In a city near bursting with cosmetic surgical talent (quite literally — there are certain stretches of the Upper West and East Sides of Manhattan where you can’t throw a stone without hitting a plastic surgeon’s door), earning the distinction as the most skilled rhinoplasty specialist surgeon in the tri-state area is no small feat. It takes a pure, unwavering focus on nose surgery to earn yourself the title of the Nose Job Queen of NYC, and for the current holder of said crown, Dr. Dara Liotta, her M.O. has been all noses, all the time from the very start.
“It’s pretty rare to have a rhinoplasty-only practice and that’s 98% of my practice,” says Dr. Liotta. “People come to me for noses — I do between five and 20 nose surgeries a week. As is true [with most anything], the more volume of something you do, the better you’re going to be at it.”
“Better” is selling herself short because Dr. Liotta has been racking up rave reviews extolling her natural-looking nose jobs from well-heeled patients of her Park Avenue practice, and she’s become the go-to media expert for major publications looking for someone to weigh in on rhinoplasty trends. She is, quite simply, the name in noses.
Dr. Liotta knew from the very early days of her schooling that her path would lead to rhinoplasty — the rock star status would follow naturally as her talent developed. “There are two roads that doctors can take going into plastic surgery: One is to go into general plastic surgery, where you are affiliated with general surgery and then do plastic surgery as a sub-specialty, or you can do head and neck surgery and have facial plastic surgery as a sub-specialty,” she explains. “One of my major motivators for going into plastic surgery in the first place was reconstruction, cleft lip, cleft palate, and cleft rhinoplasty, so I chose that second path.”
After graduating with her medical degree from Columbia University, Dr. Liotta completed a residency in otolaryngology (a fun way to say head and neck surgery) at New York Presbyterian Hospital, Columbia Presbyterian and Weill Cornell Campuses, and Memorial Sloan Kettering, followed by a fellowship in facial plastic and reconstructive surgery at Lenox Hill Hospital. She received her board certifications in both plastic surgery and otolaryngology, making her one of the elite few plastic surgeons that are dual board certified in facial plastic surgery and head and neck surgery.
“When you start your training with head and neck surgery [rather than general surgery], correcting a deviated septum is basically the third surgery you learn in your five-year residency,” she explains. “By the time you finish your residency, you’ve done hundreds if not thousands of functional breathing surgeries. In my mind, if I finished a rhinoplasty surgery and someone didn’t breathe better than before I started, that would be a major failing, even if that’s not the reason they came to see me.”
She continues, stating that after years of training in which she saw people only for breathing issues, it is subsequently ingrained in her to correct that during rhinoplasties. “Whenever I operate on a nose, I fix every possible functional thing I can see that may be a problem later on in their life because my goal for them is that their nose never has to be touched again,” she says. “I don’t want anybody to operate on them again for functional or aesthetic reasons.”
It’s not just her training that’s unique — Dr. Liotta’s entire approach is concierge-like for her patients, be it their first surgery or if they’re coming to her for revision of a prior surgeon’s work.
“Part of my consultation, especially for a primary rhinoplasty patient where we have their original anatomy and have the best chance of making the nose exactly what they want it to be, is to take pictures in the office and then I’ll image what I would do,” she says. “With imaging, my starting point is always to think, if I found them asleep in the operating room and they had no say in the surgery, what would I do to their nose on my own? We take that imaging and I work with the patient for them to say if they want to push the bridge down, or move something closer, or add a bump. What’s really important to me is that they understand what is possible given their anatomy and what to expect exactly during healing. My goal is for it to be a truly collaborative process and give them a voice because not everybody wants the same thing. Because I have a lot of experience and use a lot of different techniques, I have the ability to tailor the result.”
That end result, regardless of the actual final shape or structure, is for her patients to look natural, but with an airbrushed effect. “A well done nose should have people look like themselves, but also create almost this type of really nice contour makeup,” she notes. “To me that means that the light hits you in a nice straight line down the center with a little shine at the tip of the nose — exactly as you would do contour makeup. A really well done rhinoplasty allows your eye not to focus on any harshness or irregularities, but rather your other beautiful features like your eyes and cheekbones.”
As you can imagine, anyone who’s seen that many noses over the years can tell you how trends in rhinoplasty have evolved — including which nose look she is extremely glad is on its way out. “The little baby nose, scoop nose look. I’m super happy that’s done. People are realizing that the lowered bridge kind of scoop look really doesn’t age great. It’s cartilage and bone pushing into the skin that can give us angularity, and when there’s not enough volume of cartilage and bone, it can look doughy.”
In its place, Dr. Liotta is seeing a return to a more natural nose. “A little bit of a straight bridge really ages better and the idea of it looking natural and looking like it breathes well is on the rise,” she says. “I have people coming in and saying specifically ‘I don’t want a scoop.’ I used to get people coming in with photos of someone like Natalie Portman, but now I see more pictures of Blake Lively and Ariana Grande’s nose. People will also bring in photos of Cate Blanchett as an example of someone who wants to keep a bump.” [Obligatory disclaimer: Dr. Liotta does not claim that any of these celebs have had rhinoplasty surgery].
When she speaks about the evolution of rhinoplasty, Dr. Liotta gives a small chuckle. “The nose literally has seven pieces — two bones, two sheets of cartilage, two ribbons of cartilage that make the tip, and the septum. All that you can do as a surgeon is rearrange and support those seven structures. It’s not the kind of surgery where you are going to have major, insane new advances, unless someone develops some kind of new implant out of a strange material. Advancements in rhinoplasty are more about understanding how our bodies heal and being proactive for issues that we see as life evolves.”
That said, she does note that social media and the upgrades in camera phones over the years have been a double-edged sword for plastic surgeons as they’ve allowed her patients to be more aware of how they look and better communicate what they like and don’t like. “As surgeons, [social media] makes us perfectionists that are even more critical of our own work because we see it from so many more angles. It makes me nitpick the tiny micro-millimeters of healing, which wasn’t a thing for older generations of surgeons. That pushes me to seek out more techniques and think even harder about tiny aspects of the nose that probably don’t even register to patients.”
Dr. Liotta’s hope is that one day soon plastic surgery will gain the same acceptance some other professional treatments enjoy today. And if any procedure is going to break through the beauty taboo barrier, she thinks rhinoplasty has the best shot at doing it. “I definitely think that people are more open about rhinoplasty, and I believe it’s rhinoplasty that’s going to be the first ‘acceptable’ facial plastic surgery to talk about,” she says. “I think people who can't breathe or people who have had a facial trauma like a broken nose are going to be the segue into talking openly about rhinoplasty. I do think rhinoplasty is going to be like the next Botox in that way of like ‘oh, who doesn't do that.’”