“Rhinoplasty is the one procedure in facial plastic surgery where your artistic instincts are tested as much as your surgical technique. The anatomy is complex, the changes are permanent, and the result must be flawless from every angle. I study the relationship between the nose and every surrounding feature before designing a plan — and I do not operate if I cannot achieve a result that will look completely natural.”
What the Truesdale Rhinoplasty Approach is
In one sentence: Dr. Truesdale plans every rhinoplasty from a formal analysis of the individual face — skin thickness, cartilage framework, septal position, and full facial proportion, simulated with digital imaging — then chooses an open or closed approach by anatomy, reshapes and supports the nasal framework with the patient’s own cartilage rather than simply reducing it, and refines the nose only as far as it still looks like the patient’s own.
Every incision, every cartilage shaping step, and every graft is placed personally by Dr. Truesdale at his AAAHC-accredited True Surgical Center. The same approach governs primary rhinoplasty, ethnic rhinoplasty, and the complex revisions he accepts from patients who were told elsewhere that their nose could not be fixed.
How the nose is planned and built
The plan is designed before the operation, not during it
Every rhinoplasty consultation begins with a formal facial analysis. Dr. Truesdale evaluates the four things that decide what a nose can and cannot become:
The analysis is then translated into digital imaging, so the patient sees a simulation of the planned change before committing to surgery. If the simulation cannot produce a meaningful, natural result, Dr. Truesdale will say so and recommend not proceeding.
The approach is chosen by the anatomy, not by habit
Dr. Truesdale performs both closed (endonasal) and open rhinoplasty, and decides between them during surgical planning:
A nose that is rebuilt, not just made smaller
The classic mistake in rhinoplasty is reduction without support: cartilage is removed to make the nose smaller, the framework weakens, and over the years the tip drops, the bridge collapses, or breathing suffers. Dr. Truesdale’s approach is the opposite. The nasal framework is reshaped and reinforced, using the patient’s own cartilage for support wherever the structure needs it, so that the result holds its shape and function for life.
Function is planned alongside form. A septal deviation or a narrow internal valve is addressed in the same operation, so the nose that looks right also breathes right.
Ethnic rhinoplasty, and the nose you should have been born with
Dr. Truesdale runs one of the most diverse rhinoplasty practices in the world, and the guiding rule is the same for every patient: refine the nose, never erase it. The goal is a nose that balances harmoniously with the rest of the face and looks like it was always yours — not a standardized nose transplanted onto a face it does not belong to.
That means the plan is built around each patient’s skin thickness, cartilage strength, and facial proportions, with restraint as the discipline: when the result is right, Dr. Truesdale stops — even if more could technically be done.
Revision rhinoplasty for noses others called unfixable
Dr. Truesdale accepts complex revision cases, including patients who have been told elsewhere that their nose cannot be corrected. A revision is planned as a custom reconstruction: the analysis identifies what was over-reduced, collapsed, or left unsupported, and the operation restores structure with the patient’s own cartilage before any refinement is attempted. Revisions are almost always performed open, and healing is slower than a primary rhinoplasty — final tip refinement can take 12 to 18 months.
What makes the Truesdale Rhinoplasty Approach different
Dr. Truesdale is faculty and a live surgeon at the NYC Facelift & Rhinoplasty Master Course™, where he teaches other practicing surgeons, and a repeat podium presenter at AAFPRS national conferences. See his full speaking and teaching history →
The Truesdale Rhinoplasty Approach FAQ
Dr. Truesdale’s approach begins with formal facial analysis and digital imaging at consultation — skin thickness, cartilage framework, septal position, and full facial proportions — so the plan is built for the individual face. He chooses an open or closed approach based on the anatomy and the changes required, rebuilds and supports the nasal framework with the patient’s own cartilage rather than simply reducing it, and refines the nose while preserving the patient’s identity and ethnic character. He personally performs every incision, cartilage shaping, and graft placement, and accepts complex revision cases.
Both. The approach is chosen by anatomy and by what the plan requires: a closed (endonasal) approach when the changes can be made precisely through internal incisions, and an open approach — a small incision across the columella — when the tip or framework needs direct visualization for grafting or reconstruction, as in most revisions. The decision is made during surgical planning, not by default.
Yes. Dr. Truesdale’s practice is one of the most diverse rhinoplasty practices in the world. The goal is a nose that balances with the rest of the face and looks like it was always yours — not a standardized nose. The plan is built around the patient’s skin thickness, cartilage strength, and facial proportions, and around preserving ethnic identity.
Yes. Dr. Truesdale accepts complex revision cases, including patients who have been told elsewhere that their nose is not fixable. Each revision is planned as a custom reconstruction, which typically means restoring structural support with the patient’s own cartilage.
Yes. Every rhinoplasty consultation includes formal facial analysis and digital imaging so you can see a simulation of the planned change before committing to surgery. Dr. Truesdale does not operate if he cannot achieve a result that will look completely natural.
Discuss your rhinoplasty with Dr. Truesdale
A private, unhurried consultation with Dr. Truesdale personally — formal analysis, digital imaging, and an honest answer about what your nose can become. We respond same-day, Monday–Friday.
Book a Surgical Discovery Call online
After clicking the booking link, select “new patient” under Schedule Your Appointment and fill out the form to see our current availability for a Surgical Discovery Call with a Patient Care Coordinator and book immediately. Call us (424) 363-4112 for additional appointment times and information.All times are based on Los Angeles, Pacific Time (PT).
Book Discovery Call →Prefer to share details first? Submit the form and a Patient Care Coordinator will reach out the same business day (Monday–Friday).