Toriumi Facial Plastics

Toriumi Facial Plastics Dr. Toriumi, M.D. is a board certified facial plastic and reconstructive surgeon and world renowned Dean Toriumi, M.D.

is a uniquely skilled, board certified facial plastic surgeon, highly sought-after and known worldwide for his expertise in rhinoplasty surgery. Dr. Toriumi and Toriumi Facial Plastics offer world-class care for a variety of facial plastic surgery procedures. You will experience the highest quality care provided by a surgeon and team with unmatched credentials and success, mastered over more than 30 years of attentive, patient-focused care. Learn more about Dr. Toriumi and our services. Call to arrange a free consultation with Dr. Toriumi. Your health – and peace of mind – will be in very good hands. Phone: 312-741-3202
Fax: 312-741-3123
Website: www.toriumifacialplastics.com
Email: info@toriumimd.com

I had a great experience going back to Morelia, Mexico, for the 46th Congress. I saw many friends I hadn’t seen in year...
10/21/2025

I had a great experience going back to Morelia, Mexico, for the 46th Congress. I saw many friends I hadn’t seen in years and thoroughly enjoyed their company. 🇲🇽
The meeting topped off a successful FESORMEX Presidency of my friend Roberto Davalos. The organization was impeccable, and the participants were outstanding. I gave keynote presentations on secondary rhinoplasty and structural preservation rhinoplasty. I was also happy to see friends and mentors Yves Saban, J. Regan Thomas, and Aldo Stamm.

My keynote presentation on structural preservation rhinoplasty sparked significant interest in the upcoming Marina Medical Cadaver meeting, “The Course,” from November 14 to 16, 2025, in Fort Lauderdale, Florida.

Many participants were attracted to the three-day meeting with a fresh cadaver head each day, covering high strip, intermediate strip, and low strip, with all the bony work. This is the best way to learn preservation rhinoplasty and then incorporate it into your practice. The meeting is approaching quickly, and spots are filling up. 🏃🏼

Also consider getting the new two-volume Structural Preservation Rhinoplasty textbook from

(⚠️8-18) This 37-year-old patient presented for secondary rhinoplasty after undergoing prior rhinoplasty. He wanted his ...
10/10/2025

(⚠️8-18) This 37-year-old patient presented for secondary rhinoplasty after undergoing prior rhinoplasty. He wanted his nose to be made more masculine and also to correct his nasal obstruction. He also had a small septal perforation that caused turbulent airflow and a whistling noise when he would breathe in through his nose.
The septal perforation was successfully closed using a bilateral mucosal flap transposition and a costal perichondrium interpositional graft. His nose was restructured using his own rib cartilage. I placed a single midline tall spreader graft, a caudal septal extension graft, and lateral crural strut grafts. I left the native perichondrium on the undersurface of the lateral crural strut grafts to enhance proper curvature. His right lateral crural strut graft was slightly longer and more curved than the left lateral crural strut graft. I used platelet-rich fibrin with diced fat to camouflage his dorsum (Kovacevic).

At one year postoperatively, he is doing well with excellent nasal aesthetics. His nasal breathing is better out of his right nostril, and his left nostril is slightly smaller. This difference can be linked back to the less curved and shorter left lateral crural strut graft. Ideally, I would have made the left lateral crural strut graft more curved and as long as the right to create a larger left airway.

Secondary rhinoplasty is very complex, and even small details can affect aesthetic and functional outcomes. I take photos at set points during the operation to allow inspection of key points and to see how certain findings can impact the outcome. Every patient has some imperfections after this type of surgery, as perfection is difficult to attain, if not impossible. This type of critical evaluation of your outcomes is important for improving your outcomes. My patient outcomes have continued to improve, even over the past year, due to critical analysis of my results. 📖

(⚠️ 9-18) This 60-year-old patient presented after undergoing two prior rhinoplasties. She presented with a deviated nos...
10/02/2025

(⚠️ 9-18) This 60-year-old patient presented after undergoing two prior rhinoplasties. She presented with a deviated nose, characterized by an amorphous tip, and nasal obstruction. She requested correction of her deviation, improvement of her tip definition, and correction of her nasal obstruction.

Despite being 60 years of age, her costal cartilage was more than adequate. I harvested her seventh rib with attached native perichondrium to protect the cartilage and allow adequate vascularization. I used a caudal septal replacement graft, lateral crural replacement grafts, and lateral crural extension grafts. I kept the native perichondrium attached to the caudal septal replacement graft and on the undersurface of the lateral crural strut grafts. I also used tall spreader grafts to raise and narrow her nasal dorsum. These grafts also allowed me to straighten her nose.

Three to four months postoperatively, she presented with nasal tip swelling and tenderness that persisted. I performed an endoscopic exam and noted a trapped hair follicle that was causing a low-grade infection. Once the trapped follicle was removed, her low-grade infection cleared. She has done well since and is one year postoperative with excellent nasal function.

Despite her smoldering, low-grade infection, her cartilage grafts have maintained their structural integrity, as evidenced by her preservation of tip projection and lateral wall support. This is likely due in part to the native perichondrium left on her cartilage grafts.
In my experience, most patients aged 50 to 75 have harvestable cartilage that can be used for cartilage grafting. It is essential to maintain the native perichondrium attached to the grafts to protect the grafts and facilitate adequate vascularization. With no attached perichondrium, there is no biological interface to allow nutrients to reach the grafts, and infection can damage the grafts. With perichondrium, the cartilage can survive and heal at the surgical site, preventing resorption over time. Cadaver rib of any kind does not have perichondrium attached because of potential antigenicity. This is one of the most significant disadvantages of using donor rib, which can lead to potential resorption and infection.

All of these techniques are covered in my three-volume textbook "Structure Rhinoplasty: Lessons Learned in Thirty Years," and the newest updates are noted in the new two-volume "Structural Preservation Rhinoplasty" textbook available at the Quality Medical Publishing website.

(⚠️9-14) This patient presented after undergoing three prior rhinoplasties. She noted that her nose had become progressi...
09/25/2025

(⚠️9-14) This patient presented after undergoing three prior rhinoplasties. She noted that her nose had become progressively larger and less defined with each surgery. She presented with very thick skin and rosacea-like changes to her skin. Patients with thick skin can be very problematic with excessive postoperative swelling and scar formation, creating a poorly defined nose.
In conjunction with a dermatologist, Rania Agha , we have been treating rhinoplasty patients with thick skin with Dupilumab (Dupixant). The study’s results were presented at the Annual Meeting in Los Angeles, California, this past weekend. We have observed a marked improvement in postoperative healing, characterized by reduced swelling and inflammation after surgery. Patients who failed in prior surgeries are doing much better after being treated with Dupilumab. The patients are treated on a program that starts with a preoperative Dupilumab loading dose.
At the time of surgery, it was noted that she had dense scarring and thickening of her tip structure and skin envelope. For the reconstruction, the patient’s own costal cartilage was used to create a sound nasal structure using a caudal septal extension graft, lateral crural replacement grafts, and lateral crural strut grafts. At the end of the surgery, Doxycycline rhinodesis is used (Kovacevic), dead space suturing (Zholtikov) (See yellow circles), and Kenalog 10 mg/ml intradermal steroid injections. I place antibiotic irrigation catheters for five days, and patients go for at least seven ninety-minute hyperbaric oxygen treatments. The patients go on a strict anti-inflammatory diet for one month after surgery and tape their nose at night….continued in comments ⬇️

I was pleased to give the Gene Tardy Scholar Lecture at the Annual Fall meeting in Los Angeles, CA., this past weekend....
09/24/2025

I was pleased to give the Gene Tardy Scholar Lecture at the Annual Fall meeting in Los Angeles, CA., this past weekend. 🌴
The meeting was outstanding, and I would like to congratulate the organizing committee, the AAFPRS staff, and Ada Phillips for putting on such an exceptional meeting.
I also delivered two keynote presentations: “Secondary Rhinoplasty: Pushing the Envelope” and “Preservation Rhinoplasty by a Structural Rhinoplasty Surgeon.” I also participated in a panel on and moderated a panel on , which provided valuable information to the audience. My Gene Tardy scholar lecture was on “The Inflammation Connection: Diet’s role in health and aging.” I typically give presentations on and functional . In this case, I had the opportunity to speak on something that I am also passionate about, the anti-inflammatory diet. 🍵
I put all of my patients on the anti-inflammatory diet for one month after surgery. I believe this helps the patients with less swelling and redness after surgery. I discussed how ceremonial-grade matcha can help decrease inflammation and slow down the aging process. I have also been on the myself for over thirty years.
I was also pleased to participate in novel research with dermatologist Dr. Rania Agha, , involving the use of Dupixent (Dupilumab) in rhinoplasty. Dr. Agha presented our research at the meeting. We demonstrated statistical improvement in healing, characterized by reduced postoperative swelling and inflammation, in patients treated with before and after rhinoplasty surgery. Data included pre- and postoperative NOSE and SCHNOS scores, as well as pre- and postoperative ultrasounds. This is important research that can help patients with thick, inflamed skin improve healing after rhinoplasty. 👏🏼

(⚠️ 8-16) This forty-eight-year-old patient initially presented for revision rhinoplasty in 2002. I performed a on her...
09/18/2025

(⚠️ 8-16) This forty-eight-year-old patient initially presented for revision rhinoplasty in 2002. I performed a on her using her ear cartilage and placed a columellar strut and shield graft.
She did well over the first year but returned years later with a visible tip graft. The skin contracted over her nasal tip, revealing the shield graft. I performed a revision rhinoplasty on her in 2012 using her rib cartilage, a caudal septal extension graft, and lateral crural strut grafts with repositioning (essentially the technique I presently use to this day).
She has done well over the years with a natural-looking nose and excellent nasal function. She came back to ask about a small skin lesion on the nose that I shaved in the office.

This case illustrates how I have refined my techniques over the years to improve outcomes and enhance nasal function. I still use shield tip grafts, but primarily in ethnic patients with thick skin that need tip projection. Additionally, I always camouflage shield grafts to help prevent visibility. I rarely use shield-tip grafts in patients with thin skin due to the risk of graft visibility.
Back in 2002, I was still using ear cartilage and shield grafts in revision patients. This patient was a “watershed” patient who significantly impacted the way I perform rhinoplasty. I had been using lateral crural strut grafts, but started using them more frequently. My and outcomes improved and represent the technique I still use today. Obviously, many additional changes have been instituted over the years, such as moving away from using ear cartilage to using almost exclusively autologous costal cartilage.

Long-term follow-up of your patients is crucial to determine the effectiveness of your techniques. In the case of shield tip grafts, they are effective but must be used in particular patients to get the best outcomes. I learn a great deal from the long-term follow-up. I am even better now than I was a year ago, thanks to the changes I’ve made in my techniques. Frequently, we must reflect on our techniques and approach to rhinoplasty and make adjustments to improve outcomes.

(⚠️ 9-15)This 18-year-old patient presented after undergoing prior rhinoplasty that resulted in deformity and nasal obst...
09/10/2025

(⚠️ 9-15)
This 18-year-old patient presented after undergoing prior rhinoplasty that resulted in deformity and nasal obstruction. She had an amorphous tip and dorsal irregularities. A segment of the seventh rib was harvested via a 1.2 cm incision. Spreader grafts were placed to reconstruct her dorsum and middle vault. The lateral crura were deformed requiring lateral crural replacement grafts and lateral crural strut grafts.

She has done well over the past ten years with improved aesthetics and excellent nasal function. ✨

The nasal tip technique used in this patient is very similar to what I presently use for nasal tip reconstruction. This is a time-tested technique that has worked well over the past thirty years. Improvements have been made in other aspects of the operation, including the use of platelet-rich fibrin with diced fat (.miloskovacevic) for dorsal camouflage in thin skin patients, integration of tall spreader grafts, and use of postoperative hyperbaric oxygen treatments in all revisions. These, along with other changes, have improved my patients’ outcomes.

Long-term follow-up is crucial for assessing the efficacy of rhinoplasty techniques. I follow my patient’s long-term; allowing me to assess how my techniques are working. I can improve my outcomes year after year by following patients and making adjustments to my technique based on their results. The evolution of my techniques has enabled me to achieve more consistent results in both function and aesthetics, as noted in my three-volume textbook, “Structure Rhinoplasty: Lessons Learned in 30 years.” The most recent updates to my techniques are featured in the new two-volume textbook, “Structural Preservation Rhinoplasty,” which is available for preorder on the website.

If you do not follow your patient’s long-term, you may not be getting the full picture on how your patients are doing.

I was honored to be able to present at the Sixth Multidisciplinary Masters Symposium on Functional and Aesthetic Rhinopl...
09/09/2025

I was honored to be able to present at the Sixth Multidisciplinary Masters Symposium on Functional and Aesthetic Rhinoplasty in Sydney, Australia this past weekend 🇦🇺
I gave presentations on Structural Preservation Rhinoplasty, Dorsal Preservation, Secondary Rhinoplasty, and Surgery of the Alar Base.
I was happy to participate with other friends on the faculty and work with George, Peter, and Isabel. George and Peter should be congratulated on their years of work in organizing this important meeting in Australia. It was a very long trip, but well worth the time spent in preparation and travel to pass important information on rhinoplasty and dorsal preservation 👃🏼

This 25-year-old patient presented after suffering blunt trauma to his nose, resulting in a severe nasal fracture and de...
08/29/2025

This 25-year-old patient presented after suffering blunt trauma to his nose, resulting in a severe nasal fracture and deformity. He noted nasal obstruction, deviation, and flattening of his dorsum.

After an initial assessment, a decision was made to perform the repair in the acute stage. He was taken to surgery ten days after his injury. The possible disadvantages of early intervention were discussed with the patient. I discussed the possibility of needing rib cartilage to complete his repair. At the time of surgery, it was discovered that he suffered a septal fracture that was located along the upper septum under the middle vault. The fracture had a pattern similar to an intermediate-level dorsal preservation procedure. To utilize this septal fracture, an intermediate-level septal flap was overlapped on the side opposite the deviation to straighten his nose. A swinging door septoplasty was performed to straighten his caudal septum and to bring his tip back to the midline. He had a saddle nose deformity from the trauma that was repaired using the swinging door septoplasty and also by placing a bone graft from the vomer bone below the middle vault to raise and stabilize the dorsal strut. This maneuver corrected the saddle nose deformity. He also had a nasal bone fracture near the radix that was repaired via a small stab incision along the nasal dorsum.

The operation was performed using a closed approach, and no tip work was needed. The operation took less than two hours.
This case illustrates the power of dorsal preservation for treating nasal fractures. In the past, I would likely have used rib cartilage to correct his deformity. In this case, I was able to use an intermediate-level septal flap with swinging door septoplasty and bone grafting to the dorsal strut. The acute repair took advantage of the septal fracture and also allowed the patient to get back to work in a timely manner without deformity.

He is doing well, with excellent nasal function 8 months postoperatively, and has an improved profile compared to his preoperative contour with the dorsal hump.

More in the comments! ⬇️⬇️⬇️

(⚠️ 10-14)This patient presented with nasal deformity, nasal obstruction, and lateral wall collapse. The preoperative in...
08/22/2025

(⚠️ 10-14)This patient presented with nasal deformity, nasal obstruction, and lateral wall collapse.
The preoperative intraoperative nostril views show internal recurvature of the lateral crura bulging into the nasal airway bilaterally. The arrows on the nostril views show the bulging lateral crura. This caused nasal obstruction bilaterally. Correction required an open rhinoplasty approach with caudal septal extension graft, lateral crural repositioning, and placement of lateral crural strut grafts. The lateral crural strut grafts provided excellent lateral wall support with excellent nasal function twelve years postoperatively.

✍🏼Toriumi and published the functional results using lateral crural strut grafts with and without repositioning, showing dramatic improvement in nasal function with both. This patient demonstrated excellent improvement in nasal function with perfect NOSE and SCHNOS scores at twelve years postoperatively.
Long-term follow-up is critical to assess the efficacy of lateral wall and nasal valve support after rhinoplasty.

Unfortunately, a high percentage of patients undergoing rhinoplasty have worsening of their nasal function after surgery. It is imperative that the surgeon focuses on the functional considerations of the patient. I do not compromise nasal function for aesthetics. As a result, some of my patients are not happy with their nose early postoperatively as I have used techniques that will support the nasal airway with more widening and lateral wall fullness early postoperatively (lateral crural strut grafts). This is done to give the patient good long-term nasal function. This early compromise is important for the patients to keep in mind during the first two years after surgery.

I discuss lateral crural repositioning in the paper entitled “Lateral Crural Repositioning: Implications on nasal function” and in my three-volume rhinoplasty textbook. Lateral crural repositioning is also discussed in several chapters in the new two-volume textbook, “Structural Preservation Rhinoplasty,” which is available at the website

💡I encourage you to re-think reviews and seek information from verified sources and physicians.. ✍🏼
08/15/2025

💡I encourage you to re-think reviews and seek information from verified sources and physicians.. ✍🏼

This 23-year-old patient presented for rhinoplasty. She wanted to remove her dorsal hump and refine her nasal tip. She w...
08/13/2025

This 23-year-old patient presented for rhinoplasty. She wanted to remove her dorsal hump and refine her nasal tip. She was an excellent candidate for a closed with dorsal preservation and endonasal polygon tip surgery. I delivered her tip cartilages using an extended marginal incision and used polygon tip technique to manage her nasal tip. I used Tetris flap with a letdown to manage her dorsal hump. This complete preservation rhinoplasty operation is very sensible and works well in certain primary rhinoplasty patients.
She has done well at one year postoperative with a nice improvement in her nasal shape with good nasal function. 😊

As an open structure rhinoplasty surgeon for the past thirty years, making a change to use dorsal preservation and closed nasal tip surgery was a bit challenging. With help from Baris Cakir and , I was able to make the transition to closed polygon tip surgery. This is not the same closed rhinoplasty operation from the past. I use dorsal preservation with structure for the nasal tip in most primary rhinoplasties, but the complete preservation operation is very nice in certain candidates. The patients heal faster with minimal swelling and quicker recovery, and no external scars. 👏🏼

Learning and closed polygon tip surgery can be challenging and requires the surgeon to take a completely different approach to rhinoplasty surgery. The concepts and principles are very different and require an open mind and careful ex*****on.

👨🏻‍🏫 Learn this technique and more “The Course” in Fort Lauderdale November 14-16, 2025 (more in comments)

📕 The two-volume Structural Preservation Rhinoplasty textbook is available to pre-order at the website, and the book will be out later this year. All of the preservation techniques are demonstrated in this comprehensive textbook.

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60 E Delaware Place Ste 1425
Chicago, IL
60611

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Dr. Toriumi is board certified by both the American Board of Otolaryngology and the American Board of Facial Plastic & Reconstructive Surgery, certifying him in all areas of facial plastic and reconstructive surgery. At Toriumi Facial Plastics, we work as a team to realize a shared vision of uncompromising excellence in medical and surgical care. Visit our offices: 60 E. Delaware Pl. , Suite 1425, Chicago, IL, 60611 *By sharing your photos, videos, reviews or comments on our page, you are giving us permission to repost here on Facebook and on our other social networks. See t’s and c’s: http://bit.ly/2a9EeFl