage from the septum, ear, or rib overcomes this problem.

Improving nasal breathing is sometimes accomplished with a septoplasty. This may be done in combination with cosmetic changes. Cartilage removed can be used to improve the looks and framework of the nose.


When you work with an experienced plastic surgeon, complications are very rare. However, even the best cosmetic surgery procedure is not without risk. Your surgeon will discuss these with you at your consultation.