Rhinoplasty (also called a nose job or nasal surgery) is a surgical procedure that reshapes the nose to improve its appearance, proportion, or function. It is one of the most technically demanding procedures in facial plastic surgery โ requiring a precise understanding of nasal anatomy, skin type, and how tissue behaves over time.
Patients come to 8 West Clinic from across Vancouver, North Vancouver, West Vancouver, and the broader Metro Vancouver area โ as well as from Victoria, Kelowna, Calgary, and across Canada โ to work with Dr. Thomas Buonassisi, a specialist in Otolaryngology โ Head and Neck Surgery with a practice focused on facial plastic surgery.
Dr. Buonassisi has performed over 2,500 rhinoplasty procedures across every technique โ open rhinoplasty, closed rhinoplasty, ultrasound rhinoplasty, ethnic rhinoplasty, revision rhinoplasty, and facial feminization rhinoplasty. His approach is anatomy-first: the technique is selected based on your specific structure and goals, not a preferred method.
Every rhinoplasty at 8 West Clinic begins with a thorough consultation โ a structured conversation about your anatomy, your goals, and what is realistically achievable.
Results that look like the face they were born with โ not a procedure.
Thorough, unhurried, and clear about what is and isn't achievable.
A deliberate philosophy โ not a limitation. An expert approach to safe and lasting results.
Clear post-op communication and attentive follow-up throughout.
Dr. Buonassisi's approach is best suited for patients who want refinement that reads as natural โ a nose that improves their face without announcing that surgery occurred. Overly aggressive structural changes can compromise breathing function and long-term nasal integrity. A conservative, anatomy-first approach is not a limitation โ it is what produces safe, lasting results. Patients seeking dramatic transformation are typically better matched with a different surgical style. This is discussed openly in the consultation, and it is one reason the practice maintains a high review average across a large volume of cases.
Complete our pre-assessment and Dr. Buonassisiโs team will review your submission personally โ before you ever step into the clinic.
Not every patient is a candidate for rhinoplastyโand not every goal is achievable in the way patients initially imagine
Most people come in with a specific concern, but what ultimately matters is how your nose fits within your overall facial structure. Even small changes can have a significant impact on balance, while more aggressive changes can sometimes create results that feel unnatural or out of place.
A thorough consultation with Dr. Buonassisi focuses on understanding your anatomy, your goals, and the limits of what your tissues will support. This includes a clear, honest discussion about what is possible, what is not, and where judgment is required to achieve a result that looks natural over timeโnot just immediately after surgery.
In many cases, patients are not looking for a โdifferent nose,โ but a version of their own nose that is more refined, more balanced, and less distracting. Determining whether that outcome is achievableโand whether surgery is the right pathโis the purpose of the consultation.
The goal isnโt to fit you into a procedureโitโs to determine whether this is the right approach for you.
The information below is a brief overview. Candidacy, risks, and complications are covered in full detail on the consultation page.
Facial growth complete โ typically 15+ for girls, 16+ for boys. Assessed individually with parental involvement for patients under 18.
Non-smoker or able to quit โ smoking significantly increases surgical risk and impairs healing. Cessation is required before and after surgery.
Realistic expectations โ rhinoplasty improves harmony and balance. It cannot guarantee a specific result or replicate another person's nose.
No contraindications to anaesthesia โ no active skin infections, uncontrolled medical conditions, or contraindications to anaesthesia.
Swelling and bruising โ expected post-operatively. Most visible swelling resolves within 2โ3 weeks; residual swelling can persist up to 12 months.
Asymmetry โ minor asymmetry is common in healing. Significant asymmetry may require revision, which is discussed at consultation.
Revision surgery โ a small percentage of patients require a secondary procedure. Dr. Buonassisi performs revision rhinoplasty and will advise on likelihood.
Anaesthesia risks โ all surgical procedures carry anaesthetic risk. A pre-operative assessment ensures you are a safe candidate.
Healing variation โ individual healing rates vary. Final results are not visible until 12 months post-surgery as residual swelling fully resolves.
Dr. Buonassisi performs every rhinoplasty technique โ from preservation and ethnic approaches to ultrasonic bone reshaping and facial feminization. Each procedure is planned individually: the technique is selected to suit your anatomy and goals, not a preferred method.
Advanced ultrasonic technology for precise bone reshaping with reduced bruising and faster recovery compared to traditional osteotomy techniques.
Reshaping the nose while preserving the native dorsal anatomy โ a modern approach that reduces trauma and produces highly natural results.
Reshaping and refining the nasal tip for improved definition and proportion, tailored to your facial anatomy and skin thickness.
Smoothing the nasal bridge for a refined, balanced profile. One of the most common goals in rhinoplasty.
Adjusting the angle and projection of the nasal tip โ correcting a drooping or over-projected tip to restore balance with the rest of the face.
Enhancing your features while honouring your cultural identity and preserving your heritage โ not imposing an external standard.
Subtle nasal refinements โ reducing projection, softening the bridge, refining the tip โ as part of a comprehensive facial feminization approach.
Correcting a deviated septum to restore natural airflow and improve breathing function โ often combined with cosmetic rhinoplasty in a single procedure.
A carefully considered process for patients under 18. Parental involvement is required, and candidacy is assessed individually once facial growth is complete.