|
Frequently Asked Questions
About Rhinoplasty & Septoplasty
1. How do I know if I need rhinoplasty?
Am I a good candidate for rhinoplasty surgery?
2. How will I know what type of nose will look good on my face, and how do
I know I will get what I want?
3. Does rhinoplasty hurt?
4. Is septoplasty painful?
5. What type of anesthesia is available for rhinoplasty surgery?
Will I be awake?
6. How do I know I am going to the best doctor for my needs?
7. I am Asian (African-American,
Indian, Hispanic), should I go to an Asian
(African-American, Indian, Hispanic) surgeon to get the best results?
8. Will I be able to breathe after my surgery?
9. What are the risks of rhinoplasty?
10. How long do the bruises last?
11. How long does it take for the swelling to subside after rhinoplasty?
12. Will anyone be able to tell I have had rhinoplasty?
13. How much is rhinoplasty
(or septoplasty) surgery?
14. Is it possible to finance my rhinoplasty?
15. What if I need a revision?
16. What if I need another procedure to balance my face, such as a chin
implant or lip augmentation or lip lift surgery?
1. How do I know if I need rhinoplasty?
Am I a good candidate for rhinoplasty surgery?
Patients who are commonly interested in rhinoplasty feel their
nose is either too large, too small, or crooked for their face.
Only a skilled plastic surgeon can
determine if you are a candidate for rhinoplasty (or septoplasty) after
meeting with you and physically examining your face, however there are
requirements:
- Surgeons usually have a minimum age
requirement of 15 to 16 years. This is due to the growth
areas of the face and the age at which they are nearing
completion . Female patients normally reach physical nasal
maturity at 15, while males tend to reach physical nasal
maturity at age 16. You must also be psychologically mature enough to
understand the below requirements and the impact of an elective
surgery.
- You must be in good physical and mental
health. These are very important requirements and you should be
very honest with your surgeon.
- You must not be taking any medications
which would inhibit wound healing or increase the dangers of
anesthesia, and the surgery itself.
- You must not be pregnant or currently
nursing.
- You should be wanting
rhinoplasty for yourself, and no one else.
- You should have realistic expectations
about what can be achieved.
- You should realize that
rhinoplasty surgery will not make you popular, or change your
life. Although having a rhinoplasty may increase
your esteem in regards to your nose, it will not change who you
are unless this esteem is solely based upon the size of your
nose. Even then, if you do not have realistic expectations
or a healthy body image, rhinoplasty may be disappointing to
some. Rhinoplasty is only a surgery which can give balance
to the face.
- You must be willing to accept the
inherent risks of rhinoplasty surgery and the risks of
anesthesia. Please see our
Rhinoplasty Risks section.
- You must be willing to accept
that swelling can be prolonged and may fluctuate over the
following months after your procedure.
- You should be in a financial position to
possibly pay for additional expenses if complications arise.
- You must be willing to abide by your
surgeon's post-operative instructions and attend your follow-up
appointments to increase your chances of a positive outcome.
Back to Top
2. How will I know what type of nose will look good on my face, and how do
I know I will get what I want? A
handful of patients don't realize that their nose may be out of harmony with the
rest of their face, but feel that something looks "off". Although some
patients may meet with a surgeon and tell them exactly what they want to
achieve, not everyone will truly know what can be done and what would look best.
For instance, some patients may not need rhinoplasty at all, but rather have a
deficient chin and would benefit from a chin implant. A deficient chin
gives the appearance of a nose which is too large for the face. Plastic
surgeons are trained to determine what a patient may need.Back to Top
3. Does rhinoplasty hurt?
Recovery after cosmetic rhinoplasty is best
described as being uncomfortable, rather than being really painful, like having
a head cold. You have feel as though your sinuses are congested and you
may have a headache. Regular
icing and your prescribed pain medications should alleviate any discomfort you
may have. Sleeping elevated also considerably reduces the pressure and
will further ease and discomfort. Back to Top
4. Is septoplasty painful?
Septoplasty may be slightly more uncomfortable than rhinoplasty
due to the swelling of the septum. However, the above recovery factors
till apply to functional septoplasty surgery.Back to Top
5. What type of anesthesia is available for rhinoplasty surgery?
Will I be awake?
-
Local Anesthetics
If you have ever had an injection to numb the immediate area of your
body (such as dental work), you have had local anesthesia. Anesthetics such as
lidocaine or xylocaine are often used in conjunction with epinephrine.
The epinephrine narrows the bore of the blood vessel which in turn
prohibits much bloodloss and helps minimize the amount of
anesthetic that enters your blood stream. It is often used in
combination with IV sedation or even gaseous sedation. Local
anesthesia is used during your rhinoplasty surgery and is also is used
for non-surgical rhinoplasty. Local
anesthesia may also be used for in-office procedures such as suture
adjustment or scar revision.
-
Conscious Sedation, or Twilight Anesthesia
(Intravenous (IV) Sedation)
Twilight Anesthesia, is commonly used for
rhinoplasty surgery. Anesthetics such as Versed (midazolam), Diprivan (propofol) are
delivered directly into the bloodstream along with a saline bag by the
use of an IV catheter. It only takes a few seconds for the
anesthetics to take effect. Rhinoplasty procedures are normally
performed with the patient fully sedated. Discuss with
your surgeon the level of consciousness you will have. This
method is most often used due to the location of the treatment area.
-
General Anesthesia
General anesthesia is also common in rhinoplasty surgery.
General Anesthesia uses a combination of medications either
intravenously or via gas you will breathe during surgery. General
gaseous sedation is administered via a tube down your throat and also
with a medication which will be delivered via an IV, depending upon
your needs. The tube will keep the airway open and free and
clear and your breathing is monitored and stable. You will be intubated after receiving Twilight IV sedation so that you are unaware
of the intubation procedure. You will only fall asleep and wake
up just as you were when you were put under, unaware of the entire
process. General sometimes causes nausea post-operatively,
however there are medications which care administered either
beforehand or during to alleviate most patients of their nausea.
Please see our
Anesthesia
Information Section for more on this topic...Back to Top
6. How do I know I am
going to the best doctor for my needs?
Only you can determine if a surgeon is right for
you. Although please know that even great surgeons do not have the best
bedside matters. Unfortunately, a great bedside manner will not give you
the best result. We all want to have the best surgeon with the best
surgical skill and a great personality, but it isn't always so.
The pros of having a surgeon who has both is that better
communication is often experienced with surgeons who you feel listen to your
concerns and is more open to your thoughts as a patient. If you feel your
surgeon lacks good communication skills and doesn't have the best opportunity,
this doesn't mean he is not capable of giving you a great result, it just means
the both of you may fail to understand one another in regard to your desired
outcome. In the event of a revision or any disappointment, if you feel
your surgeon doesn't listen to you before your initial surgery, you are less
likely to have communication for a secondary surgery.
Again, a surgeon who may coddle you
and have a great sense of humor isn't necessary to achieve great results,
but it is important for you to be on the same page in aesthetics and have
good communication.
Meeting and talking with patients who
have had surgery with your desired surgeon, will help you further gauge
his/her results outside of a cherry-picked book of images. Although
be mindful of those who may be advertising for a surgeon, or the opposite,
trying to ruin his/her reputation for real or imaged reasons. I know this
sounds like a very difficult part of the process, but if you take your
time researching, consulting and listen to your instincts you will have a
better chance of determining who may be best for you. Back to Top
7. I am Asian (African-American,
Indian, Hispanic), should I go to an Asian
(African-American, Indian, Hispanic) surgeon to get the best results?
Not necessarily. Good aesthetics and skill are paramount,
as is experience with cases similar to your own. A surgeon's results , no
matter is heritage, will speak for themselves. Back to Top
8. Will I be able to breathe after my surgery?
You may find it difficult to breathe through your nose in the
interim. This may be due to packing, dried blood, mucous, and of course
the swelling. You will find that unrestricted airflow will fluctuate
throughout your healing process. In fact, you may notice decreased airflow
after exercise, after eating spicy foods, or due to allergies even well into the
recovery process.Back to Top
9. What are the risks of rhinoplasty?
- Lidocaine toxicity, which is
normally uncommon due to the small amounts of lidocaine used in
rhinoplasty.
- laryngospasm
- bronchospasm
- aspiration
- intubation injury
- pulmonary edema
- respiratory arrest
- asthma flare-up
- Cardiovascular complications may include:
- myocardial ischemia/infarction
- myocardial ischemia
- myocardial infarction
- cardiac failure
- cardiac arrest
- hypotension.
- Hematoma: A collection of blood in the
treatment area or surrounding area
- Seroma: a collection of fluid in the n the
treatment area or surrounding area
- Allergic reaction to any medications
administered during the procedure
- Heart palpitations due to pre-existing
disorders or as a reaction to any medications administered during your
procedure
- Difficulty breathing due to pre-existing
disorders or as a reaction to any medications administered during your
procedure
- Cardiac
arrest: or heart failure due to
pre-existing disorders or as a reaction to any medications administered during
your procedure
- pulmonary thromboembolism, embolism (blood
clots going to the lungs, heart, brain)
- Nerve damage
- Bacterial infections due to bacteria
introduced during surgery or during recovery with improper aftercare.
- necrosis (tissue death) due to blood supply
disruption during surgery or due to considerable swelling, or extensive and
improper icing techniques.
- suture opening due to post-operative injury
or considerable swelling
- bleeding
Back to Top
10. How long do the bruises last?
Bruising may last up to 3 weeks in severe cases or
in patients who tend to bruise easily and heal slowly. Some bruises may
develop into permanent discolorations which must be treated with Intense Pulsed
Light, laser peels, medications, or chemical peels over time.
Some surgeons feel that arnica
montana or bromelain may help swelling and bruising, and that after the
first 48 hours, alternating from cold to warm compresses every 15 minutes
will help with bruise dissipation and fluid removal. Please ask your
surgeon how he/she feels about alternating between warm and cold
compresses.Back to Top
11. How long does it take for the swelling to subside after rhinoplasty?
The initial swelling, the most noticeable, usually subside within
3 months, prolonged swelling that only you may notice may last up to a year.
You may notice fluctuations in the amount of swelling if you do not properly
elevate your head during the recovery period. Spicy foods and exercise, as
well as allergies may also increase swelling for short periods of time.
Most outsiders will only notice in
the interim, especially with presence of bruising, but as you heal, they
usually will not notice like you do. Most people are not that
observant, save for people who see your face every day. And even
then your nose may just appear to them to be the size it was prior to your
procedure.Back to Top
12. Will anyone be able to tell I have had rhinoplasty?
This depends upon whether or not you tell anyone (so
they will know to look for it), if they see you with a cast and bruises (which
is obvious), or how long after your procedure you are in the public eye.
Proper head elevation and icing techniques will help the swelling dissipate
faster. Styling your hair differently
around the same time of your procedure can divert attention from
your nose. Back to Top
13. How much is rhinoplasty surgery?
Rhinoplasty costs vary from surgeon to surgeon and region to
region. If you are having corrective surgery, your insurance may cover some of
the costs. The average cost of a rhinoplasty ranges from $4,000 to $7,000,
higher for a septoplasty/rhinoplasty surgery or for secondary and tertiary
revision rhinoplasty.Back to Top
14. Is it possible to finance my rhinoplasty?
Patient financing is available in most plastic surgeon offices.
Even if your surgeon does not offer patient financing, you may qualify for a
personal loan. However, I personally feel that you should be in a
financial position to cover complications in the event that they arise.
Cosmetic surgery is often higher than expected due to medications, recovery
items, time needed off of work, etc.Back to Top
15. What if I need a revision?
You should not consider revision in the first few months after
surgery unless there is complication. Swelling can last for quite a while
with rhinoplasty surgery and you will not be able to truly gauge your end result
for about 7 to 9 months. Many surgeons have their patients wait 9 months
to consider a revision surgery for this very reason.
You should also determine what your
surgeon's revision policy is. This is a double edged sword as we all want
to remain positive and don't wish to rock the boat prematurely (asking a
surgeon if he will cover a revision before you even have gotten on the
table may raise flags in his/her eyes and also pre-maturely create
a negative mindset for yourself before you even have the original surgery.
Take care in this discussion, however any great surgeon will understand
your normal concerns.
Just remember, cosmetic surgery is surgery. Your nose is not made of clay
and cannot be molded into perfection, nor should you expect it to be. But
you should expect improvement and understanding from your surgeon. While
he or she may have performed rhinoplasty 1000s of times and may seem
desensitized, this is your first (or second) and you should be able to voice
your concerns in a comfortable atmosphere.
Also, please realize that rhinoplasty can have a great impact on
those who are older. Reason being, one grows quite accustomed to the
appearance of their nose, every day in the mirror, feeling it with their hands
as they wash their face. Changing this foundation can trigger regret or
being undecided if the change is positive. Even though you are changing only
your nose (if applicable), this will change the way you see your whole face.
Computer Imaging can help you envision what your nose may look like after
surgery. Hopefully your surgeon offers this, or is open to your bringing
photos which have been altered to convey your desires.Back to Top
16. What if I need another procedure to balance my face, such as a chin
implant or lip augmentation or lip lift surgery?
Changing your nose may or may not cause you to closely inspect
other areas of your face. From experience, I can tell you that after you
take the first jump, the second is easier. Having a smaller nose which does not
stand out as it once did may trigger you to fixate on your lips or chin, which
may now appear small or large. Whatever the case, you and your surgeon can
discuss other areas of concern at your consultation. While you are never
expected to have more procedures than you are interested in, some surgeons may
suggest another procedure to complement your rhinoplasty. This is not
because he or she wants more of your money, it is because he or she feels that
it will create better balance and further enhance your result. Back to Top
|
