I know if my appearance can be improved by surgery?
your first office visit, this question will be
discussed and your pictures will be taken, either
with a digital camera, a regular camera, or both. Drawings
and sketches done on your profile pictures will
clearly show what changes may be made to improve
your appearance. You will be given copies of all the
pictures taken and all the drawings done.
The color prints
from film require one or two weeks and are five by
seven inches in size. You will be offered copies of
each one or they can be mailed to you.
The drawings on your
own pictures show what is possible. The
prints of the drawings can be done on the first
visit and are eight by ten inches in size and are
black and white. We prefer black and white prints
even though they can be printed in color for many
You will have the
opportunity to see twenty books, each containing
approximately 200 before and after 5x7" photos of
changes in appearance of the nose. This can give you
an idea of what can be done on a routine basis.
Anyone who wants to
know what improvements can be made in their
appearance may take this opportunity to have their
pictures taken to see what can be done.
Actually, just about
anything that can be drawn can be done. And we can
make the nose just about anything we want it to be
in shape with few limitations (which, if they exist,
will be explained in detail).
So anyone can do the
drawings. If the person wishing to have a certain
look or appearance wants, they can do the drawings
themselves, or have someone else do it. For many
years different artists have done the drawings for
us, usually with pen and pencil long before there
were personal computers. And we can show some of
those drawings and allow copies to be taken.
And still, today we will use the pen or pencil on
copies of the digital drawings to further improve
Many copies and
photocopies of the photographs and drawings may be
taken home for further study. When
you have selected the drawing that is the most
attractive for your face and personality, the doctor
will know how you want to look.
surgery itself is not painful. There
is usually very little discomfort following the
operation, although the nose may be somewhat tender
to touch. Rarely is medicine for pain required. Over
90% of patients say the surgery was a pleasant
there visible scars from the operation?
All incisions are made inside the nose where they
cannot be seen, although there are some very rare
For these rare
exceptions this will be explained to you. There
should be no scars.
There is such a
thing as the open technique, which leaves a little
scar in the skin on the little column of tissue that
is between the nostrils. This can result in a
visible scar. We do not do this.
there any danger in nasal surgery?
is not much danger involved. It
is probably more dangerous to drive to the office to
have it done (because of the risks involved in
driving a car) than to have the surgery. Some
infection or nosebleed may occur in a very small
percentage of cases. The incidence of noticeable or
serious infection or bleeding is less than one in a
anesthesia is preferred over general anesthesia
because it is so much safer.
age may surgery be done?
surgery can be done at any age. A
badly injured or deformed nose with obstructed
breathing may be repaired in children. Also,
many elderly persons benefit tremendously in their
appearance and breathing comfort because of nasal
age is it best to have nasal surgery to correct an enlarged
nose or a nose with a "bump" on it?
nose is usually still growing until age twelve or
thirteen for girls and fourteen or fifteen for boys. It
is usually best to wait until about this age.
Sometimes the younger person will have a much better
result if the procedure is done early before the
nose grows and becomes very large.
the nose grow longer and larger with age?
we grow older, our noses tend to droop along with
the skin of the eyelids, cheeks and neck. Normal
elongation of the nose accentuates any hump-like
appearance and makes the person look older and the
nose larger. Many
breathing problems that result from aging may be
corrected, and a more youthful appearance can be
restored via nasal surgery.
nasal surgery performed?
patient is given sleeping medicines and medicines to
prevent any discomfort. Enough
medicine may be given to allow the patient to sleep
through the procedure if desired. Shaping
and remodeling of the nose is carefully and gently
done, working inside the nostrils. The
nose is made numb with local anesthetic. The
patient is assured there will be no significant
patients complete a questionnaire about
their experience with the operation and the
anesthesia, and anyone visiting us is welcome to see
all of the thousands of questionnaires and the
answers have been tabulated and summarized for quick
is this surgery performed?
surgery may be performed either in our outpatient
surgery center or in the hospital, especially if
insurance is expected to cover part of
the cost. Many patients prefer to have surgery
performed as an outpatient because of greater
privacy and the financial savings gained from not
having to pay for a hospital bill.
cosmetic surgery of the nose be performed at the
same time as surgery to correct a breathing problem?
this is frequently done very successfully. Occasionally
the problems must be handled separately.
breathing through the nose be made worse by having
cosmetic surgery performed? This
is certainly possible, though it is very rare and
unexpected, especially when surgery is performed by
a nose specialist who also does surgery to correct
caused the "bump" on my nose, or how did my nose
become crooked? Sometimes
there is a clear history of injury. Many
crooked or bumped noses, however, result from minor
injuries in early childhood or infancy which neither
the person nor the parents remember. Some
large noses and breathing problems are partly
medical insurance pay for the surgery? If
there is a legitimate breathing problem or if there
is a history of an injury causing a deformity and/or
a breathing problem, insurance will usually pay part
of the cost. The
office staff can help you determine how much your
insurance will cover.
much will nasal surgery cost? We
follow the California Medical Association's Relative
Value Scale guidelines. These guidelines can be
explained by the office staff. The
fee may be more or less, depending on what needs to
be done. The
exact cost will be determined for you when you are
seen in the office.
does it cost to be seen and have my photographs
initial office consultation as of 1998 is eighty US
dollars and includes follow-up visits as needed
several weeks later for discussion of the pictures
and for planning of the change in appearance. There
is no additional charge for photographs.
nose more fragile after surgery? The
nose should be touched only very gently for three
weeks following surgery. Contact
sports such as football and basketball, in which the
nose may easily be injured, are prohibited for two
there any restrictions on my activity following
the first week, the less active a person is, the
less swelling they will have. Swimming
is allowed after one month. Written instructions are
given to each patient for post-surgery care.
Occasionally, a cast is required, but usually there
is no bandage and the person is breathing
comfortably through the nose with no stuffing or
packing required after surgery? Not
very often. More than 90% of our patients require no
packing in the nose, and are breathing through the
nose when they are ready to go home.-- Usually the
nose becomes quite congested after the first night,
and frequently is so obstructed with congestion in
the first week that little or no air at times can
get through. Then it is like recovering from a cold.
breathing obstructed after surgery? Yes
usually. There is some congestion or swelling inside
the nose in most cases, and it feels like having a
common cold in the first week or so. Some persons
who had very blocked breathing before surgery,
breath better than ever from the moment the surgery
What can be done for the stuffy nose in the first
week after surgery? The
patient is encouraged to sniff back or to inhale
through the nose to keep the airway as clear as
possible. Blowing is prohibited because it will
cause more swelling or even a nosebleed. It is
alright to take over the counter decongestants, such
as Sudafed or Actifed, but nose sprays or drops must
not be used.
On your after
surgery instructions there is an explanation of
sniffing warm salt water and this can be very
soothing and a great help.
If the patient is
unable to breathe well on the second or third day
after surgery, a visit to the surgeon can correct
the problem by opening the airway to make the
patient much more comfortable.
be "black and blue" after surgery? Most
patients have no "black and blue" and very little
swelling. Usually if there is slight discoloration
or swelling, it can
be covered with make-up the day the tape is removed
from the nose in the office, five or more days after
surgery. Some persons bruise easily no matter what
is done, and may become discolored and swollen in
appearance. Our usual patient who has no significant
discoloration finds that the very little swelling
present has mostly subsided in one or two weeks
long does it take to be presentable in appearance
after nasal surgery? Usually
only one week after surgery, with the help of a
little skin tone make-up, strangers you meet will
not be able to tell any surgery was done. For those
patients who bruise easily, two or
three weeks may be required. Close friends and
relatives may detect a change in appearance,
depending on how great a change is made, especially
in the first month after surgery. Those persons who
want only to be seen when they look their best, and persons
who are especially sensitive to the opinions of
others, may want to take several weeks to adjust to
their new look themselves before they make any
does the nose appear normal after surgery? Very
often the nose appears shorter and more turned up in
the first two or three weeks due to swelling. Most
of the swelling subsides by the
end of three weeks. The remainder gradually
disappears over a period of months. When the change
in appearance in the nose has been a small one, the
nose usually looks near normal when the cast is
removed. The greater the change, the more the
swelling and the longer time required
for the swelling to subside.
long does it take for the swelling and discoloration
to disappear? There
is usually very little swelling or discoloration.
Ordinarily the small amount of swelling present has
mostly subsided in one or two weeks. Any
slight discoloration present may usually be masked
by make-up when the tape from the nose is removed
four to five days after surgery. Some individuals
bruise very easily and no matter what is done, they
may become discolored and swollen in appearance.
These cases are generally back to normal in three or
Will my nose look too turned up or will it fit my
your first visit, your pictures will be taken, and
you will be asked to return to discuss the
photographs. You should plan to spend an hour or
more with my assistant and myself on that visit.
Computer drawings may take the place of photographs.
In the discussion of your pictures you will be asked
what changes you feel would most benefit your
appearance. My assistant and I will make some
suggestions and indicate to you what can be done. As
the plans are made, a final goal is selected from
the profile drawings we have made and on which there
is mutual agreement. You may take copies of the
for further study.
The result of
surgery is generally very much like the planned goal
and is often better than expected. Frequently,
however, the nose looks temporarily too turned up in
the first few weeks until the swelling subsides.
I be sure I will be happy with my nose? Though happiness
cannot be guaranteed, most people are happy with an
improvement in appearance. It is our goal to create
a change in appearance that almost everyone will
agree is an improvement. I believe the most
important person to please is the patient. Every
reasonable effort will be made to accomplish this.
In about one out of four patients, some additional
surgery may be done to achieve the most desirable
may I return to work? Some
persons who are self-employed, such as the owner or
manager of a business, return to work the next day.
If the work involves stooping or straining or
appearing in society, at least a week's leave should
be taken. Some of my office assistants have returned
to work in the office with the bandage still on the
nose one or two days after surgery. For those who
have sick leave accumulated and want to be away from
work during the healing period, up to three or more
weeks off work is recommended.