Nose Surgery Expert in Santa Monica and Beverly Hills

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Kare Plastic Surgery & Skin Health Center  ·  Santa Monica & Los Angeles

Rhinoplasty & Nose Job Surgery in Los Angeles

804 7th Street, Santa Monica, CA 90403  ·  Near Montana Avenue  ·  (310) 998-5533

Open rhinoplasty, closed rhinoplasty, revision rhinoplasty, ethnic rhinoplasty & non-surgical nose job — by UCLA School of Medicine graduate and double board-certified plastic surgeon Dr. Raffy Karamanoukian at Kare Plastic Surgery near Montana Avenue in Santa Monica

Call (310) 998-5533 Request a Consultation
📍 804 7th Street, Santa Monica CA 90403
📞 (310) 998-5533 — Rhinoplasty Consultations
🏠 Near Montana Avenue & Brentwood
🕘 Mon–Fri 9:00am–5:00pm
UCLASchool of Medicine Graduate
DoubleBoard-Certified Plastic Surgeon
RevisionRhinoplasty Specialist
ScarExpert & Wound Healing Specialist
RealSelf 100Top Surgeon

The Art & Science of Rhinoplasty

 

Rhinoplasty in Los Angeles: Natural Results That Enhance Your Face Without Announcing Surgery

Rhinoplasty is consistently ranked among the most technically demanding operations in cosmetic surgery — a procedure that requires the surgeon to simultaneously understand facial proportion and aesthetic harmony in three dimensions, master the structural mechanics of cartilage and bone manipulation, predict how the living tissue will heal and evolve over 12–18 months as postoperative swelling resolves, and execute every step with the precision that determines whether the result is a nose that looks naturally beautiful on the patient’s specific face or a nose that announces surgical intervention to every observer. This combination of artistic judgment and technical mastery is what separates the surgeons who consistently produce natural-looking rhinoplasty results from those who do not.

At Kare Plastic Surgery & Skin Health Center at 804 7th Street in Santa Monica — near Montana Avenue and accessible from throughout the Los Angeles metropolitan area — UCLA School of Medicine graduate and double board-certified plastic surgeon Dr. Raffy Karamanoukian, MD, FACS performs rhinoplasty with a foundational philosophy: every nose must be designed for the specific face it lives on, the changes must be proportional and harmonious with the patient’s entire facial architecture, and the result should produce the response “you look great” rather than “you had a nose job.”

His rhinoplasty practice encompasses the full spectrum of nasal surgery — from subtle tip refinement and dorsal hump reduction in primary rhinoplasty to the most complex revision cases involving scarred, over-resected, or structurally compromised noses requiring cartilage grafting from the ear or rib. As a nationally recognized scar expert and wound healing specialist, Dr. Karamanoukian brings an additional dimension to both primary and revision rhinoplasty that most Los Angeles surgeons cannot offer: a reconstructive understanding of how scar tissue forms, matures, and can be managed in the healing nose that directly informs his intraoperative decisions and post-operative wound care protocols.

Rhinoplasty Services at Kare Plastic Surgery

  • Open rhinoplasty — complete structural access and visualization
  • Closed rhinoplasty — endonasal, no external scar
  • Dorsal hump reduction — nose bridge refinement
  • Nasal tip refinement — deprojection, definition, rotation
  • Alar base reduction — nostril width narrowing
  • Septoplasty — deviated septum correction
  • Turbinate reduction — breathing improvement
  • Revision rhinoplasty — correction of prior nose surgery
  • Ethnic rhinoplasty — culturally sensitive nasal reshaping
  • Post-traumatic rhinoplasty — injury reconstruction
  • Non-surgical rhinoplasty — dermal filler nose job
  • Cartilage grafting (septal, auricular, rib) for reconstruction

Surgeon Expertise

 

Dr. Raffy Karamanoukian: Rhinoplasty Expertise Built on UCLA Surgical Training, Scar Science & Revision Experience

Dr. Karamanoukian’s rhinoplasty expertise is built on the same three pillars that distinguish him across all facial surgery: formal academic surgical training at UCLA that included rhinoplasty across its full spectrum from primary cosmetic to post-traumatic reconstruction; a nationally recognized subspecialty expertise in wound healing science and scar management that directly informs his rhinoplasty incision planning, cartilage graft handling, and post-operative healing management; and a significant revision rhinoplasty practice that has given him intimate clinical knowledge of the consequences of poor technique — knowledge that continuously sharpens his commitment to precision in every primary case.

His UCLA medical training at one of the country’s premier academic medical centers provided exposure to the full complexity of rhinoplasty — from the straight-forward primary cosmetic refinement to the most technically demanding reconstruction of noses damaged by trauma, prior surgery, infection, or tumor excision — under the supervision of attending surgeons who operate at the academic forefront of nasal surgery. This breadth of training is what allows Dr. Karamanoukian to approach the revision rhinoplasty patient whose nose has been over-resected, the ethnic rhinoplasty patient whose nasal anatomy requires a culturally sensitive and structurally sound approach, and the primary rhinoplasty patient whose goals require both cosmetic refinement and functional breathing improvement within the same operation — all with equivalent clinical confidence.

His scar expertise is uniquely valuable in rhinoplasty practice. The nasal tip and dorsal skin are among the most scar-sensitive tissues in the face — and the quality of the transcolumellar scar in open rhinoplasty, the healing of cartilage graft-to-host interfaces, and the tissue response to internal suturing all depend on the same wound healing science that Dr. Karamanoukian applies to his scar revision and keloid management practice. Patients whose previous rhinoplasty has produced visible scarring, supra-tip fullness from excessive scar contracture, or tip stiffness from internal adhesion all benefit from his reconstructive approach to scar management in the healing nose.

“The best rhinoplasty result is the one where, when the swelling resolves a year later, the patient looks like they have always had that nose. It fits their face, it moves naturally, it breathes well, and there is no sign of surgery. That result requires planning the nose for the face, not from a template — and understanding exactly how each tissue change will heal over the following twelve months.”

— Dr. Raffy Karamanoukian, MD, FACS — Kare Plastic Surgery, Santa Monica

UCLASchool of Medicine graduate
DoubleBoard-certified plastic surgeon
ScarNational expert in wound healing
RevisionComplex rhinoplasty correction specialist

What Rhinoplasty Addresses

 

Nasal Concerns Treated with Rhinoplasty at Kare Plastic Surgery in Los Angeles

Every nasal concern has a specific surgical or non-surgical solution. Dr. Karamanoukian evaluates each patient’s anatomy at consultation and recommends the precise intervention that addresses the concern effectively.

Dorsal Hump

A dorsal hump — the visible bump or convexity along the nasal bridge — is one of the most common rhinoplasty indications and one of the most satisfying to treat. Hump reduction involves carefully rasping or osteotomizing the bony and cartilaginous excess along the dorsum, lowering the bridge to a straight or slightly concave profile that brings the nose into proportion with the rest of the face. After hump reduction, lateral osteotomies close the open roof created by the dorsal reduction. The key is appropriate hump reduction — enough to create the desired profile without over-reducing the bridge to an unnatural concavity.

Bulbous or Poorly Defined Tip

A bulbous, boxy, or poorly defined nasal tip is the result of excessive width between the lower lateral cartilages, excessive convexity of the domes, or excess soft tissue coverage over the tip cartilages. Tip refinement — through cephalic trimming of the lower lateral cartilages, dome suture techniques, interdomal suturing, and tip grafting when appropriate — narrows and defines the tip to create the subtle point that gives the nose visual sharpness without the unnaturally pinched appearance of over-reduced tips that is the hallmark of poorly performed rhinoplasty.

Wide Nose & Wide Nostrils

Nasal width is determined by both the bony vault width (the upper third of the nose) and the alar base width (the horizontal distance between the outer edges of the nostrils). Narrow bony vault width can be addressed with lateral osteotomies that fracture the nasal bones and allow them to be repositioned medially. Excessive alar base width is corrected with alar base reduction — removing a precisely measured wedge of tissue at the nostril-cheek junction to narrow the nostrils without visible external scarring — an incision placed in the natural alar groove where it becomes virtually invisible at healing.

Droopy Nasal Tip

A drooping tip — where the nasal tip points downward, particularly evident during animation when smiling causes further tip depression — is corrected by rotating the tip cephalically (upward) through a combination of tip suturing, depressor septi muscle release, and columellar strut or septal extension graft placement. The columella-to-lip angle is simultaneously adjusted to produce the appropriate relationship between the tip, the columella, and the upper lip that defines the lower third nasal proportions in the patient’s specific facial context.

Over-Rotated or Upturned Tip

An excessively upturned “ski slope” nose — where the tip points upward exposing the nostrils from the front view — is among the most difficult rhinoplasty corrections because it typically requires structural support to counteract the existing over-rotation while achieving natural-appearing de-rotation. Cartilage grafting with a septal extension graft or columellar strut is frequently required. De-projecting an over-projected tip while simultaneously achieving the appropriate rotation is a challenge that tests the technical breadth of any rhinoplasty surgeon and is a procedure for which Dr. Karamanoukian’s full surgical training provides the necessary technical foundation.

Crooked or Asymmetric Nose

A deviated or crooked nose — whether from genetics, prior trauma, or prior surgery — requires correction of every structural layer contributing to the deviation: the nasal bones (via asymmetric osteotomies), the cartilaginous dorsum (via spreader grafts and direct cartilage repositioning), and the nasal septum (via septoplasty to correct the central structural deviation that drives the external crooked appearance). The crooked nose is one of the most technically demanding primary rhinoplasty presentations because it requires precise analysis of which layers are contributing to the deviation and addressing each in the correct anatomical vector.

Breathing Problems & Deviated Septum

A deviated nasal septum — the midline cartilaginous and bony partition of the nasal airway that deflects to one side — is a significant cause of nasal obstruction, sleep-disordered breathing, and chronic mouth breathing. Septoplasty corrects the deviation by accessing the septum through an endonasal incision, repositioning or removing the deviated portions, and restoring a midline position that opens both nasal passages symmetrically. Turbinate hypertrophy is frequently a concurrent contributor to obstruction and is addressed with inferior turbinate outfracture or partial turbinoplasty at the same operation. The functional component may qualify for PPO insurance coverage.

Post-Traumatic Nose Deformity

Nasal trauma can cause longterm breathing problems due to an obstruction of the nasal passage. This can either be caused by bony or cartilage obstruction that leads to septal deviation or visible changes in the shape of the nose. Dr. Karamanoukian’s is trained in both cosmetic and reconstructive surgery of the nose and can restore both form and function to your surgery. 

Surgical Approach

 

Open vs. Closed Rhinoplasty: Choosing the Right Approach for Your Goals

The choice between open and closed rhinoplasty is one of the most important technical decisions in rhinoplasty planning — and it is determined by the complexity of the changes needed, not by the surgeon’s personal preference for one approach over the other. Dr. Karamanoukian performs both approaches and selects based on the anatomy and goals presented at consultation.

Endonasal Approach — Selected Presentations

Closed Rhinoplasty

Closed rhinoplasty (endonasal rhinoplasty) places all incisions inside the nostrils — within the intercartilaginous and intracartilaginous mucosal surfaces — with no external visible scar. The nasal skin is elevated from below through these internal access points, modifications are made to the cartilage and bone working through the limited exposure available, and the skin is allowed to re-drape over the modified nasal framework at the conclusion of the procedure.

The advantages of closed rhinoplasty are real and meaningful for appropriate patients: no transcolumellar scar, reduced post-operative swelling (because the columellar skin flap is not elevated and its lymphatic drainage is preserved), and faster resolution of tip edema. The limitation is access — the working space available through endonasal incisions restricts the complexity of structural modification achievable, making closed rhinoplasty most appropriate for patients whose goals can be achieved with more modest cartilage manipulation, hump reduction, and tip suturing without the need for complex grafting or direct structural reconstruction.

Dr. Karamanoukian performs closed rhinoplasty for appropriate patients and does not default to the open approach simply because it provides more access — he uses the approach that is appropriate for the specific goals and anatomy at hand.

External Approach — Complex Presentations & Revisions

Open Rhinoplasty

Open rhinoplasty (external rhinoplasty) adds a small transcolumellar incision across the narrowest point of the columella to the standard internal endonasal incisions, allowing the nasal skin envelope to be reflected upward over the tip cartilages and providing direct, binocular vision of the complete nasal framework from the tip to the osseocartilaginous junction. This exposure allows modifications that would be impossible or imprecise through the limited access of closed rhinoplasty: precise dome suturing under direct vision, accurate placement of tip grafts, spreader graft insertion in the correct pocket, columellar strut placement, and the direct visualization of scar tissue management in revision cases.

The transcolumellar scar of open rhinoplasty, placed in the narrowest part of the columella in a broken-line or step design that distributes the tension of healing, is typically imperceptible at 6–12 months in patients without a predisposition to hypertrophic scarring. Dr. Karamanoukian’s scar expertise is directly applied to the design, execution, and post-operative management of this incision — producing consistently well-healed columellar scars that are not visible at conversational distance in his operated patients.

Open rhinoplasty is Dr. Karamanoukian’s preferred approach for revision rhinoplasty, complex structural modifications, significant tip work requiring precise cartilage suturing and grafting, and all cases where the accuracy of structural modification under direct vision is essential for the desired outcome.

On the transcolumellar scar: The most common hesitation about open rhinoplasty is the fear of a visible external scar. In the hands of a surgeon with formal scar management training — which Dr. Karamanoukian uniquely brings to his rhinoplasty practice — the transcolumellar scar is designed with broken-line irregular geometry that distributes healing tension, closed in precise anatomical layers, and actively managed post-operatively with silicone gel and sun protection. The result in Dr. Karamanoukian’s patients is consistently a scar that is not visible at normal conversational distances and is not a meaningful cosmetic concern.

Procedure Types

 

Rhinoplasty Procedures at Kare Plastic Surgery in Los Angeles & Santa Monica

01

Primary Rhinoplasty

Primary rhinoplasty — nasal surgery in a patient who has never had prior nasal procedures — is the foundation of Dr. Karamanoukian’s rhinoplasty practice. The primary rhinoplasty consultation at Kare Plastic Surgery involves a thorough three-dimensional assessment of the nasal anatomy in relation to the patient’s specific facial proportions: the relationship of the nose to the brow-tip aesthetic line, the dorsal profile in relation to the lip, the tip-defining points and their position relative to the alar lobule, the nasal base width in relation to the intercanthal distance, and the columella-to-lobule ratio that determines the lower third balance. Digital imaging is used to simulate the anticipated surgical result, allowing the patient and surgeon to align on the goal before any incision is planned.

Recovery: 7–14 days of social downtime; cast and splint for 7–10 days; full swelling resolution at 12–18 months; returning to exercise at 3–4 weeks
02

Revision Rhinoplasty

Revision rhinoplasty — the correction of unsatisfactory results from a prior rhinoplasty procedure — is one of the most technically demanding operations in all of plastic surgery and requires a specific combination of skills that not all rhinoplasty surgeons possess. The published revision rate for rhinoplasty ranges from 5–15% in the peer-reviewed literature, reflecting both the inherent complexity of predicting nasal healing and the frequency of suboptimal primary outcomes. The most common revision presentations at Kare Plastic Surgery include over-reduced dorsum (scooped-out profile), over-resected tip cartilages (pinched or bossae tip), nasal obstruction created by structural collapse, residual asymmetry, excessive scar contracture causing supra-tip fullness, and the dreaded “operated” appearance of a nose that announces its surgical history.

Revision rhinoplasty requires cartilage grafting in the majority of cases — because the primary rhinoplasty has consumed or weakened the septal cartilage that would be used in a primary case, requiring harvest of auricular (ear) cartilage or costal (rib) cartilage for structural reconstruction. Dr. Karamanoukian performs all three graft source approaches at Kare Plastic Surgery and selects the appropriate graft based on the specific structural deficit being corrected.

Timing: A minimum of 12 months after the primary rhinoplasty is required before revision surgery — full scar maturation must be complete before the structural changes of revision can be reliably assessed and corrected
03

Ethnic Rhinoplasty

Ethnic rhinoplasty requires the preservation of the patient’s ethnic facial identity alongside the aesthetic refinement they seek — an approach fundamentally different from the “Western standard” rhinoplasty templates that produce the recognizable “done” appearance when applied inappropriately to patients of diverse ethnic backgrounds. The diverse patient population of the Los Angeles and Santa Monica community — encompassing patients of Asian, Middle Eastern, Hispanic, South Asian, African American, and mixed heritage — is one of the most ethnically varied rhinoplasty markets in the country, and appropriate ethnic rhinoplasty requires cultural sensitivity, facial proportion analysis specific to each ethnic heritage, and the technical skill to address the specific structural anatomy common to each background.

For East Asian patients, ethnic rhinoplasty typically involves augmentation of the dorsum and refinement of the tip with implant or cartilage grafting — the opposite of Caucasian rhinoplasty which most commonly involves reduction. For Middle Eastern patients, dorsal hump reduction and tip refinement must be carefully balanced to preserve the strong nasal character that is culturally appropriate. Dr. Karamanoukian evaluates every ethnic rhinoplasty patient’s facial identity at consultation and designs the nasal change that achieves the patient’s goals while preserving the cultural authenticity that defines their appearance.

Best For: All ethnic backgrounds; culturally sensitive planning that respects facial identity; the diverse Los Angeles patient population; augmentation or reduction as anatomically appropriate for each heritage
04

Functional Rhinoplasty & Septoplasty

Functional rhinoplasty addresses the internal nasal airway in patients whose breathing is impaired by structural problems: deviated nasal septum, turbinate hypertrophy, internal valve collapse, external valve collapse, or nasal fracture malunion. When combined with cosmetic rhinoplasty, the functional component is performed simultaneously — correcting the internal airway in the same operation that modifies the external nasal appearance. The septoplasty is typically performed first, as the septal cartilage harvested for septoplasty often provides the graft material for structural rhinoplasty maneuvers performed in the same case.

The functional rhinoplasty benefit is profound for patients who have lived with chronic nasal obstruction: improved sleep quality, reduced snoring, elimination of chronic mouth breathing, improved exercise tolerance, and reduction of headaches related to sinus drainage impairment. The functional component of rhinoplasty may be partially or fully covered by PPO insurance when deviated septum or turbinate hypertrophy is documented by examination and endoscopy, and Dr. Karamanoukian’s office assists with insurance pre-authorization for the functional component of combined functional-cosmetic rhinoplasty procedures.

Insurance: Septoplasty and turbinate reduction may qualify for PPO coverage when functional impairment is documented; Kare Plastic Surgery assists with pre-authorization; cosmetic rhinoplasty component remains self-pay
05

Non-Surgical Rhinoplasty (Liquid Nose Job)

Non-surgical rhinoplasty — the use of injectable dermal fillers (typically hyaluronic acid such as Restylane or Juvéderm) to reshape and refine the external nasal contour without surgery — is an option for carefully selected patients who want subtle nasal improvement with zero downtime and the reversibility of hyaluronidase dissolution if the result is not desired. The most effective non-surgical rhinoplasty applications are camouflage of small dorsal humps by filling the dorsum above and below the hump to create a straighter profile, tip projection improvement with a small depot of filler at the supra-tip, and correction of mild asymmetry or post-rhinoplasty contour irregularities that do not warrant repeat surgery.

Non-surgical rhinoplasty at Kare Plastic Surgery is performed with the anatomical precision of a plastic surgeon who understands the vascular anatomy of the nose — the angular artery, the dorsal nasal artery, and the lateral nasal artery branches — and the catastrophic complication of vascular occlusion and skin necrosis that results from filler placed in or adjacent to these vessels under excessive pressure. Dr. Karamanoukian uses the smallest effective volume, the lowest injection pressure, and aspiration technique before injection — the technical standards that minimize vascular risk in a zone where the consequences of error are irreversible.

Limitations: Non-surgical rhinoplasty cannot reduce a large hump, narrow a wide nose, refine a bulbous tip, or correct significant structural asymmetry. It is additive, not subtractive. Surgical rhinoplasty is the only approach for significant nasal change
06

Post-Traumatic & Reconstructive Rhinoplasty

Nasal trauma from sports injuries, motor vehicle accidents, altercations, and falls is one of the most common causes of facial injury in the Los Angeles area, and the resulting nasal deformities — dorsal deviation, tip depression, septal dislocation, nasal fracture malunion, and soft tissue injury — require a reconstructive surgical approach that combines the aesthetic goals of rhinoplasty with the structural restoration requirements of reconstructive surgery. Dr. Karamanoukian’s UCLA reconstructive surgery training included management of facial trauma — including nasal bone fractures, septal hematoma, and post-traumatic nasal reconstruction — making him the appropriate surgeon for patients whose nasal deformity has a traumatic rather than congenital or prior-surgical etiology.

For patients who have recently sustained nasal trauma and are evaluating whether acute reduction (manipulation within 7–10 days of the fracture) or delayed definitive rhinoplasty is the appropriate management, Dr. Karamanoukian provides consultation with clear recommendations based on the specific fracture pattern and the patient’s goals for the final nasal appearance.

Timing: Acute nasal fracture reduction within 7–10 days of trauma; definitive post-traumatic rhinoplasty after 6–12 months of swelling resolution; emergency consultation available for acute nasal trauma at (310) 998-5533

The Rhinoplasty Experience

 

What to Expect: Rhinoplasty at Kare Plastic Surgery in Santa Monica

 

Consultation & Three-Dimensional Nasal Analysis

Dr. Karamanoukian will perform a thorough biometric analysis of the nasal anatomy and its relationship to the entire facial structure at your rhinoplasty consultation. Photographs of your nose in standardized views (frontal, bilateral lateral, bilateral oblique, and base) may be taken to analyze the nasal proportions using cosmetic reference points: the Frankfurt horizontal, the brow-tip aesthetic lines, the alar-columellar relationship, and the nasal base width in relation to the intercanthal distance. A discussion of the open vs. closed approach selection, the specific structural modifications planned, the expected recovery timeline, and the realistic expectations for the final result at 12–18 months will complete the consultation. 

 

Surgical Planning & Pre-Operative Preparation

A detailed pre-operative consultation at 1–2 weeks before surgery reviews the surgical plan and confirms the goals. Blood-thinning medications, supplements (aspirin, ibuprofen, vitamin E, fish oil), and herbal products are discontinued for 2 weeks before surgery. Smoking cessation for a minimum of 4 weeks before and after surgery is mandatory. For patients with seasonal allergies that could increase post-operative mucosal swelling, management optimization with an allergist is recommended before rhinoplasty. Pre-operative photographs under standardized lighting and consistent positioning are taken for surgical documentation. For revision rhinoplasty, prior surgical records and operative reports are requested and reviewed before the surgical plan is finalized.

 

Surgery Under General Anesthesia

Rhinoplasty at Kare Plastic Surgery is performed under general anesthesia an accredited surgical facility. Local anesthetic will be used at beginning of the procedure to minimize intraoperative bleeding and provide post-operative analgesia. The surgical plan is executed systematically according to the pre-operative design, with intraoperative assessment at each step to confirm the result is tracking toward the planned outcome. A thermoplastic cast and internal nasal splints are applied at the conclusion of surgery. Total operative time ranges from 2 hours for closed rhinoplasty to 4+ hours for complex revision.

 

Recovery & Post-Operative Scar Management

The external cast and splint are removed at 7–10 days with an early view of the results with residual swelling.  Most patients return to desk work and social activity at 7–14 days; return to full physical exercise at 2-4 weeks. Persistent tip swelling and supratip fullness are expected for 6-9 months as the thick nasal tip skin slowly re-drapes over the refined framework. Minor swelling can be seen for 1 year after surgery and this is completely normal. 

 

Long-Term Follow-Up & Final Result

Rhinoplasty results are followed at 1 week, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months after surgery. The definitive evaluation of the rhinoplasty result is performed at 12–18 months when virtually all swelling has resolved and the scar tissue in the tip and dorsal skin has fully matured. If any subtle irregularities, asymmetries, or contour concerns are identified at this assessment that would benefit from refinement, Dr. Karamanoukian discusses whether minor office-based procedures (steroid injection for persistent thickening, filler for small contour irregularities) or a minor secondary revision are appropriate. 

Who We Treat

 

Who Is a Good Candidate for Rhinoplasty in Los Angeles?

✓ Ideal Candidates for Rhinoplasty at Kare Plastic Surgery — Santa Monica & Los Angeles

  • Adults who are physically healthy and psychologically motivated by personal goals for nasal appearance — not by external pressure from others or unrealistic expectations of dramatic life change as a consequence of cosmetic surgery
  • Patients whose nasal growth is complete — typically 16–17 years for women and 17–18 years for men, when the nasal framework has reached adult proportions and structural modifications will produce a stable, predictable result
  • Those with specific, articulable nasal concerns (dorsal hump, tip bulbosity, nasal width, breathing problems, asymmetry) who can communicate clearly what bothers them and are realistic about what surgical correction can achieve
  • Non-smokers or patients who have stopped smoking for at least 4 weeks before surgery — smoking dramatically impairs nasal skin blood supply and is the most significant modifiable risk factor for poor wound healing and scar thickening after rhinoplasty
  • Patients who have completed a full 12 months of healing after a prior rhinoplasty and whose nasal scar tissue has fully matured before revision surgery is considered — operating on a healing nose before maturation is complete produces unpredictable structural results
  • Those seeking ethnic rhinoplasty who want a surgeon who will preserve their cultural facial identity while achieving the refinement they seek — not apply a standardized Caucasian template to an ethnically distinct nasal anatomy
  • Patients with documented nasal airway obstruction from deviated septum or turbinate hypertrophy who want functional improvement with or without concurrent cosmetic change, and who may qualify for partial PPO insurance coverage of the functional component
  • Those who want non-surgical rhinoplasty and understand its limitations — that it can camouflage small humps and add tip projection but cannot reduce a wide nose, narrow nostrils, or achieve the structural changes that only surgery can produce
  • Adults with realistic expectations about the rhinoplasty timeline: understanding that tip swelling persists for 12–18 months after surgery, that the nose at 3 months does not reflect the final result, and that patience through the healing process is an essential part of a successful rhinoplasty outcome
  • Patients seeking revision rhinoplasty who have had careful consultation with Dr. Karamanoukian at least 12 months after their primary procedure and who have a clearly defined, surgically achievable correction goal for the specific concern they want addressed

Find Us in Santa Monica

 

Kare Plastic Surgery — Rhinoplasty Near Montana Avenue, Santa Monica

Kare Plastic Surgery & Skin Health Center is located at 804 7th Street, Santa Monica, CA 90403 — near Montana Avenue and accessible from throughout the greater Los Angeles area. Patients from Beverly Hills, Brentwood, Pacific Palisades, Malibu, West Hollywood, and all of the Westside choose Kare Plastic Surgery for rhinoplasty because of Dr. Karamanoukian’s unique combination of UCLA surgical training, scar expertise, and the natural-looking results that define his practice philosophy.

Practice Information

  • Address: 804 7th Street, Santa Monica, CA 90403
  • Phone: (310) 998-5533
  • Hours: Monday–Friday, 9:00am–5:00pm
  • Neighborhood: Near Montana Avenue, Santa Monica
  • Zip Codes: 90402 · 90403 · 90404 · 90405
  • Rhinoplasty: Consultation with Dr. Karamanoukian
  • Non-Surgical Rhinoplasty: Same-day filler appointments available
  • Revision Rhinoplasty: Second opinions welcome

Communities Served

  • North of Montana — Santa Monica 90402
  • South of Montana — Santa Monica 90403
  • Brentwood — 90049
  • Beverly Hills — 90210
  • Pacific Palisades — 90272
  • Malibu — 90265
  • West Los Angeles & Westwood — 90025
  • West Hollywood · Culver City · Mar Vista
  • Out-of-state & international patients welcome

Common Questions

 

Frequently Asked Questions About Rhinoplasty in Los Angeles

Where can I get a natural rhinoplasty near Santa Monica and Los Angeles?

Kare Plastic Surgery & Skin Health Center at 804 7th Street in Santa Monica near Montana Avenue offers expert rhinoplasty by UCLA School of Medicine graduate Dr. Raffy Karamanoukian, a double board-certified plastic surgeon. Open rhinoplasty, closed rhinoplasty, revision rhinoplasty, ethnic rhinoplasty, and non-surgical rhinoplasty with dermal fillers are all available. Call (310) 998-5533 for a rhinoplasty consultation. We serve Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, and all of Los Angeles.

How long does rhinoplasty recovery take?

Most rhinoplasty patients take 7–14 days away from professional and social activities while the external cast is in place and the initial bruising and swelling are most visible. The cast and splint are removed at 7–10 days, after which most patients are comfortable returning to work with makeup coverage of any residual bruising. Significant residual swelling, particularly in the nasal tip, persists for 3–6 months — the thick nasal tip skin is the slowest to re-drape and the tip appearance at 3 months does not reflect the final result. The definitive rhinoplasty result is evaluated at 12–18 months when virtually all swelling has resolved. Return to exercise is permitted at 3–4 weeks; contact sports are avoided for 3–4 months.

How much does rhinoplasty cost in Los Angeles?

Published rhinoplasty pricing in the Los Angeles and Beverly Hills market ranges from approximately $10,000 to $30,000+ depending on the surgeon’s experience, the complexity of the procedure (primary vs. revision, open vs. closed, degree of grafting required), anesthesia and facility fees, and whether functional septoplasty is combined with cosmetic rhinoplasty. Revision rhinoplasty is typically more expensive than primary rhinoplasty due to the greater operative complexity and time required. A personalized cost estimate is provided at Dr. Karamanoukian’s consultation once the specific procedure is planned. The functional component (septoplasty, turbinate reduction) may be covered by PPO insurance when medically documented.

How is ethnic rhinoplasty different from standard rhinoplasty?

Ethnic rhinoplasty requires that the surgeon understand and respect the patient’s ethnic facial identity alongside the specific aesthetic changes requested. For many ethnic backgrounds, the appropriate rhinoplasty involves augmentation rather than reduction — adding cartilage or implant to build the dorsum and project the tip, rather than the hump reduction and tip narrowing more common in Caucasian rhinoplasty. The goal is always a nose that looks natural and harmonious on the patient’s specific face and ethnic heritage — not a nose that has been shaped to fit a Western aesthetic template. Dr. Karamanoukian evaluates every ethnic rhinoplasty patient’s full facial proportions and cultural identity at consultation before recommending any surgical modification.

Can rhinoplasty fix breathing problems?

Functional breathing improvement is the primary motivation for cosmetic and function nose surgery. Septoplasty corrects a deviated nasal septum; spreader grafts or alar batten grafts correct internal and external valve collapse. When functional and cosmetic rhinoplasty are performed simultaneously, we will recommend  single surgery to correct both problems simultaneously. The functional septoplasty component may be covered by PPO insurance when medically documented, potentially offsetting a portion of the total surgical cost.

When can I have revision rhinoplasty after a prior nose job?

A minimum of 12 months must elapse after the primary rhinoplasty before revision surgery is performed — and in complex cases, 18–24 months is preferable to allow complete scar maturation before operating in the scarred tissue. This waiting period is not arbitrary — the nasal tip skin undergoes active collagen remodeling for 12–18 months after rhinoplasty, and the structural assessment made at 6 months does not accurately reflect the final structural position at 18 months. Operating prematurely on a healing nose produces unpredictable results because the tissue being manipulated is still in a state of active change. At Kare Plastic Surgery, no revision rhinoplasty is performed in less than 12 months from the prior procedure, and patients are counseled to bring any operative reports from the prior surgery for review before their revision consultation.

Kare Plastic Surgery & Skin Health Center  ·  Santa Monica  ·  Los Angeles

Schedule a Consultation

Schedule a consultation with Dr. Raffy Karamanoukian, a graduate of the UCLA School of Medicine and double board-certified plastic surgeon with two decades of experience in cosmetic plastic surgery and complex reconstruction — including primary rhinoplasty, revision rhinoplasty, and ethnic nasal surgery.

(310) 998‑5533
 
Online Consultation Request 804 7th Street  ·  Santa Monica, CA 90403

Kare Plastic Surgery & Skin Health Center  ·  804 7th Street, Santa Monica, CA 90403  ·  Near Montana Avenue  ·  (310) 998-5533

Dr. Raffy Karamanoukian, MD, FACS — Graduate, UCLA School of Medicine  ·  Double Board-Certified Plastic Surgeon  ·  Rhinoplasty · Revision Rhinoplasty · Ethnic Rhinoplasty · Non-Surgical Rhinoplasty  ·  Santa Monica 90402 · 90403 · Beverly Hills · Brentwood · Malibu · Los Angeles