The nose is the central feature of the face, and its loss — whether from cancer surgery, trauma, or a congenital condition — has a profound effect on both appearance and daily function. A custom nasal prosthesis restores the shape, color, and contour of the nose using medical-grade silicone fabricated and tinted to blend with the surrounding skin. At Ocean Breeze Prosthodontics in Boynton Beach, Dr. Nicholas Goetz designs and delivers nasal prostheses as a fellowship-trained maxillofacial prosthodontist, one of approximately 150 in the United States with this credential.
A nasal prosthesis is a custom-fabricated, patient-specific artificial nose made from medical-grade silicone. It replaces part or all of the external nose that has been lost due to cancer surgery, traumatic injury, or a congenital condition, and is retained using medical adhesive or osseointegrated implants. Because the nose occupies the center of the face and is visible at all social distances, nasal prosthesis fabrication requires both clinical precision and artisan skill in color matching and surface texture replication.
Nasal prostheses are an established component of maxillofacial prosthetic rehabilitation. According to the National Cancer Institute, head and neck cancer treatment can significantly alter facial appearance, and prosthetic rehabilitation is a recognized part of cancer survivorship care. At Ocean Breeze Prosthodontics, Dr. Goetz evaluates each patient’s defect anatomy, retention options, and aesthetic goals before fabricating a prosthesis designed to integrate as naturally as possible with the surrounding facial features.
Porcelain veneers are thin ceramic shells — typically 0.3 to 0.5mm — custom-fabricated to bond to the visible front surface of a tooth. They are a minimally invasive solution for patients who want to improve appearance without significant tooth reduction. The porcelain material resists staining, reflects light naturally, and integrates with surrounding teeth in a way that composite alternatives cannot replicate long-term.
Veneers are well-suited for correcting a wide range of cosmetic concerns, including tooth discoloration that doesn’t respond to whitening, chips or cracks affecting the front teeth, minor gaps between teeth, teeth that appear uneven in length or shape, and worn enamel that has changed the look of your smile. According to the American Dental Association, candidates should have good underlying gum health and sufficient enamel before placement — Dr. Goetz evaluates both before recommending any veneer treatment.
Nasal prostheses can be retained with medical-grade silicone adhesive or osseointegrated implants placed in the nasal bones. The right approach depends on the extent of the defect, available bone, radiation history, skin condition around the defect margins, and patient lifestyle. Dr. Goetz evaluates all of these factors before recommending a retention method.
Adhesive-retained nasal prostheses are secured with medical-grade silicone adhesive applied to the skin each morning and removed at night. No surgery is required, and this approach is appropriate for patients who are not implant candidates due to bone availability, radiation history, or personal preference. Adhesive retention is more susceptible to displacement in heat and humidity, and the silicone requires replacement every one to two years as pigmentation fades. The margins of an adhesive-retained prosthesis require particularly careful feathering during fabrication to minimize visible edges against the surrounding skin.
Implant-retained nasal prostheses attach to osseointegrated fixtures placed in the nasal bones or adjacent maxillary bone, providing secure retention through bar, magnet, or clip attachment systems. This eliminates daily adhesive management, reduces skin irritation at the margins, and provides more consistent seating. Implant retention is typically preferred for patients with adequate bone and no contraindication from radiation. Dr. Goetz evaluates bone volume using CBCT imaging and works with the surgical team if implant placement is required before prosthesis fabrication.
Nasal prosthesis fabrication begins with detailed impressions of the defect site to capture its exact contour and dimensions. For partial nasal defects, the remaining nasal anatomy is documented and used as a reference for symmetry. The prosthesis is sculpted in wax and evaluated at a try-in appointment before processing. The final prosthesis is fabricated in medical-grade silicone with intrinsic pigmentation applied throughout and extrinsic tinting at the surface to replicate the translucency, texture, and subtle color variation of natural nasal skin.
Partial nasal prostheses replace a portion of the nose — the nasal tip, one nasal ala, or a larger segment — while integrating with the remaining intact nasal structure. These cases require the most precise margin design because the prosthesis must blend seamlessly where it meets living tissue. Total nasal prostheses replace the entire external nose and are designed as a self-contained unit. Both types require the same level of artisan fabrication, but partial prostheses demand greater attention to the transition zone between prosthetic and natural tissue. Dr. Goetz evaluates which approach is appropriate based on the extent of the defect and the condition of the surrounding skin.
Nasal prosthesis fabrication requires a clinician trained in both the clinical complexity of post-surgical anatomy and the artistic demands of replicating the face’s most central feature. Dr. Nicholas Goetz completed his Maxillofacial Prosthodontics Fellowship at UCLA, where extraoral prosthetics — including nasal, auricular, and orbital prostheses — are a core component of the training curriculum. Dr. Goetz holds a DMD and MS from the University of Florida, where he completed his Prosthodontic Residency. He is one of approximately 150 board-certified maxillofacial prosthodontists in the United States, with clinical experience at U.S. Army and VA Medical Hospital settings treating patients with complex facial rehabilitation needs. For Boynton Beach patients facing nasal loss from any cause, that background means the prosthesis is designed by a clinician who has trained specifically for this level of care. — it requires a clinician who understands how teeth function under load and how restorations integrate with the full bite. Dr. Nicholas Goetz brings that depth of training to every case he plans in Boynton Beach.
Dr. Goetz holds a DMD and MS from the University of Florida, where he completed his Prosthodontic Residency, and followed that with a Maxillofacial Prosthodontics Fellowship at UCLA. He is among approximately 150 board-certified maxillofacial prosthodontists in the United States — a distinction that reflects training well beyond the scope of general cosmetic dentistry. His background includes clinical work with the U.S. Army and VA Medical Center.
For patients considering veneers, that background means the planning process accounts for bite mechanics, gum tissue health, and long-term durability alongside the cosmetic design — so the final result looks as good at year 15 as it does at placement.
We believe financial concerns shouldn’t keep you from treatment that can change your daily life. Ocean Breeze Prosthodontics offers flexible financing options so the path to a complete smile feels manageable from the very first visit.
While we are not in-network with insurance companies, we’ll still help you get the most out of your plan. We file claims on your behalf and assist you in securing any reimbursement your PPO plan allows.
Candidates include patients who have experienced partial or total nasal loss due to skin cancer, oral cancer surgery, trauma, or a congenital condition. Patients for whom surgical nasal reconstruction has not been performed or has not achieved the desired aesthetic result are also appropriate candidates. Dr. Goetz evaluates the defect, skin condition, bone availability, and medical history before recommending an approach.
With proper daily cleaning and care, a nasal prosthesis typically remains in good condition for one to three years before pigmentation fades noticeably. Implant-retained prostheses generally have a longer functional lifespan than adhesive-retained alternatives. Dr. Goetz monitors prosthesis condition at follow-up appointments and advises on replacement timing before change becomes visible at social distances.
For most patients with adequate bone and no radiation contraindication, implant retention provides better stability, less daily management, and lower skin irritation at the margins than adhesive retention. Dr. Goetz evaluates each patient’s anatomy and medical history before making a retention recommendation. Where implants are not appropriate, a well-fabricated adhesive-retained prosthesis with carefully feathered margins remains a highly effective solution.
Radiation affects bone vascularity and can reduce implant osseointegration reliability at the nasal site. Dr. Goetz reviews radiation field location, total dose, and time elapsed since treatment before recommending implants for patients with a radiation history. In some cases, hyperbaric oxygen therapy before and after implant placement may be recommended to support healing in irradiated tissue.
Nasal prostheses are often covered under medical insurance when nasal loss resulted from cancer surgery, trauma, or a documented congenital condition. Submit to both your dental and medical plans. Ocean Breeze Prosthodontics is a fee-for-service practice and participates as an out-of-network provider with PPO plans — our team files claims on your behalf. Flexible financing options are also available.
Dr. Goetz is one of approximately 150 board-certified maxillofacial prosthodontists in the United States, with fellowship training at UCLA that specifically included extraoral prosthetics for patients affected by cancer, trauma, and congenital conditions. Patients come to Ocean Breeze Prosthodontics from throughout Palm Beach County and surrounding communities for nasal prosthetic care that requires this level of specialist training.
Schedule your consultation at our Boynton Beach office today, or call (561) 265-1998 to speak with our team.
**Requested time is not final until you receive confirmation from our office. Please do not submit any Protected Health Information (PHI).
"*" indicates required fields
