NOSE JOB BEFORE AND AFTER | BEST NOSE JOB SURGEON | QUESTIONS
ANSWERS BY NOSEPLASTY CLINIC TO COMMONLY ASKED QUESTIONS ABOUT NOSE PLASTIC SURGERY
- Are the super-specialists in rhinoplasty surgery at NosePlasty Clinic internationally trained and registered?
Yes- Mr. John-Calinikos. The surgeons are internationally trained in rhinoplasty surgery and have international medical recognition and registration. Registered International Membership of the prestigious American Academy of Facial Plastic and Reconstructive Surgeons. Our lead surgeon is Fellow Royal College of Surgeons-Edinburgh and has medical registration in Greece, South Africa (previously United Kingdom and New South Wales Australia) and has dual specialist training- (Otorhinolaryngology and Facial Surgery).
- Nose Job before and after.
By reading answers to the following variety of questions we will cover most if not all the queries about nose job before and after surgery.
- Best Nose Job Surgeon.
There is no best nose job surgeon! Rhinoplasty is the most difficult surgical procedure to master. It's a 3 dimensional art form and it takes many years of specialised training and surgical experience and an artistic eye in order to obtain good cosmetic results. No two noses are the same. No two artists are the same. There is no short cut to surgical artistry and there is no guarantee of perfection. Every surgeon trained in nose job surgery has to have humility and has to recognise his/her and his patient's limitations. Every surgeon has his/her limitations. If you are looking for the best surgeon then find the surgeon whom you trust and who has integrity, honesty, humility and dedication to his surgical art. Never expect cosmetic perfection and avoid the surgeon with the three B's (bragging, bluff and b......t). The best nose job surgeon for you can be in your own nearest city!
- What is cosmetic, nose plastic surgery or rhinoplasty or nose job or noseplasty?
All the above words or descriptions is nasal surgery designed to improve the outward appearance of the nose in relation to facial aesthetics and often to deal at the same time with internal nasal functional problems-such as nasal blockage and possibly snoring. NosePlasty Clinic surgeons follow the aesthetic ideals described by classical Greek and Renaissance artists, but they also perform nose jobs respecting African and Asian standards of beauty.
- What is nose reconstructive surgery?
This is surgery designed to cosmetically reconstruct abnormal nasal anatomy, which has been congenitally acquired or has been damaged by injury or by previous unsuccessful nose surgery. In this regard it is often necessary to do surgery on the nasal septum, the internal valves of the nose and the side walls of the nose. Surgical specialization training in Ear, Nose and Throat surgery is a pre requisite for this type of internal nasal surgery. NosePlasty Clinic surgeons have these qualifications.
- What is nose revision surgery?
This is surgery designed to improve or correct the cosmetic appearance or function of a nose previously operated upon. This surgery is usually performed in cases which have had previous nasal surgery with an unsuccessful result. These cases often require graft material (usually obtained from the patient’s own septum or ear). They may require 'spreader' grafts or 'caudal' extension grafts or 'shield' grafts or 'tip' graft - (these are medical terms).This surgery is highly specialised and is performed as an open approach and only rhinoplasty trained surgeons like Mr. John-Calinikos can perform these procedures.
- What is nose functional surgery?
This is surgery directed towards the function of the nose. Most functional problems are related to obstruction of the airflow through the nasal passages. These obstructions are corrected by functional surgery. The obstruction may be at the entrance of the nose, in the passage of the nose or at the back of the nose, and each type of obstruction is dealt with in a different manner. A surgeon who has training in surgery of the nasal passages best performs functional surgery, because he/she must deal with the complicated anatomy and structures of the inner nose. Very often grafting material needs to be obtained from the inside of the nose and these grafts need to be placed and stitched inside the nose to relieve nasal valve airflow obstructions. These are called ‘spreader’ grafts. It has been shown (by Prof. Rollins USA) that more than a third of clients presenting for rhinoplasty have clinical nasal obstruction, which if not treated at the time of the cosmetic surgery, will lead to functional nasal breathing obstruction.* Mr. John-Calinikos always corrects septal problems at the time of the cosmetic surgery procedure.
Snoring is very often associated with functional nasal problems and Mr John-Calinikos has a special interest in snoring and in the treatment of its causes.
"Snoring is generally regarded as a cosmetic issue by health insurance requiring significant out of pocket expenses by patients." Source Dr. Yaremchuck Henry Ford Hospital USA
- What is a septoplasty or submucous resection of the septum (SMR)?
This is surgery to the nasal septum performed by ear, nose and throat trained surgeons in order to relieve an airflow obstruction inside the nose, usually caused by a deviation of the nasal septum.* This procedure is routinely performed during NosePlasty Clinic surgery if there is a deviation of the septum causing nasal ostruction.
- What is turbinectomy?
The turbinates (or conchae) are the tissue masses on the sidewall of the nose, which act as air conditioners and humidifiers inside the nose. They have a rich vascular supply with millions of mucous and serous glands moistening the air and they also provide filtering, cooling and warming of the air flowing through the nasal passages. Turbinectomy or turbinate surgery is surgery to the turbinates by a trained ear, nose and throat surgeon, usually performed to alleviate obstruction of the nasal passages. NosePlasty Clinic surgeons seldom find it necessary to perform surgery to the turbinates.* If there is nasal obstruction it is usually due to bony and cartilaginous deviations in the nasal passages and NosePlasty Clinic surgeons do not treat patients who have allergic turbinate or polyp problems.
Read the physiology section in this website for more information.
- What is the difference between open and closed rhinoplasty?
The decision to do open or closed rhinoplasty depends on the surgeon as to what needs to be done. If the cosmetic change requires minimum correction the surgeon will opt for a closed approach. If the change needs to be extensive then an open approach can be and is usually used. We emphasise ‘can be used’ because many surgeons perform only closed approach surgery. In closed rhinoplasty the incisions are all made inside the nostril and are invisible from outside. In open rhinoplasty a small, V-shaped incision is made under the nose and a skin flap of the nose is raised in order to work more accurately on the bridge, septum and cartilages of the tip and/or to accurately place grafts where they can refine the tip of the nose or raise the bridge of the nose. The open approach takes longer to do and can have additional risks but has many advantages. The small incision under the nose heals well and becomes virtually invisible unless especially looked for with a good light. Please refer to the Anatomy and Physiology section for better understanding.
- Can functional and cosmetic surgery be done at the same time?
Yes. It is recommended that cosmetic and functional surgery be performed at the same surgical session. The support of the nose is very dependent on the inner anatomy of the nose, mainly from the septum. If the septum is damaged during surgery there is a danger of collapse of the nose with consequent nasal obstruction. A surgeon trained in both cosmetic and functional nose surgery is best able to deal with both functional and nasal cosmetic surgery. Snoring problems due to nasal obstruction can also be dealt with at the same time as the cosmetic rhinoplasty or noseplasty procedure. It is not a medical problem on it's own and "most health insurers regard snoring as a cosmetic issue" *-Quote Dr. Yaremchuk-Henry Ford Hospital
- Are there age limits to rhinoplasty surgery?
Yes. For females the minimum age is 15 and for males 18-19 years of age. (This is in order for the nose to have attained its full growth before surgery). Otherwise there is no age limit provided there is no general health problem. As a general rule nasal cosmetic surgery is not done on younger ages unless there is severe nasal obstruction and even then, any surgery performed is extremely conservative. There is no upper age limit for rhinoplasty.
- May I choose the shape of my future nose, if I so wish?
Essentially ‘Yes’, with a proviso that it is realistic and reasonable and that there is an aesthetic balance between the nose, the chin and the face. The surgeon has to be careful to preserve harmonious facial features and weigh the risk-reward ratio. Each case is evaluated in detail in order to result in the best possible outcome. Imaging helps in deciding nose and facial shape desires. Also some nasal cosmetic requirements requested by the client demand open nasal surgery with or without grafting in order to maximize the results as close as possible to the request. One has to weigh the risks and rewards for using open rhinoplasty in order to maximise the result. Open rhinoplasty surgery has its own risks, which may outweigh the requested reward for minor changes. Clients need to be guided by the NosePlasty Clinic experienced surgeon. See also consultation at NosePlasty Clinic.
- Is there much bleeding?
No. The bleeding at a NosePlasty Clinic procedure is usually minimal. During the surgery bleeding is usually less than during a tooth extraction. This reduction of bleeding is achieved by employing conscious sedation and the fact that NosePlasty Clinic surgeons do not use suction during surgery because it stimulates bleeding. There is slight bleeding when the nasal plugs are removed the next day, and this subsides within a few minutes. Understandably you must be off any medication or nutrients or vitamins that may interfere with bleeding time or coagulation of your blood. In a routine noseplasty procedure the blood loss is usually less than a couple of thimbles.
- Is there bruising or swelling of the nose after surgery?
Yes if the nasal bones have to be narrowed or moved. The bruising and swelling usually subsides within 7 to 10 days and disappears within 4 to 6 weeks. If surgical narrowing of the bones of the nose is not performed then there is no bruising and almost no swelling. If an open approach is used then there will be some swelling. With our post operative regime any swelling and bruising disappears rapidly. At NosePlasty Clinic procedures there is generally minimal bruisng and swelling because of the special techniques used during the surgery in order to prevent tissue injury. Medication to diminish bruising is prescribed and instructions are given whiich accelerate the reduction of any post operative swelling.
- How long does the actual surgery take?
Usually 1-2 hours and longer depending on the complexity of the surgery. Some complicated procedures last well over four hours.
- Does noseplasty or a nose job rhinoplasty make one look younger?
The answer is decidedly 'yes'.
A large or ugly nose distracts people's look from the eyes to the nose. When
someone looks at you they initially, reflexly look first at your eyes. This is the
natural optic reflex which is related to the survival of species. If the nose is
ugly or large or drooping or humped or with a bulbous tip, the look focuses
on the dominant ugly (to their aesthetic sense) feature of the face which is the
nose. A proportionate, well shaped nose in harmony with the face defines the
eyes and the beauty of the face and gives the illusion of vitality and youth
rather than of an ageing face. So it does make you look younger usually by
about 8 years! (survey report)
- Is there pain in rhinoplasty at NosePlasty Clinic?
No. The pain fibres of the nose are anaesthetised (blocked) prior to the surgery whilst the patient is in conscious sedation. There is no pain during or after the surgery. Rhinoplasty (by Noseplasty) has a very comfortable post-surgery recovery. See Conscious Sedation. There is some feeling of fullness and discomfort because the nose is plugged post operatively and when the nasal plugs are removed there is also some discomfort. The removal of the plugs may cause the most discomfort experienced throughout the whole experience.
- Does rhinoplasty leave scars?
Yes and No. If an open approach is used there is a small external scar at the base of the nose, which is hardly visible. In the case where an endonasal (inside the nose) approach is used there are no visible scars.
- Will the nose reach the definitive result regarding shape and function immediately after surgery?
No. In the first phase, at about the 5th to 7th day, because various aesthetic imperfections having been reshaped, there will be some swelling, which will decrease with time over a 3-4 month period. Some people have a shorter recovery time. The final result is reached after about one year. We do not advise further surgery till at least one year has elapsed.
- Will my breathing improve after surgery?
Yes. If you read the text of the web site you will note that over a third of people presenting for cosmetic nose surgery suffer from some form of clinical nasal obstruction, which if left unattended at the time of the surgery, results over time with functional nasal obstruction. The obstruction to nasal breathing is often due to nasal valve or septum deviation problems. At NosePlasty Clinic the surgeons are specialised in nose plastic surgery and in inner nasal surgery (ear, nose and throat trained surgeons) and they deal with the problems in a combined surgical procedure, thereby avoiding a second operation.*
- I have a constant or recurrent 'running nose' or post nasal drip. Will noseplasty surgery correct this?
No. Experience has shown that these symptoms are most often related to allergy or sinus blockages. If there is some nasal obstruction due to a septum deviation or valve obstruction this will be dealt with at the time of the cosmetic procedure. In most cases these chronic symptoms are alleviated, provided of course that you do not have a chronic sinusitis or allergy-which can only be diagnosed and treated by a trained ear, nose and throat surgeon.* NosePlasty Clinic limits its surgery to cosmetic and functional issues.
- What is a chin implant or mentoplasty?
This is a surgical procedure performed to enhance the chin projection in order to attain an aesthetic balance of the face. The usual method is to place a silicone implant through an incision in the mouth or by an incision under the chin. At NosePlasty Clinic the implant is placed through a mouth incision.
- What is conscious sedation?
This is an advanced anaesthetic technique, used at NosePlasty Clinics whereby sedation is provided by sophisticated, computer controlled, intravenous medication which causes twilight sleep during surgery. There is no pain and no recollection of the surgery. Within 15 minutes after completion of the surgery the patient is able to walk out of the operating theatre and able, after an hour or so to go back to their residence. Because general anaesthesia is not used, physiological reflexes are retained (such as maintainance of muscle and blood circulation tone) during the surgery. Bleeding is therefore much less than would occur under general anaesthesia and thereby swelling and bruising is kept to a minimum. All the above, results in the recovery period being lessened to a matter of hours rather than days. See Conscious Sedation
- How soon after the surgery can I go back to work?
We normally suggest that patients take a couple of days off work (depending of what work they do), but if it's office type of work they can (if they wish) go back to work the very next day. Except for the slight swelling and discolouration around the eyes, and the nasal splint-which may attract comment, there is usually no reason for patients not to return to work.
- How long does it take for the nose to settle down after surgery?
In the short term (10-14 days) the nose shape settles down to its new shape. After the swelling and bruising has subsided, the nose takes on its permanent shape after about a six weeks, but it is totally healed and assumes its final shape after a year.
- How long does it take for the nose to be completely healed?
The nose heals remarkably quickly and within ten days the nose is practically healed even after complicated rhinoplasty. All incisions inside and outside the nose are healed within 10-14 days. However it takes about one year for the nose to settle and attain its final shape. By totally healed is meant that the nasal bones, cartilages and the soft tissues have stabilized and assumed their final form. Scar tissue formation is the unpredictable factor, which in some cases can change the final, predicted result. Most rhinoplasty (noseplasty) procedures depend to some degree on the predictability of scar tissue to retract in order to achieve the result that the surgeon aims for. In some cases there is too much scar tissue retraction, which can distort the results predicted. In other there is too little scar tissue retraction. It is advisable that further attempts at correction are not done until at least a year from the original surgery. In the first year after surgery it is imperative that the nose is totally protected from any injury and abuse.
- What is post operative recovery like at NosePlasty Clinic?
Following rhinoplasty, you will need someone to drive you home and preferably be with you for the first 24 hours. At surgery, a small splint will be placed on your nose to protect it and to keep it stable for at least five to eight days. If packing is placed inside the nose during surgery, it is usually removed the morning following the surgery. Expect to be slightly swollen and if you have had nasal bone work you might be bruised around the eye and cheek regions and have a blocked nose. Nose blowing is not permitted until your doctor allows it. You may also have a mild headache and your cheeks and jaw might feel tight, especially if you have had a chin implant, so a diet of soft food is recommended for a few days following this procedure. Keep your head elevated even while you sleep and make sure that you do not sleep with your nose touching the pillow. In the first 12-24 hours cool compresses and anti-inflammatory medications (which are prescribed by the Clinic) can make you more comfortable and reduce swelling. You may also experience mouth dryness in the first 24 hours because you'll be breathing through your mouth until the nasal swelling subsides. Sucking candies and drinking extra liquids can help. Just remember, these are common symptoms after rhinoplasty that will subside within the first few days. You should be able to go back to office work the day after your nasal plugs have been removed. You will be able to present your self socially without wearing a splint 6 days after the surgery. See also Post Surgery at NosePlasty Clinic
- Is post operative medication given?
Yes. It usually consists of a course of antibiotics, mild anti-inflammatory and anti-bruising medication. You might also need a nasal spray to clear the nasal passages. Painkillers are not necessary as there is no pain, only some discomfort until the plugs are removed. NosePlasty Clinic also prescribes specially formulated nose and eye creams to be applied after the surgery. The Clinic advisor will recommend nasal protection, care and nose skin maintenance over the years.
- How often do I have to see the surgeon after the surgery?
It is mandatory that you see the surgeon the day after the surgery, when the internal nasal packing is removed. Thereafter you are seen after 5-7 days when the nasal splint is removed. The nose is then taped for another 5-7 days after which you instructed how to remove the tape yourself. You can then return to your country of origin. As a precaution we ask patients to take a 10-14 day 'break' from date of surgery before travelling or flying to another country. The surgeon would like to see you again (if possible) within 6-8 weeks, 6 months and then after one year.
- Can I wear my eye glasses on my nose?
No. Only extremely light glasses are allowed that do not apply any weight or pressure on the nose. If you wear eye glasses, be ready to keep them in their case for several months Contact lenses can be used. NosePlasty Clinic recommends special, stylish frames for spectacle wearers. Ask the clinic co-ordinator or doctor for advice. There are glasses available which have been specially designed for post rhinoplasty.
- What about exercise? Can I exercise?
Nose plugs are removed (usually within 24 hours) and you can go back to your normal routine within 10-14 days and back to regular exercise within four to six weeks but avoid strenuous exercise for six weeks post operatively. At NosePlasty Clinic you are encouraged and required to walk 5 Kms. per day post surgery. If you are involved in any sport or activity that may cause injury to your nose, wear appropriate protection or better still don't play the sport for about one year until the nose is properly healed. Also be sure to protect your nose from sun exposure.
- How do I prepare for surgery?
To prepare for surgery take a few days away from work. Have someone to pick you up after the surgery. (Transport and accommodation can be pre arranged at NosePlasty Clinic). As you are not given general anaesthesia you will be fully functional within fifteen to thirty minutes after surgery, but for safety we insist that you do not drive until the next day!
- Can I smoke before or after rhinoplasty surgery?
No. NosePlasty Clinic surgeons will not operate on you if you are a smoker. You must cease smoking for four weeks prior to the surgery and you may not smoke for 12 weeks thereafter. Smoking interferes with the healing process and may even make you vulnerable to infection or rejection of grafting material.
- Can snoring problems be dealt with during rhinoplasty surgery?
Yes. The nose has three valve areas which should be functional and free of obstruction. Studies have shown that more than a third of clients desiring cosmetic rhinoplasty have compromised nasal breathing - which in time may lead to snoring. As a matter of interest a drooping nose tip causes a turbulent inspiratory flow of air that actually causes nasal blockage and hence snoring. Treating this drooping tip by means of the rhinoplasty surgery results in normal inflow of inspiration and results in significant dimunition or even stopping of snoring. Noseplasty Clinic and it's surgeons do not treat or deal with medical problems related to compromised nasal function.*
- How much is too much nose plastic surgery?
Your psychological make up, your age, your motivation, your realistic (or unrealistic) expectations and physical health should all be taken into account when considering cosmetic plastic surgery. Good advice is to consult with your immediate family especially if there may be ethnic objections to a nose shape change. Some Afro-American or Oriental ethnic groups of people consider a change of the nose shape undesirable. Make sure that your spouse and family will accept the change, because a rhinoplasty change is often permanent and not easily undone. Nose job surgery is a serious decision and you must be psychologically prepared and want the change and make an elective decision and weight up the pro's and con's. NosePlasty Clinic surgeons never encourage rhinoplasty surgery for psychological reasons.
If you have had previous nose surgery remember that every surgical intervention lays down scar tissue and every operation becomes more and more complicated with every surgical intervention. The surgery may make your nose shape look even worse, rather than better. Be guided by your surgeon.
- Will a septoplasy (or submucous resection-SMR) change the shape of your nose?
Yes it can and often does, especially when it is incorrectly performed.
The nasal septum forms part of the bridge of your nose. The septum is an important structure for nose shape, and if too much of the septum is removed or damaged in septoplasty the nasal bridge can collapse. If too much of the septum has been removed in a septal surgery then it may be impossible to obtain grafting material from the nose if it is required as graft material for nose tip reconstruction. So it’s best to combine the cosmetic nose shaping with the septum surgery and not to have septal surgery prior to rhinoplasty. If the septum surgery has been aggressive a septal perforation can result with it's severe consequences. See 'Anatomy and Physiology'
- Can the shape of the nose change naturally?
Yes. With the understanding that it does get ‘longer’ with age, just as the ears become longer because of the pull of gravity and diminishing muscle tone of the face. Also the nose tip cartilage attachments to the septal cartilage weakens with age and gravity thereby resulting in a “relative” hump to the nasal dorsum. This can be corrected by a minor, surgical, noseplasty procedure. Noses that have had noseplasty or rhinoplasty tend to retain their shape better than non-operated upon noses.
- What should I beware of when I am looking to have rhinoplasty?
The 3 B's from surgeons-'Bulls..t' , Bragging , Bluff !
NosePlasty Clinic does not treat medical conditions.*
Snoring is an anatomical issue when it's related to partial nose blockage (due to nose shape causing nasal passage partial obstruction). In such cases cosmetic nose shape surgery should* be designed to also relieves nasal blockage, thereby stopping or reducing snoring and sleep problems. Long term partial nasal blockage CAN and often DOES LEAD to various serious medical (and matrimonial) problems. Snoring can be a sign of nasal obstruction and sleeping disorders which can lead to serious repercussions. * The purpose of cosmetic nose surgery is to correct unaesthetic appearance, not to correct nasal blockage and for this reason many medical insurances do not pay for cosmetic nasal surgery.
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Text 14 November 2020 15:35