7 things you should know about Rhinoplasty

1)  Cosmetic Plastic Surgeons can sculpt your nose and make it look better, but they have to work with what they are presented.  In other words, you need to reconcile desires with reality.  What do you want and what will my nose allow me to have?  It’s fine to provide your cosmetic plastic surgeon with photos of noses you like, but keep in mind that you may not always get what you want but actually what you need and what is in keeping with your framework.

2)  Perfect noses don’t exist after rhinoplasty.  It’s likely that you’ll still find flaws, possibly any bump on the nasal bridge or an uneven nostril.  Try to keep in mind that you’re going for improvement, not perfection.

3)  You may have “raccoon eyes” and look a bit like an Egyptian mummy for the first few days post-operatively.  If the nose needs to be broken, expect a splint over the bridge of your nose, possible packing in your nostrils and a pad taped under your nose to catch drainage.

4)  Don’t wear glasses/sunglasses for the first six weeks post-operatively, so that the nasal bridge can heal correctly.

5)  You may find this surprising but rhinoplasty is usually painless, especially if you stay on top of your medications.  You will, however, be tired and possibly nauseas.  Your breathing may have been improved if a deviated septum was fixed at the same me.  Sometimes, breathing may be made significantly worse after the procedure (this may result in a very nasal voice for a few weeks to months) but generally improves once the swelling subsides.

6)  What most people find amazing who have had a rhinoplasty is how many family members and friends won’t notice you’ve had anything done despite having your nose reshaped and many weeks recovering.

7)  Right after your new nose is revealed, you don’t look exactly like yourself and that can feel strange and you may feel a sense of disappointment.  You need to give things me to settle down: usually 70 % of the result is seen at 3 months and typically you have to wait 12 months for the final result.

Thanks for reading!

 

Dr Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au

Can you achieve the perfect nose?

Rhinoplasty or nose surgery is one of the most common cosmetic procedures. You only notice the nose if it’s too big, too wide, or seems to be misshapen. In these type of cases, most people would want to have a rhinoplasty, also known as a nose job, to make an improvement in their appearance and thereby, increase their self-confidence and quality of life. Rhinoplasty are also performed to correct an accidental fracture or to improve chronic nasal congestion. In such cases, the surgery falls under functional surgery.

Can you achieve the perfect nose.jpg.001

Who Are Good Candidates for Rhinoplasty?

Rhinoplasty is suitable for anyone in good health. It is advisable that the procedure be done on a fully developed nose. Complete maturation of the nose is developed by the age of 16 for girls and 18 for boys. The commonest age group for a rhinoplasty are the late teens and early twenties. Adolescence and early adulthood exposes individuals to great pressure from their peers and society with regards to the way they look. Having a nose that is unappealing places enormous stress on one’s self-esteem and can cause severe effects on a teenager’s confidence.
Fixing bumps or making the nose smaller usually gives the face better proportion, leading to an improved appearance that will give teens and early adults the confidence they need to tackle  life and their foray into the real world. Older individuals who have rhinoplasty done either do it for cosmetic or for functional reasons, the latter usually to correct difficulty in breathing caused by chronic nasal congestion and other conditions.  For many, a drooping and sagging nose caused by ageing makes them look a lot older and having rhinoplasty can rejuvenate them again.

Insurance Issues

Cosmetic surgery is generally not covered by health funds. However, when a rhinoplasty is needed to correct an injury like a fracture, nasal obstruction, or to correct a congenital nasal deformity, then it can fall under functional surgery and therefore be covered. It all depends on the reason behind the nose job. Make sure you know what your medical insurance covers so you know how to proceed with your planned surgery.

The Steps to Having a Rhinoplasty

Before you consider a nose job, make sure you know where to have it done. Do your research and choose the best clinic or plastic surgeon who will help you achieve the look you want for your nose.  Set an appointment with the plastic surgeon and gauge whether or not you are comfortable and confident with the professional who will be doing the procedure. If everything is in place, such as the look you are going for, the budget, and the schedule, then it’s time you make the appointment for your rhinoplasty. Advanced technology like the VECTRA 3D Imaging System is available in certain clinics, which provide you with computer simulations of your before and after pictures. If you don’t like what you see, you can discuss further with your plastic surgeon about how you want the structure of your nose to look like.

What to Expect with the Rhinoplasty

Rhinoplasty is an outpatient procedure performed under general anaesthesia. The entire procedure takes about 1 to 3 hours or longer for complicated cases. Most plastic surgeons today perform an open rhinoplasty where the the incisions are made just under the nose, as well as,  inside the nose so the scars are inconspicuous once the nose heals. Depending on what needs to be done, plastic surgeons either remove bone and cartilage to make the nose smaller, or add tissue to make it bigger especially in Asians and African-Americans. Once this is done and the structure of teh nose is in place, the skin is re-draped and the incisions closed with fine sutures. A splint is then placed on-top of the nose to provide support to the new shape until it heals.

Recovery

Patients can go home after a rhinoplasty but for more complicated surgeries, patients would need to stay overnight at the hospital. Splints are usually taken off after 7 days. Many patients get to return to work after 1 week but swelling and bruising will still be present. Expect your face to feel puffy, especially on the areas around your eyes and nose. Swelling usually improves after 10-14 days.

Risks

The risks involved with rhinoplasty include infection, bleeding, nasal blockage due to swelling, and asymmetry. It is best to consult with your plastic surgeon should there be any unexpected side effects of the procedure.

Question: What do you think are the  main benefits of rhinoplasty? You can leave a comment below. 

Teenage Cosmetic Surgery: Why So Much Pressure?

 

There has been a storm brewing for some me now regarding teenage cosmetic surgery.  A concoction made up of quick fixes,  a society obsessed with beauty, and the commercialisation and overexposure of cosmetic surgery. This has all lent themselves to the growth of cosmetic surgery for  Generation  X and younger.  This has been further compounded by the increasing number of medical specialists entering the cosmetic arena.

My worry is that this Generation X and their successors wanting teenage cosmetic surgery may become an abused marketplace.  It would appear that they have it a little easier, in the sense that, they have parents or relatives who have had cosmetic surgery and are approving of it, in an economy that has been both buoyant and robust for some time now.  This takes away from the fact, that teenage cosmetic surgery needs much more scrutiny because it can play on people’s insecurities and promises of an instantly better life.

Most plastic surgeons I believe are responsible individuals with a conscience who try and counsel teenagers, usually in front of their parents, of the risks, benefits, and outcomes of procedures, as well as whether they are appropriate or not. They try very hard to show that TV programs like Extreme Makeover,  Dr.  90210  and  The Swan trivialise and glamourise cosmetic surgery and that glossy magazines like Teen Vogue or Teen Cosmo display airbrushed photos of models and celebrities that are in reality unachievable.

Now teenagers who want to have cosmetic surgery usually have different motivations and goals than adults.  They too have cosmetic surgery to improve physical characteristics they feel are awkward or flawed,  that if left uncorrected, may affect them well into adulthood.  Teens tend to have cosmetic surgery to fit in with peers, to look similar.  Adults tend to have cosmetic surgery to stand out from others.  Teenagers frequently gain self-esteem and confidence when their physical problems are corrected.  In fact, successful teenage cosmetic surgery may reverse the social withdrawal that generally accompanies teenagers who feel different.  Not every teenager seeking cosmetic surgery is well suited for an operation.  Teenagers must demonstrate emotional maturity and an understanding of the limitations of cosmetic surgery.

I would caution teenagers and parents to keep in mind that cosmetic surgery is real surgery, with great benefits, but also carries some risks. Teenagers should have realistic expectations about cosmetic surgery and what it can do for them. In addition, certain milestones in growth and physical maturity must be achieved before undergoing cosmetic surgery. The most rewarding outcomes are expected when the following exist:

  1. The teenager initiates the request.
    The young person must appreciate both the benefits and limitations of cosmetic surgery, avoiding unrealistic expectations about life changes that will occur as a result of the procedure.
  2. The teenager has realistic goals.
    While parental support isn’t lessened at all, the teenager’s own desire for cosmetic surgery must be clearly expressed and repeated over a period of time.
  3.  The teenager has sufficient maturity.
    Teenagers must be able to tolerate the discomfort and temporary disfigurement of a surgical procedure.  Cosmetic surgery is not recommended for teens who are prone to mood swings or erratic behavior, who are abusing drugs and/ or alcohol, or who are being treated for clinical depression or other mental illness.

Some of the commonest teenage cosmetic surgery procedures include:

  1. Rhinoplasty (nose reshaping)

Cosmetic surgery may be performed on the nose to straighten the bridge, remove an unsightly hump, reshape the point or open breathing passages. Ordinarily, this is not performed until the nose reaches its adult size –  about age 15 or 16 in girls and a year later in boys. The procedure accounted for nearly 50 percent of all cosmetic surgical procedures performed on this age group.

2.Otoplasty (ear surgery)

Surgical correction of protruding ears, in which the ears are pinned back, may be performed any time after the age of five. Otoplasty made up 11 percent of all cosmetic surgical procedures performed on this age group.

3. Correction of Breast Asymmetry

When one breast grows to a much larger size than the other, an operation may correct the difference by reducing the larger breast, augmenting the smaller, or both. Many teenagers who want breast augmentation tend to have one breast that is larger than the other – sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a breast implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

4. Breast Augmentation

Breast implants can be used for breast augmentation in women 18-years or older and for breast reconstruction.

Many teenagers who want breast augmentation to have one breast that is larger than the other -sometimes a full cup size or more in difference. This condition is called breast asymmetry. Using a breast implant in the smaller breast allows the patient to have breasts of the same size. Although waiting may prolong the physical awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

5. Breast Reduction

Surgical reduction of very large breasts can overcome both physical and psychological burdens for a teenage girl.

In fact, many teenagers suffer ongoing back pain due to overly large breasts. Although waiting may prolong the psychological awkwardness, it is advisable to delay surgery until breast growth ceases in order to achieve the best result.

6. Acne and Acne Scar Treatment

Acne eruptions may be controlled by the proper use of modern prescription drugs. In addition to supervising the use of these medications, plastic surgeons may improve acne scars by smoothing or “refinishing” the skin with a laser or with a fine sanding technique called microdermabrasion. Other treatments for acne related skin problems include laser skin resurfacing, dermabrasion, and chemical peels.

7. Male Breast Reduction (Gynaecomastia)

Teenage boys with large breasts, known as gynecomastia, are often eager to undergo plastic surgery. Surgical correction can be accomplished in a variety of ways including liposuction and/or surgical excision of the breast tissue.

As a plastic surgeon, I am an advocate for the right teenage cosmetic surgery, at the right time, and for the right reason. Things like correction of prominent ears, breast reduction in adolescent boys or breast reconstruction in young girls with an underdeveloped breast can truly advance the person’s quality of life. It is our responsibility as plastic surgeons to guide teenagers (and their parents) in the right direction and to educate them that cosmetic surgery is not a panacea for the everyday pressures that teenagers’ face. Cosmetic surgery can make you more attractive but not necessarily happier!

Question: What do you think is the commonest reason teenagers want cosmetic surgery? You can leave a comment below.

Non-Surgical Nose Job – Does It Work?

A non-surgical rhinoplasty (nose job) involves injection of safe and effective filler materials (typically hyaluronic acids, tiny calcium granules or fat injections) to alter the shape of the nose.  Non-surgical rhinoplasty can only be used to alter the shape by adding structure to the nose and cannot remove any structure from the nose.  It is always an “additive” procedure because placing more volume in the nose makes it larger (remember very few primary rhinoplasties are performed to make the nose larger).

Indications

Patients suitable for non-surgical rhinoplasty include:
  1. Noses with small humps or bumps
  2. Asian or primary rhinoplasty patients requiring dorsal augmentation only
  3. Noses that have had prior surgery and are overly scooped (“ski slope noses”) or have small contour deformities/irregularities
  4. Saddle nose deformity (“Boxer’s nose”), which is caused by a collapse of nasal structures typically caused by fracture
  5. Polly beak (supratip) deformity
  6. Nose with a retracted columella (a sharp and deep angle between the upper lip and the nose)
  7. Noses with slight asymmetry
  8. Patients that are too young to operate on

Contra-indications

Non-surgical rhinoplasty typically cannot help with the following types of noses:
  1. Noses with large humps
  2. Large noses
  3. Noses with significant asymmetry
  4. Noses that need a reduction

The most common filler material used for non-surgical rhinoplasty are hyaluronic acid fillers as they can be injected and molded into shape, yet firm enough to maintain their shape after injection. They are very safe and well tolerated by the body. It is very important that the filler material is injected deeply, just above the bone or cartilage of the nose.

Non-surgical rhinoplasty is a quick and easy alternative for those who want to improve certain features of their nose as indicated above.  Non-surgical rhinoplasty takes less than 5-10 minutes to perform and has minimal discomfort and minimal recovery associated with it.  Results typically last up to one year.  The good thing about a non-surgical rhinoplasty is that it is not permanent and if you don’t like your nose enlarged, the fillers will be resorbed in a several month period and it will return to its original size.  Fat grating may offer a more permanent solution short of surgery.  Non-surgical rhinoplasty should ideally be performed by a surgeon who is also experienced in surgical rhinoplasty.

Thanks for reading!

Dr Tim – Sydney Cosmetic Plastic Surgeon

www.cosmeticculture.com.au
www.drtim.com.au