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How to get the best results from a rhinoplasty?

Plastic Surgery Aesthetic Medicine
I want to get a rhinoplasty to fix my crooked nose. What should I discuss with my surgeon to ensure that I can get the results that I want from my procedure? I don’t want to be disappointed.
DOCTOR’S ANSWER (3)

Thanks for your question. This is a commonly asked question and I would like to break it down into : Pre-Surgery Consult, Surgery and Post-Surgery Recovery.

Pre-Surgery Consultation

1. It is important to know why you are going for a rhinoplasty and what changes you want to achieve from the surgery. The motivation for a rhinoplasty should be self-driven and not for other reasons. 

2. Make the most of your consultation. Being able to identify what changes you would like to achieve will enable the surgeon to discuss with you the various possibilities of what can be achieve.

    a. Some of the common requests for Asian patients are: making the dorsum higher, making the nose longer, refining the nasal tip to make it sharper and narrowing the nasal base. Spend time to think about what changes you want and discuss with your surgeon if this is achievable and how it can be done. 

    b. The next common question is whether you should have an implant-based rhinoplasty or a total autologous rhinoplasty which may require additional donor sites such as using your ear or rib cartilage. Again, discuss with your surgeon the pros and cons of both.

    c. The consultation is a time for you to get to know your surgeon, to find out more about his experience, training and past patient.s It’s important not to leave the consultation with questions unanswered. Please take the time to find out the answers to all your concerns.

3. The internet provides a lot of information and it is always good to do some research on the procedure as well as the doctors that can do this surgery.

4. 3D Simulation and Consultation. An in-person consultation with your surgeon is most critical for you to get comfortable with your surgeon and also to discuss your surgical goals and to see if they can be met, considering your time requirements, downtime and donor sites. A 3D Simulation is very helpful for both the patient to appreciate the changes that will happen and also for the doctor to be able to understand if we have the same aesthetic goals.

5. Choose your surgeon carefully. When performed by untrained hands or a person with limited experience, a lot may go wrong with the procedure. Pick a surgeon that understands your objectives and have a look at some pre-post photographs. Speak with a few and pick the one that you are most comfortable with.

Rhinoplasty

Surgery

1. Plan for the surgery taking into consideration the recovery that you would need and always give enough time so that you can excuse yourself from important social or work events. In general, expect the nose to be swollen for up to a few weeks with the best results only after months. This is of course also dependent on how much is being done.

2. Double check your health. Ensure that you are optimised for surgery by making sure that you are not taking medications or supplements that can lead to excessive bleeding or bruising. If you are a smoker, consider quitting or stopping at least 2-4 weeks before surgery.

3. Get enough rest before the night of surgery.

Post-Surgery Recovery

     Here are some of my standard tips for recovery after a rhinoplasty procedure.

1. Apply cold-compress to the forehead, eyes and cheeks for the first 48 hours and get ample rest at home.

2. Keep the head elevated to reduce the swelling over the face and nose. You may want to sleep on more than one pillow. Taking frequent light walks will help the circulation and swelling to reduce.

3. Avoid strenuous activity for 2 weeks and any contact sports for up to 6 weeks. 

4. I routinely prescribe a nasal splint to help reduce swelling and also protect the nose during the healing period. This should be worn for a period of 2 weeks.

5. Avoid wearing glasses and sunglasses that may push on your nasal bones. This is especially so if an osteotomy of the nasal bones has been done. 

6. Try not to blow your nose for 2 weeks. Anti-histamines are often given to patients who are prone to have sniffles or allergic rhinitis. 

7. Avoid diets that are high in salt as this may increase the swelling. 

8. Stop smoking. This should be done 2-4 weeks before surgery and for 4 weeks after until everything has healed.

9. Gets lots of rest, sleep well, and drink lots of water.

Rhinoplasty is a very gratifying surgery that can give permanent long-term results. Following these will help you to expedite the healing process and obtain the most optimum results.

I hope this answers your question. Have a great weekend!

Rgds,

Dr. Terence Goh

Plastic Surgeon

 

0 103 views 30 Jan 2019

Thank you for your question.

Prior to your consultation, you may want to think about the outcome you wish to achieve or the areas that are bothering you. If you can let your plastic surgeon know your concerns, that would provide a great starting point for further discussion.

For a start, you may want to assess the face in 3-D to identify the area(s) of concern.

1. Should I make my nose bigger or smaller, higher or shorter? And which areas should be addressed?

2. The nose can be assessed in the frontal and side view. In the frontal view, you have to decide whether the nose is too wide and which part needs correction? Is it the upper 1/3 (Bone), middle 1/3 (Bone and upper lateral cartilages) or lower 1/3 (lower lateral cartilages and alar rims and alar bases).

3. In the side view, you have to decide the height of the bridge (nasal dorsum), is there a hump to be removed? How high should the bridge be? At what level should the root of the nose start?

4. Does the tip of the nose need to be made more or less pointy? Does the nose need lengthening? Does the columella need lengthening or shortening?

The more specific you are with your outcome, the easier it is for the surgeon to understand your desire and decide whether or not it is attainable.

Apart from that, you can check if your surgeon is able to do a 3D simulation of the possible outcome based on your surgery plan. I find this particularly helpful and it is a great way to align patient’s expectation with the potential surgical outcomes.

I hope my reply helps.

Best regards,

Dr Por Yong Chen

0 291 views 19 Nov 2018

Thank you for your question. Beauty is very subjective. You will have your own perception and your doctor may have another perception of what is attractive. 

For you to get the “best” results it is important that you know exactly what you want and are able to express that to your surgeon. There are some things that may not be possible to achieve and it’s important that your surgeon is realistic in what can and can’t be achieved.

You can see photos of previous patients or you may be able to have a virtual simulation of the surgery. These things can help you in deciding which surgeon you choose to do your surgery.

I’d advise you to consult a few surgeons and pick the one you are most comfortable with.

Hope this helps.

0 333 views 12 Nov 2018
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