Overview

The aesthetics of the face are often said to be in the eye of the beholder, but some aspects appear to be accepted universally.It is not possible to enhance a nose cosmetically without understanding of nasal anatomy,patient aspirations,available techniques and possible ethnic characters,cultural trends & surgical pitfalls. It is said that if Cleopatra's nose would have been less sharp;world history Would have been different.

Concepts of beauty cannot be defined scientifically. They change ethnically, regionwise, societywise. They Change from time to time.

Aesthetics of Nose

In our society,young people want nose to be straight, long,narrow with sharp pointed tip if possible.it is very important to remember that cosmetic surgery can improve/enhance your looks but it cannot change your face totally to look like some actress or actor whom you adore.

From the side, the bridge is straight in the male and may be straight or have a mild sloping in the female. The tip comes straight out or has a slight upturn. From the side, the tip makes a 100 degree angle with the upper lipThe tip is no wider than the bridge. From the front, the bridge is well-defined. The nose is straight and symmetrical . The outer skin of the nostrils is no wider than the inner corners of the eye. The shape of the skin that forms the nostrils has a roundness that compliments the tip. The tip is defined. The edges of cartilage bring it to a clear point.

Comment

In no other structure than the nose are the rules of beauty so variable. In general, the smaller the nose the better. Classically, the nose is meant to breath and not be seen. We adorn the eyes and the lips to increase their beauty, but the nose is not considered a center of beauty. Again, ethnic variations and different characteristics may lend unique positive qualities to different noses. Exceptions to these rules are common.

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Self-Evaluation

Have a picture taken of your nose. Face only. One straight from the front and one directly from the Draw on the profile photo and erase or increase the bridge as desired. Does the tip come out too far from your face? Maybe the tip doesn't come out far enough. That is a problem with projection. Is the tip too high or too low? That is a problem with rotation. Check the front view. Is the crest of your nose straight? Does the tip point in one direction? . Are the nostrils symmetric? Do they pass the corners of your eye? Is there definition in your nose? Is the base too broad and flat? Is the tip too round and bulbous?

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How Much Can Be Improved?

Nose can be changed up to a point If the nose is made too small breathing problems can develop. The smaller the nose, the harder it may be to breath. This is particularly the case if the base is reduced too much. Thick skin can limit the appearance of definition in the nose. Very thick skin can be thinned but mildly thick skin may not be worth the risk. . Scarring can occur at the bottom of the nose if the nostrils are reduced. The more skin removed, the more tension on the tissue, and the worse the scarring. Otherwise, all of the surgery can be done from inside the nose. The breathing can always be improved by increasing the size back to the original conditions. It amazes me how many patients would rather suffer with a blocked nose than have it widened again! . A perfectly straight nose can be achieved 95% of the time. Proper tip height as well. Tip definition and other features can all be improved 95% of the time as well.

Reasons for rhinoplasty can be few or many. It is important to know what can and cannot be changed and what rhinoplasty can and cannot do for you. Just remember, be sure to have proper communication with your surgeon - it is easier to take away than to add after the fact.

We will cover the most common reasons for rhinoplasty - both realistically and irrationally. We will start with the common complaints regarding physical attributes.

Typical complaints

  • Too large
  • Too flat
  • Too humped
  • Too wide or fat
  • Too thin
  • Too long
  • A bifid (BEYE-fid) tip (where there is a ditch between the two tip cartilages, sometimes horribly referred to as "buttnose")
  • Too short
  • Too pinched looking
  • Scooped
  • Hanging columella
  • Breathing problems
  • Crooked
  • Asymmetry, in general
  • Bumps
  • Deficient chin
  • Dents
  • Scar tissue build up from breaks
  • Hooked
  • "Piggish"
  • Pointy
  • Bulbous
  • Not angled enough
  • Angled too much
  • Deficient jaw/mandible
  • Weak or prominent maxilla (upper jaw)

Dr. Chaudhari has facility to offer state- of-the-art Computer Imaging. Computer imaging of the face allows you to fully describe to the surgeon what is desired, and for the surgeon to illustrate what is possible.

After pictures are taken by digital camera, a computer is used to work with your image and portray any desired changes. This is very useful for profile changes such as in Rhinoplasty (cosmetic nasal surgery), Facelift or Chin augmentation. In certain cases, we can show you several different possibilities which can then be discussed with Dr. Chaudhari. A final image that you like and which is attainable surgically is then decided upon as your goal. These images give you a good idea of the expected outcome of surgery. The best part about computer imaging is that it allows you to communicate to your surgeon exactly what you want. It allows patients to see the expected results of surgery before having the operation. A picture is worth a thousand words and computer imaging is an efficient way to help patients decide whether the likely result is worth the cost and discomfort of surgery.

Insertions

  • Medications
    • If you are taking regular medication check with dr regarding taking your medication on the day of surgery. If dr instructs you to take your medication on the morning of surgery, do so with a sip of water (no juice or other liquids).
    • Do not take any vitamin e once booked for surgery and after surgery for two weeks.
    • Do not take aspirin or any medication which contains aspirin for 10 days before and after your surgery. Please check the labels of any medications you take (even those available without a prescription) to make sure they do not contain aspirin (or acetyl salicylic acid).
    • Please check our additional list. If you are not sure ask your doctor or pharmacist. Taking aspirin will increase your tendency to bleed at the time of surgery. Hormone replacement therapy should also be stopped before surgery. You will be instructed when to restart it.
  • What to wear
    • On the day of surgery, wear loose fitting clothes which do not have to be put on over your head and low heel shoes. No panty hose/tights. Do not wear make-up or nail polish or cosmetics. Bring scarf and sunglasses to wear after your operation.
    • Contact lenses cannot be worn in the operating room, wear glasses.
    • Leave all valuables and jewellery at home. Although you will be provided with a locker for your clothing while you are in surgery, the Hospital cannot be responsible for any valuables or jewellery misplaced or lost.
  • Smoking

    Smokers should try to stop smoking from the time of the surgery booking. Smoking irritates nasal passages and causes coughing which might bring on a bleed several days after your operation. It is also a contraindication with General Anaesthesia. Smoking also slows healing due to a decreased blood supply to the operated area.

  • Pre & Post-Operatively

    Report any signs of cold, infection, boils or pustules, fever, appearing before surgery.

  • Transport Instructions
    • You must not drive home after your operation. You should make arrangements for a responsible person to accompany you home after your operation. If you live more than an hour's drive from the hospital, we recommend you arrange to stay in Sydney for your post-operative night.
    • After surgery do not remove bandages or splint unless instructed to do so.
  • The Night/Day Before Surgery
    • Start taking medicines as directed by doctor.
    • Shower and wash your face with mild soap, shampoo your hair. Remove all make-up, nailpaint, jewellary & bangles.
    • Do not cream your face afterwards.
  • The Morning of Surgery
    • Light breakfast.
    • Always shave the operative area as advised & have bath.
    • Your pre-operative medication will be given to you after arrival and ordered.
    • Take medications as prescribed. Check with the surgeon and the anaesthetist.
    • Plan to be at the clinic at the time required.
    • Please do not hesitate to call during regular office hours if you have further questions about these instructions.
    • Do not take anything valuable to the hospital.
    • Take something to relax you while you wait e.g. magazine, book, walkman.
  • Pre-Operatively

    Pre-operatively please attend to the following highlighted points.

    • Blood tests.
    • Chest X-ray (45 years and over, history of heart/lung disease or smoker).
    • ECG (45 years and over)
    • Photographs.
    • Consent forms signed.
  • Pre-OP Drug Instructions

    Prescription given by Doctor. N.B. If you have any questions about drug instructions please call the clinic. Check with your doctor or nurse regarding regular medications.

    • The typical Rhinoplasty Surgery day
    • Rhinoplasty surgery is the name for a group of operations. Each component is chosen and modified for your specific nose. Many different three-dimensional problems can be addressed by such sculpting. Some inherit their nasal shape, while others get theirs from trauma and injury. Many patients also need breathing obstruction issues addressed. Not all patients are aware of their nasal obstruction. During Dr. Chaudhari consultation with you he will try to learn what your concerns are and help you learn what surgery realistically has to offer.

    • Preparing for your surgery
    • Dr. Chaudhari will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly. While you're making preparations, be sure to arrange for someone to drive you home or your hotel room after your surgery and to help you out for a few days if needed. Where your surgeon may be performed in our office state of the art operating room, an outpatient surgery center, Dr. Chaudhari works. It's usually done on an outpatient basis;no admission is required.

    • Anesthesia for Rhinoplasty
    • Rhinoplasty can be performed under local anesthesia, & mild sedation. With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; you'll be awake during the surgery, but relaxed and insensitive to pain.

    • The Surgery
    • Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and Dr. Chaudhari's preferred technique. Finally, the skin is redraped over the new framework. If your nostrils are too wide, small wedges of skin are removed form their base, bringing them closer together.

    • Open vs. Closed Rhinoplasty
    • Most nasal surgery is done from inside the nose. Several cuts are made in the nostrils depending on what needs to be done. In open rhinoplasty, the cuts start just inside the nostril and extend over the columella (the post between the nostrils). Surgeon usually makes a stair step incision over the columella. This external scar visible from below is usually not significant. When the two nostril incisions are connected, the nasal skin can be elevated exposing the anatomy of the nose. Particularly effective for nasal tip and complex septal problems, the deformity can be addressed with the structures in their natural anatomic position. The cartilage and bone are sculpted under the skin.

      Closed rhinoplasty depends on incisions inside the nose only. There is no incision made across the skin of the columella. When the tip needs to be modified, it must be delivered through the nostrils and worked on in the delivered deformed position. View graphic pictures of the exposure of open rhinoplasty.

  • Immediately After Surgery
    • Sleeping
    • - First night Stay in the company of a responsible adult. Rest quietly in bed after surgery, with the head straight and elevated on two pillows.

    • Swelling & Bruising
    • - Gauze squares soaked in a bowl of ice water makes good ice compresses as it is not heavy on the eyes & over cheeks.

      - Continuous compresses are to be continued for 48 hours without fail and are one of the most important aspects of your immediate post-operative nursing care.

      -Then ice is to be used intermittently for 1 week.

    • During the first week of surgery
      • Restrict talking and laughing.
      • Avoid lots of visitors. Rest quietly, working at a minimum.
      • Do not strain or do anything which requires significant effort.
      • Avoid making a lot of head movements.
    • NASAL CARE - After removal of the packs

    • Initial wound care
      • Your nose will feel stuffy when you wake up as you may have nasal packing or a nasal splint. This will resolve when removed in a few days.
      • Folded gauze secured with tape will be placed under the nose to catch drops of blood in the first 24 hours. Change as required.
      • You will have a nasal splint or tape on your nose. Do not disturb this until reviewed by your doctor.
      • Do not put anything up your nose, not even cotton buds.
    • Wound care after day 3-4

      Once the doctor has reviewed your nose and removed your packs

      • Clean the edge of the nostrils or stitches with ¼ strength hydrogen peroxide and ¾ strength normal saline using cotton buds.
      • Apply antibiotic ointment to the edge of nostrils and any stitches that you may have.
      • Your external splint will remain on for 1 week. Note: If you had a graft, it may stay on for 10 - 14 days.
      • After the splint has been removed, the nose is to be taped daily with Micropore for 1 week. The tape is to remain on overnight along with the splint. Note: It can take a good six weeks for the bones to set.
      • Following this, tape the nose for 4 weeks at night only and wear your splint over the top to protect the nose while sleeping.
    • Hygiene
      • Bathing - You may bathe 24 hours after surgery. Do not get the bandages or nose wet. Shower with your head back.
      • Brush your teeth very gently for the first 2 weeks and use mouth wash.
      • Hair may be washed after 24 hours, providing you have someone to help. Do not bend your head forward. Tilt your head backwards.
    • Sleeping
      • Sleep on your back with your head elevated on two pillows for six weeks. (Sleeping on one side can cause the nose to bend to one side).
      • Place 2 pillows either side of your waist to rest your arms, to avoid turning to your side.
    • Pain & Medications
      • No drinking of alcohol for 1 week after surgery and keep this to a minimum as it tends to increase swelling.
      • Do not make any legal decisions after the anesthetic or under the influence of medications.
      • Do not take Aspirin or any medication containing Aspirin or Vitamin E for at least two weeks after surgery.
    • DIET
      • A light diet is best as the anesthetic can make you nauseous. Vomiting may cause bleeding and increase swelling and stuffiness of the nose.
      • Avoid foods that are chewy for the first one week.
      • Failure to do so may cause excessive bleeding/swelling, haematoma, and/or displacement of the nasal bones in the early post-operative stage.
      • Sometimes there is a loss in the sense of taste or smell. Do not worry this will usually return in 3 months.
    • Eyeglasses

      Do not wear eyeglasses or sunglasses whose frames rest on the nasal bones for at least 6 weeks. Gauze may be folded and placed on the bridge of the nose, so that glasses do not directly rest on the nose and cause any indentations. Nose pads can be purchased from an optometrist to alleviate this.

    • Do not
      • Do not strain while having a bowel movement.
      • Do not smoke for a week after surgery because it irritates the lining of the nose and causes coughing, both of which could bring on a late nose bleed.
      • Do not cough and sneeze - do so with an open mouth if necessary.
    • Activity Level
      • During the first 5 days after surgery, it is important not to engage in any activity which will elevate the blood pressure and possibly produce bruising under the skin.
      • During the first 48 hours, I recommend bed rest as this is the most convenient position to do your ice compresses.
      • During the next 3 or 5 days, you should restrict your normal activities.
      • Persons who feel well enough can cook and care for their personal needs. e. Flying is permitted one week after surgery as this increases swelling.
      • Do not exercise or engage in strenuous physical activity until cleared with the physician - generally six weeks.
      • Do not participate in any contact sports for 6 weeks.
      • Do not swim for 6 weeks.
      • Do not dive for 6 weeks.
      • Avoid exercise for 6 weeks as it increases swelling and could alter the result. Light walking or use of an exercise bike and light leg weights are permitted.
    • You can expect
      • Initial nose bleed for about 4-5 hours. Change 'drip pad' gauzes under your nose as needed.
      • Moderate discomfort, use pain killers as prescribed.
      • Swelling and black and blue around your eyes sometimes more on the second or third day after surgery than the first.
      • Blood-shot "whites" of your eyes. Eye-drops can be prescribed if this persists or is irritating.
    • Call if you have
      • Severe pain not responding to medication.
      • Prolonged profuse bleeding (sometimes more than 5 drip pads per hour, after 4 hours).
      • If any other questions or problems arise. Some oozing is normal, but if bleeding continues and is bright red, call the office on 3287044.
    • In case of heavy bleeding

      Put your head back, apply ice packs, hold gauze under the nostril, lie still for 40 minutes and call the clinic if it doesn't settle.

    • Please note

      About two weeks after the operation, some swelling will have subsided, usually enough to return to work or visit friends. The majority of swelling should subside in 6 - 8 weeks. The healing process can take up to 12 months, and during this time you will see progressive improvement in the fine details of your nose. Normal breathing at times may take up to three months to recover completely.

    • To purchase prior to surgery for dressings
      • Normal Saline - 0.9% - 100 ml.
      • Cotton buds.
      • ½ inch Micropore tape
    • Please call the clinic for routine questions and to schedule follow-up visits. 020-5441103 For Emergencies ONLY call 9822058916.

FAQ's

  • 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 in the desired shape, often narrow and straight.

    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.

  • 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.

  • 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!

  • 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 when required 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.

  • 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.

  • 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) your sutures will get absorbed

  • 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.

  • 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.

  • Are there any new techniques to repair a deviated septum. Is cauterization used? Does the nose always have to be packed after surgery?

    There are many ways to fix a septum. Generally cautery is used only on the turbinates or the initial incision on the columella in open techniques. The septum is like a wall frame in a house. The skin (mucosa) over it is like wall paper, and the cartilage on the inside is like drywall. You place an incision in the front part of the nose where it is hidden and raise the wallpaper off the wall. Then you can perform the necessary correction to the "drywall" (cartilage) and when you put the "wall paper" (mucosa/skin) back it looks like nothing was done.

    Usually packing will be required however, some patients are eligible for tubes or straws placed in the center of the packing on each side so that direct airflow through the nose is possible. Most patients find this a psychological discomfort rather than a physical.

  • I am 16 and have been thinking of rhinoplasty for a long time. At what age is it safe to have a rhinoplasty?

    Usually rhinoplasty is performed at the earliest, 13 or 14 years of age in girls and 15 to 16 years of age in boys. Reason being, and it is a known fact, girls physically mature faster than boys and the collective goal is to perform surgery when at least 90% of the growth is complete. 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 teen stops growing. Rhinoplasties performed on teenagers and young adults, it seems, are often beneficial to the social development and self confidence of the individual.

    In other words, this depends upon the stage of growth in the face as well as the gender of the patient. A qualified surgeon can better help you upon personal examination.

  • 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?

    Usually, there is no visible scarring unless it is an "open rhinoplasty". Some surgeons perform all of their rhinoplasties, "open" -- some, all closed. It solely depends upon the surgeon. You will find that most surgeons tend to disagree when it comes to technique. They either prefer open or they prefer closed, OR if they are highly skilled, know that it is case-dependent and different patients have different needs. If it is an open rhinoplasty the scar would be on the columella (the skin that separates the nostrils) sometimes resembling a straight line or a flattened "z".

    You can expect swelling, especially in the tip if you are having tip "work" performed. The swelling usually begins to subside within the first month but the end result may not be seen until at least 9 months [post-operatively. Although this time period tends to lean towards a year and over.

  • 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?

    Many patients complain of "runny noses" after rhinoplasty/septoplasty surgery. Some over 2 years. Most of the excess mucous production ceases at 9 months but can continue well after that. For now I can only advise to carry more Kleenex around as it may persist for several more months.

  • My surgeon mentioned a shot of cortisone to help some of the scar tissue. Why is this and what will this do?

    A Injections of Cortisone or Kenalog can help break up excess tissue. It is a common remedy to inject steroids such as these and also is used primarily to reduce swelling and inflamed tissue. Although care must be taken regarding excess use of these injections as it can break down the tissue too much.

  • 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?

    This is very common. A weak chin can and does make even an "ideal" sized nose look larger than it actually is. The chin augmentation is a relatively minor procedure when implants are used although it entails some risks all on its own. Such as lower lip numbness which can be remedied (usually) by removing the implant and trimming the implant so that it is not pressing up against the nerve as much.

  • 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?

    Most patients report a little tenderness when the cast is removed but if your surgeon uses a cotton swab saturated with alcohol to help remove the adhesive from the tape and glue you should be okay. Although it really shouldn't cause you great discomfort.

    The sutures that may be removed may hurt when someone else removes it due to them not actually being able to tell when they are hurting you. They also may snip your flesh slightly when the scissors are used to cut the actual suture. This isn't as rare as it as it should be and solely depends upon the surgeon's meticulous nature.

  • 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?

    For many patients with thick skin, the skin is thinned out in the surgery as the tip is worked on. This really adds a lot to help with definition. Excess skin length just shrinks away as the swelling decreases. Also, many patients with thick skin actually do better with rhinoplasties because the flaps that are elevated are so firm that you can do a lot more with the cartilages and it is better hidden. Very thin skin, shows every little imperfection.

    Going on several consults and getting a second, third and even more opinions is a good idea in any case. "Shopping" for surgeons is a serious matter and you should be as comfortable as you can be with a surgeon, his skill, and his bedside manner.

  • Can I see other operated patients before & after photographs?

    Yes. Doctor can show you photographs of patient who had similar problem like yours.

  • What is a "hanging columella"?

    A nasal columella is the external, and sometimes partial internal, fleshy section of the nose which separates the nostrils. When it is referred to being a "hanging columella" this section is often prominent or hangs down.

  • Is it possible for someone to be allergic to dissolvable stitches? And if so, what would the reaction be?

    This isn't as uncommon as you may think. There are usually two types that promote a response in those who are sensitive to these sutures. These two are usually Absorbable Poly (glycolide/L-lactide) Surgical Suture material and Absorbable Gut Suture material.

    If you experience redness and itchiness and sometimes pus formation - you very well may be allergic to the dissolvable type sutures. Sometimes the symptoms may not show up until about 3-4 weeks after surgery, if this happens, antibiotics can be given but it usually reoccurs. The best thing to do in some cases is to remove any of the left over material and replace it with nylon sutures. These sutures are usually removed in 10 days. Another option can be tissue glue although this isn't very mainstream for rhinoplasty.

    Also be advised that when the skin gets red and itchy around a suture, be it absorbable or non-dissolving - usually it is time for them to be removed. Your body knows and will tell you when your healing. Besides healing skin always turns itchy. Know the difference between typical irritation and an allergic reaction.

  • I recently had a rhinoplasty & septoplasty, its almost 6 months & on one of my nostrils I still can hardly breath. Is this normal?

    Usually by the 6th month the breathing is most definitely restored. In fact, most patients notice improved breathing within a month to two months of surgery if they had difficulty breathing beforehand. I would suggest that you have a follow up with your surgeon and ask his advice or determine if the lack of airway is indeed from a deviated septum, redundant mucosa or enlarged or redundant turbinates. I do not know from your question if this is a constant occurrence or if this is at certain times of the day, while the body is horizontal or after exercise. These factors can also hinder breathing due to engorged tissue due to increased blood flow.

  • I am 55 years old. Can I undergo rhinoplasty?

    Yes. Provided you don't have diabetes, blood pressure ,etc .you should be medically fit.

  • During childhood I had undergone surgery for cleftlip but nose is still unsymmetrical,can it be corrected?

    Yes.

  • Can my own tissues be used for augmentation of nose bridge? What are the nasal implants? Are there any side effects?

    Implants are synthetic materials usually derived from silicon polymers.e.g.prolen mesh,porex, etc. There is always remote possibility of infection,displacement Or extrusion of implant.