Frequently Asked Questions About Rhinoplasty

[ilike]

1. What is Rhinoplasty?
2. When can rhinoplasty be performed?
3. What does a typical Rhinoplasty consultation entail?
4. How is Rhinoplasty performed?
5. What should I expect post-operatively?
6. When will the cast be taken off and does this hurt?
7. When will I be able to see the results?
8. What are the risks of Rhinoplasty?
9. What are Arnica montana and Bromelain homeopathics, I have heard that it reduces swelling and bruising? Which is the best kind to take?
10. Are there any new techniques to repair a deviated septum. Is cauterization used? Does the nose always have to be packed after surgery?
11. I am 16 and have been thinking of rhinoplasty for a long time. At what age is it safe to have a rhinoplasty?
12. I'm getting a deviated septum and a hump fixed all in one and I wanted to know what kind of scarring I should expect. Also, how long is it after the operation that I'll see good results?
13. How much would a rhinoplasty, without insurance ect...be? Is the average price range like $5000 to $6000?
14. It's been five months since my surgery and now since I started to get back in shape and returned to my gym. I have notice that when I run and workout my nose drips. It is very runny, here I am walking away and every few min. I have to use a tissue. Is this just part of the healing stage or need I bring this up to my doctor? Its really annoying! Has anyone experienced this at all?
15. My PS mentioned a shot of cortisone to help some of the scar tissue. Why is this and what will this do?
16. I'm going to get my nose done soon and my doctor also recommended me getting a chin implant because he says my nose will still appear 'big' since my chin goes a little further in then it should...Do people get both these procedures at the same time? And do you recommend I should do this?
17. I have to get my cast off soon and wanted to know if it is going to hurt? Is there anything I can do beforehand?
18. I have thick nasal skin and a surgeon I spoke with said that I may not be able to see much detail with my rhinoplasty? Is this true? Should I see another surgeon?
19. Is it improper to ask to speak with previous patients who have had revision rhinoplasty done by the surgeon I am considering for the same procedure?
20. What is a "hanging columella"?
21. Is it possible for someone to be allergic to dissolvable stitches? And if so, what would the reaction be?
22. I had a rhinoplasty done around 13 years ago and since then I have experienced impaired breathing. When I sleep on one side, the upper nostril seems to collapse a bit and obstruct my breathing. Can this be corrected? and How?
23. Do you have advice for African American persons on picking a PS?
24. Can Pollybeak deformity be corrected? How is this done?
25. I used to be addicted to cocaine. As a result, my past (I'm recovered) addiction left a hole inside my nose, between my nostrils. Can I have the hole filled?
26. I recently had a rhinoplasty & septoplasty, its almost 6 months & on one of my nostrils I still can hardly breath. Is this normal?
27. How much does rhinoplasty cost?

[ilike]

1. What is rhinoplasty?

Rhinoplasty is cosmetic surgery of the nose. It is also known as nasal refinement and the layman's term. nose job. With rhinoplasty, 'defects' from either birth or trauma can be corrected by infracturing or breaking the bones of the nose and re-setting them narrower and straighter. Outfracture is when the bones are broken and moved out to widen the nose.

A hump may be removed to give a more pleasing, symmetrical look. The cartilages of the nose can be molded and trimmed to create a more compact or pleasing shape. Rhinoplasty can soften an otherwise beautiful face by refining one's features.

[ilike]

2. When can rhinoplasty be performed?

Extensive nasal surgery is generally avoided in children. There are major growth centers in the nose that affect the growth of the face. In cases of severe disfigurement due to accidents, surgery is performed in an attempt to restore the alignment of those centers. For lesser deformities surgery is deferred until after the child stops growing. Rhinoplasties performed on teenagers and young adults, it seems, are often beneficial to the social development and self confidence of the individual. The aging process is reflected in many ways in the nose and its correction can add youthfulness and freshness to the appearance.

[ilike]

3. What does a typical Rhinoplasty consultation entail?

First, your doctor will discuss your goals with you and he will explain what can be achieved realistically. A good doctor will not just slim your nose or shorten it, rather he will take into account what your facial features and bone structure would benefit from. Be it a slimmer more defined or perhaps more turned up. Perhaps it is only a hump that is desired to be removed, making it unnecessary to even have a Full Rhinoplasty. There is no "one size fits all" when it comes to this procedure. It is all individual. Just like you!

[ilike]

4. How is Rhinoplasty performed?

Usually, Light Sleep Anesthesia is utilized. A Rhinoplasty can also be performed under General Anesthesia. The patient usually arrives early and medications are administered and supplemented with intravenous medication. After you are asleep and your vital signs are determined as safe and stable, local anesthesia is then applied to the nose. Surgery generally lasts about one and a half hours. The patient experiences no pain during the surgery.

A splint or cast is applied and will be worn for approximately 7 days. Many patients remember very little about the surgery. After the procedure is completed, the patient then recovers in a relaxed environment and monitored for a couple of hours before being driven home by a companion. You absolutely can not drive yourself home after a ANY procedure.

[ilike]

5. What should I expect post-operatively?

After your surgery your surgeon will have placed a pressure dressing over your eyes and a gauze pad underneath your nose to catch blood and mucous. You will remove the pressure dressing after a few hours or as specified by your surgeon. You may become sick from ingested blood during the procedure and vomit, expelling a black mixture of stomach acid and blood. This will pass as soon as the blood is expelled. It really isn't that much so you shouldn't be sick for long unless you were under general anesthesia -- you may become sick from this alone. Your doctor can give you special medications to remedy or prevent this. If you continue to vomit and/or run a high fever, contact your doctor immediately.

You nose will be sensitive for approximately a month and a half although patients report no serious pain or discomfort. However, patients do report the discomfort of breathing with the packing and cast on the nose. Some patients feel claustrophobic feeling as if they cannot breathe. This feeling widely resembles a head cold or sinus infection. Only when the cast is removed do you feel slight discomfort, unless you bump it accidentally.

[ilike]

6. When will the cast be taken off and does this hurt?

The cast is removed approximately 7 days post-operatively. You may feel a slight stiffness in the upper lift as the swelling moves downward. This will subside in a matter of hours. you must be very careful not to bump it as it is vulnerable to breakage. It isn't a bone china figurine but it isn't as strong as your nose was before the rhinoplasty either. Don't worry, the bones will completely mend within 2 months.

If you had a rhinoplasty where the nostrils were narrowed (in the case of flared nostrils) you will have your sutures removed. This may sting a bit, especially since it is in a sensitive area. Although most patients still feel numb in the tip area and report only minor discomfort.

[ilike]

7. When will I be able to see the results?

The nose will be very sensitive for approximately a month and a half. The patient will start to see a difference immediately but it will still be swollen. The swelling starts to generally disappear about a week after the cast is removed. Approximately 80% of the swelling and 100% of the discoloration are usually gone by 2 weeks after surgery. 90% of the swelling is gone by two months after surgery and the rest slowly disappears over the next year. Although the nose is still swollen after the first month, most people would not recognize this fact. The patient will not notice this swelling. Instead the patient will notice that the nose becomes more refined with better definition over the first year. The inside of the nose may be swollen for approximately three weeks after the surgery. Nasal breathing may be difficult during this time. If surgery is performed to straighten the nasal septum, an improvement in breathing will be appreciated at about 3 weeks.

[hemalatha]

8. What are the risks of Rhinoplasty?

It is possible to develop tiny red marks and spots, this can be the result of blood vessels that may have burst under the skin's surface during the surgery. Although this is extremely infrequent it can happen and the spots may not ever go away. Scarring is minimal if the incisions are made inside of the nose, however when an open technique is used, or if narrowing of the nostrils is desired the scars made on the outside of the nose may be visible for am undetermined amount of time (usually until maturation). Even when a highly skilled surgeon performs your surgery, sometimes your body may not heal correctly or have adverse reactions causing undesired results. If so it is quite possible that additional surgeries may be needed. Some patients will lose their sense of smell, temporarily. Your nose may be slightly swollen and for over a year. Scar tissue may heal in a way that may cause a whistling sound to be heard when you breathe in and out.

This surgery has the highest rate of revisions. It seems that some people, especially mature people, may not readily accept the new look. Being accustomed to their old nose, they just can't seem to comfortably make the transition. Although there are a few rhinoplasties that just don't heal correctly, due to something as serious as human error (the surgeon's) or as simple as not having your head elevated enough or sleeping on one side a lot without a proper cast. The nose can pull to one side if the cast does not support it properly in the first week. Or quite simply, your body may just heal that way.

[hemalatha]

9. What are Arnica montana and Bromelain homeopathics, I have heard that it reduces swelling and bruising? Which is the best kind to take?

also known as: Mountain Tobacco, Leopard's Bane.
parts used: Roots, flowers.
description: Arnica montana or Leopard's Bane is a perennial herb, growing close to the ground. The leaves form a flat rosette, from the center of which rises a flower stalk, 1 to 2 feet high, bearing orange-yellow flowers. The rhizome is dark brown, cylindrical, usually curved, and bears brittle wiry rootlets on the under surface.
habitat: Indigenous to Central Europe, in woods and mountain pastures, although it has been found in England and Southern Scotland.

Arnica Montana is an herb which grows wild in the Swiss Alps and has been used as a part of European herbal medicine for over a thousand years for the reduction of bruising and swelling and to shorten the recovery period after physical trauma.

Every Plastic Surgeon should inform each of their patients prior to surgery that bruising and swelling are natural consequences of the surgical procedure which the patient has decided to undergo. Each patient will respond individually with more or less bruising and swelling, but each patient will experience both of these symptoms in some degree. There is more or less bruising and swelling depending on many factors including, the type of procedure, the age and overall health of the patient, whether the patient is a smoker, the patient's inherent tendency to bruise easily, and many others. Arnica montana has been shown to dramatically improve the tendency to bruise and cuts significant swelling almost 80% if taken in pharmaceutical grade strengths.

One such product we recommend is SinEcch. SinEcch speeds healing after a planned trauma like plastic surgery. It has also been used before undergoing medical operations such as hernia repair, intestinal disorders and more. SinEcch will significantly reduce both bruising and swelling for most patients gently and safely.

SinEcch is a set of 12 capsules on a blister card with the information about when to take each dose printed right on the card. The dosage regimen is custom designed to match the level of bruising and swelling which most patients experience in the most common plastic surgery procedures, facelift, rhinoplasty (nose surgery), blepharoplasty (eyelid surgery), liposuction, etc.
Bromelain
from the plant of the: Pineapple
also known as: Ananas, Nanas, Pina
plant family: Bromeliaceae
type: herbaceous perennial
parts used: mostly in the stems of pineapples, but some fruit is used as well.
description: 2 1/2 to 5 ft. high with a spread of 3 to 4 ft. The plant is like a thick stem with a rosette of wide, waxy leaves. These pointed green, red, and white/off white striped leaves are approximately 18 - 70 inches long and graced with a spiny needle-like tip. The plant produces a sweet to tangy and sometimes sour fruit that is yellow to white in color. The unpeeled fruit is brownish with a hard, spiky covering and a large green sprout from it crown. The fruit is shaped like a coffee can with rounded ends and is about 10-12 inches long usually when considered prime and may even weigh up to 10 lbs.

habitat: Indigenous to southern Brazil and Paraguay, The fruit is now grown all over in green houses and in the fields of Spain, Guatemala, Hawaii and more. The pineapple is a tropical plant and thrives in hot, humid places. Although it can survive cold snaps, it is not recommended for the more northern areas if intended to be grown outdoors.

Bromelain is an anti-inflammatory formula containing the proteolytic enzyme from the stems of pineapples. Proteolytic enzymes are capable of dissolving proteins. It is most often used after sports injuries, to relive edema and after surgical procedures to help with swelling.