I've wanted to get a rhinoplasty done for 12+ years! I just never thought I'd actually follow through with it until I gradually (over the past couple years) started having trouble breathing at night. It got to a point where I was so exhausted trying to fall asleep and then when I'd wake up in the feeling so foggy and it'd last throughout the day. --- Research --- Somehow I came across the RealSelf site around the same time as I started having trouble breathing and it helped me build up the courage to take the next steps for myself and find a surgeon to meet with. I did a ton of research for doctors up and down the i-5 corridor and I found Dr. Lichtenberger. I saw a couple of his before and afters on his website and was really drawn to the results of two people who I felt had a relatively similar case to mine. They both had prominent curves to their noses and he was able to construct a straight nose for both of them and the results looked amazing. I did a little more research and watched a video of presentation he gave where he described his goals for rhinoplasties in general: natural, conservative results where the nose blends right into the face. I was sold and scheduled a consultation right away! --- Consultation --- I'm so glad I followed through with the consultation because not only was Dr. Lichtenberger super nice and helpful, but Katy and his entire staff made me feel so welcome and comfortable opening up about what bothered me about my nose and the struggles I'd started to experience with my breathing. I also felt super validated after telling Dr. L about what I saw and then having him go over what I had said and point out the ways in which he'd help me to achieve the overall goal of both straightening out my nose and helping me breathe better. Apparently, I had a deviated septum that was definitely obstructing my airways so hearing that helped solidify my decision to move forward with the next steps. In that same consultation he explained to me the differences between a septoplasty and rhinoplasty and also showed me some examples of his work as he talked through the approaches he took. He even walked through the two people I saw on his website that I had come across on my own and it gave me the confidence that he could help me too. --- Surgery --- I booked the surgery with Dr. L and patiently waited for the two months to pass before my surgery date. I created YouTube playlists of people who had went through this surgery and also saved some reviews here on RealSelf to better prepare myself for post-op care. When my surgery date came, the only thing I was nervous about was going under anesthesia but otherwise I was totally confident in Dr. L and his team. My pre-op care was amazing! I met with the nurse who prepped me and had me change and then wrapped me in warm blankets. Then, I met with Dr. L who caught up with me about how I was feeling, answered any questions and then drew some markings on my nose. Lastly, I got to meet with the anesthesiologist who asked me a few more questions before the nurse came in to help me over to the operation room. Everyone was super nice and put me at ease and then just like that I was waking up in the post-op room with another nurse. She kept me company and was super attentive. My husband came back to the room too and she explained post-op care and then Dr. L came back too and helped answer additional questions and check in on me before I was off to recover at home. --- Recovery --- Recovery wasn't too bad for me and I attribute that to Dr. L's skill and approach. He had sent me home with surgical tape, gauze, nasal moisturizing spray and afrin nasal spray as well as prescriptions for antibiotics and pain medicine (which I picked up days before my surgery). He also sent me home with directions for post-op care which was helpful. I'll detail my recovery in a separate post but by the time it came for the cast to come off (about a week later) I was so ready to see my new nose. --- Cast Removal --- I think the worst part of the removal was the numbing spray they gave me. It went right through my nose and down my throat and tasted terrible! But that was honestly the worst part for me. Katy and Dr. L were gentle and walked through each part with me getting me prepared for when the cast came off, when the stents were coming out and cleaning out the gunk and mucous. I can't fully describe how wonderful it was to breathe again after that past week of recovery. But also, how wonderful it was to breathe after having a deviated septum for my whole life!!! To this day my breathing is still greatly improved even after Dr. L warned me that my nose on the inside might swell a bit now that the stents are removed. Dr. L then cleaned the outside of my nose before the big reveal! I cried a tad when I saw what he was able to do! My nose was slightly swollen but so straight and beautiful! He gave me the nose I'd always envisioned and I couldn't believe how perfect the results were. --- One Month Post-op --- I'm a couple days past my one month post op and I am still in awe of the results and the fact that I actually did this for me! I can't recommend Dr. Lichtenberger enough and am so happy with the results that I've had no problem sharing with co-workers and even extended family. I feel so much more confident with myself and truly do not waste time thinking about my nose and worrying about how it looks like I had done before surgery. My nose is still slightly swollen but that's to be expected and will continue to change overtime. Also, having improved breathing has been amazing!!! I have not struggled to fall asleep at all post-op and wake up feeling so much better than before surgery. I highly recommend Dr. Licthenberger and can't wait for my 3 month check-in! Updated on 6 Nov 2018: Today marks 8 weeks post op! I'm still amazed at the results when I compare how my nose looks today with how it used to look before. There's definitely some swelling still and the bridge of my nose is sensitive to touch. I make sure to be extra gentle when I do have to touch it when washing my face in the morning and at night. My skin is oily now post op so I'm trying to remedy that by finding a new skin care routine. Otherwise, the healing process is going well and I don't think about my nose at all! In a good way of course. I don't waste energy worrying about how it looks from certain angles and I'm not so insecure anymore. Also, I sleep so much better now because I'm not struggling to breathe through my nose! The incision site is healing well too and is super hard to see it anymore. Updated on 19 Mar 2019: A couple weeks ago marked my 6 months post op. At the 3 months mark I had a check-in appointment and everything went well! I let my doctor know that I was very happy with the results and being able to breathe so much better. I also let him know that sometimes I feel like I see a very slight curve in the left side. But it's still a little early to do anything about it because there was still swelling in my tip and on the right side. If need be once, I get to my 1 year post op there are some options I can do to get it touched up. Now that I'm 6 months post op I feel like the swelling in the right side of my nose is starting to decrease more each week. I've also been able to blow out my nose no problem and my nose is no longer sensitive to accidental bumping; for example like if my shirt bumps it or when I'm washing my face. I love the way it looks and I can't believe how quickly the months go by. I'm looking forward to my 1 year to see how the graph has settled and how the swelling has disappeared. Updated on 19 Mar 2019: --- What I Ordered --- • Soft gel Ice packs (avoid using these too close to your nose) • Lip balm and/or Vaseline (TBH I didn’t need to buy a huge thing of vaseline but it was nice to have to coat my lips overnight when I tried to sleep) • Travel neck pillow for sleeping. I ended up buying a body / pregnancy pillow and I’d highly recommend that! Or if you have 4 pillows you could make your own makeshift body pillow. • Biotene Moisturizing Mouth Spray (Or some sort of dry mouth spray) - You might be able to find in the grocery store but I had to purchase on Amazon • Button up pajamas and comfy pants. You don’t want to wear clothing that you have to put over your head. • Micropore hypoallergenic surgical tape - I ended up not using this because my Dr gave me both the tape and gauze and his supply lasted me the entire time. --- Grocery Store / Dr Supplied --- •Straws - you’re going to want to drink EVERYTHING through a straw. • Orajel - I don’t know if your teeth will hurt but mine did. This helped take away the ache. Honestly, my teeth bothered me way more than the stuffy nose!!!! • Q-tips for cleaning your nose. The Dr may give you some but you’ll want a HUGE supply of your own to get gunk out because you can’t blow your nose for quite a bit after surgery (I think about two weeks). But then, your nose will be swollen and you won’t want to blow through it anyways, so a q-tip is good to get in there. • Baby or travel sized toothbrush • TheraBreath Dry Mouth Lozenges - Great for when your mouth is dry BUT also they help settle your stomach • A good hand moisturizer. I loved CeraVe. • Arnica tablets for under your tongue - HOLY GRAIL!!!! Seriously minimized my bruising and swelling. • Arnica cream (don’t apply near cast because it could loosen it) - I applied it to my cheeks, jaw and the sides of my eye bone maybe about 3 times a day. • Nasal saline spray - your Dr will probably give you some but I also bought Major deep sea premium saline nasal moisturizing spray • Afrin - I NEVER used it. I was so nervous my nose would get “addicted” to it. My nose did get stuffy at times but never that bad where I needed to use afrin. Your Dr will give you a bottle of it anyways for the “just in case”. • Zinc - I believe this helped with the nose and healing • Extra strength Tylenol OR Signature Care Extra Strength Pain Relief Acetaminophen • Vitamin D3 • Vitamin A • Hydrogen peroxide - for cleaning your nose • Gauze - My Dr gave me enough gauze but I bought a box of 25 pads just in case. Never had to open them though but hey now I have extra for my first aid kit. • Summer’s eve cleansing cloths or something along these lines because you really don’t want to risk showering and loosening up your cast • Dry shampoo *totally optional* but it felt nice to freshen up --- Food --- • Pineapple juice • Oatmeal • Chobani greek yogurt • Peppermints • Jell-o • Saltine crackers • Low sodium soups (I lived off of potato soup and Chicken noodle soup) • Smoothies • Pudding • Apple sauce --- Notes --- Bromelain (found in pineapple juice, helps with inflammation) -- I know pineapple juice is added to my list above and you should STOP taking it 2 weeks before surgery as it could increase bleeding. But after surgery drink ALL the pineapple juice lol. Between that, the anicare tablets and ice packs, my bruising was minimal. Do not try and do any chores that first week! Seriously, take it easy the first 72 hours. Only get up to change your gauze and clean your nose. If you can have someone stay with you, don’t feel bad asking them to bring you stuff. This will help minimize swelling! Don’t be afraid to really get that dried blood and gunk cleaned up around your nostrils. It might hurt just a tad the first time you do it, but if you get yourself cleaned well then every time afterwards will be easy. Also, your Dr should show you how to clean it without damaging anything. And it was good to practice using a saline nose rinse before the op if you've never used one before. It's super simple but knowing what it feels like will help you be less nervous spraying it up into your nose after surgery. If you have an open septo/rhinoplasty DO NOT get tempted to pull out the removable sutures. Take photos! I took photos morning and night for two weeks straight and then once a week for 3 months and now I’ve only done photos for appts and the upcoming 6,9 and 12 months. It’s so fun to look back and see how far you’ve come. Take a Tylenol before you go get the splints/cast removed. Fill prescription prior to surgery. --- In the photo attached to this post "Cleaning Station" (top photo) --- I kept the following items ready in the bathroom for when I needed to clean my nose. It made life SO easy, especially in the middle of the night when you need to deal with the situation. • q-tips • Hydrogen peroxide • A small bowl to add a little bit of hydrogen peroxide for dipping clean q-tips into • Deep sea nasal spray • Neosporin or the dr might give you “bacitracin zinc ointment” • The gauze from the dr • The tape from the dr • Arnicare gel • Orajel --- In the photo attached to this post "Medicine Station" (bottom photo) --- In my kitchen I kept the following items and wrote down the time I took certain things and set my phone timer to stay up on meds: • Prescription pain meds • Arnicare tablets • Zinc • Vitamin A • Vitamin D3 • TheraBreath Dry Mouth Lozenges • Biotene So I know that was a long post but these types of things were what I searched all around RealSelf for prior to my surgery to make sure I had everything I needed. I didn't attach links into the post to keep it from getting too crazy and cluttered but I hope the photo attached of the items I used will help anyone find what I listed.

Exceptional doctor. I had a deviated septum that had been repaired by another surgeon 25 years earlier. Since the original repairs I had broken my nose a couple more times and need another repair - and some cosmetic work. Dr. Lichtenberger provided the service was I was looking for. Importantly he listened to my requests, gave sound advise when needed (which I followed) and the surgical procedure was excellent with very little pain afterwards. The results are incredible. Do your research when looking at surgery, as I did, but take it from me, Dr. Lichtenberger is the best in Bellingham.

Had my first round of Kybella injections on Friday. Swelling wasn't bad, peaking after 24 hours and now almost entirely gone after 96 hours. Burning didn't last more than an hour and was about a 2 on a pain scale of 1-10. So far, I have no hardness in the area or bruising or pain of any kind. The only evidence I had the procedure done is a bit of jiggle still present in the skin from the excess fluid. I will most likely update to a "Yes" it was worth it once the weeks go by. But so far, it's been less painful than an eye exam. Updated on 20 Mar 2017: Not seeing *any* improvement. Wondering if Kybella just isn't for me. Photo on left taken just before first treatment in late December, photo on right taken today, March 20.

January 21, 2015 Dr. Jason Lichtenberger 2940 Squalicum Parkway Bellingham, WA 98225 Dr. Dr. Lichtenberger and Staff, From the moment I entered your clinic it was a marvelous experience. I was treated with the utmost kindness and concern and caring during a very vulnerable time in my life. I also want to express appreciation to the nurses who cared for me as well, and in particular, Julie Adams. She was professional, warm, caring and concerned and did everything she could to make this a comfortable experience for me. I would highly recommend your clinic, staff and just the general caring atmosphere you have created to ensure the best possible experience for your patients. Sincerely, Lynn Thank you so much

This has been a long time coming! As of the time of writing this, it is the day of my rhinoplasty and I am just at home recovering. I had two consults with Dr. Lichtenberger before scheduling my surgery, and he was great at answering my questions and letting me know what to expect. He used photo editing software to give me a general idea of our goals for my nose after the surgery and in the long run once it has fully healed of course. I will be updating this review with my final rating and whether or not it was "worth it" once I'm a bit further along in the process, but everything has been great so far! The surgical and anasthesia staff was all great and put me at ease, as it was my first time under general anasthesia. I didn't have any bad side effects from it like nausea or anything. I was just a bit groggy when I came out of it, and have a bit of a sore throat from the intubation, but it's manageable! I have only taken a minimal amount of my prescription pain meds so far, as the pain has not been too bad overall. I can currently see some brusing near the top of my nose and inner corners of my eye area, but nothing crazy so far! I'm doing really well currently, and just relaxing and recovering at home. I will post some before and just after surgery photos, and then of course more later once the cast and splints are removed! Updated on 1 Mar 2019: I had my surgery on Tuesday and now it's Friday, so I'm currently three days post op! I only had to use the drip pad below my nose for about the first 24 hours after surgery, and after that the bleeding and dripping had subsided enough that I could go without it. The bruising near the top of my nose has already mostly gone away, but I did get some more that appeared underneath my eyes (not super dark). I also stopped taking the prescription pain meds last night, so I've transitioned just to regular Tylenol now! My pain previously was only somewhat bad when I was trying to sleep. More uncomfortable than anything else. I've been pretty tired and just resting at home mostly, though one of my friends got me to get out of the house for a little bit yesterday and we went to get one frozen yogurt, which was nice for my sore throat! I'll post a photo of how my recovery and healing is going today! Updated on 4 Mar 2019: Today I am 6 days post op and I got to get my cast remove and splints taken out of my nose! It's amazing to see what my new nose looks like (more or less) and so nice to be able to breathe better and feel more comfortable without all that stuff in my nose. I've posted some photos here of what my results look like so far! No more significant bump in my side profile, and my nose is so much straighter! Plus the tip is a bit more smaller and defined. I feel like my swelling really isn't all that bad. I was expecting it to be worse and for my nose to look a lot bigger at first, but it still looks smaller than before! It will definitely take some getting used to, and it doesn't really feel like my nose yet, but I am overall really happy with it! I know it is still going to change a lot over the next several months I have some numbness in my tip, which I know is super common and normal, and will diminish over time. My incision site is still a bit tender, and some of the dissolvable stitches won't really be gone for a few more days, but they aren't noticeable. I'm also still tender in some areas of my nose, but it's not noticeably painful on a regular basis or anything. My bruising as well is nearly gone at this point! Also, I was originally going to note this in the first part of my review but forgot: the procedure cost for the rhinoplasty was only $6000, but then you end up paying about $3000 in additional costs once you add the operating room fee and anasthesia fees on top of that. I figured it was more helpful for people to get the full picture of the cost that way! I'll continue to update as we go, and my next follow-up visit is with my surgeon in one month!

Update on Kybella treatment a little over 8 weeks after the 2nd injection of 2 vials for a total of 4 vials overall. I don't think anything's changed. LOL. I've very carefully taken photos tonight to compare to where I started in late December of last year, and I can't tell any difference at all. This is backed up by friends and family who also see no difference. I'm thinking I should cut my losses and either stop the Kybella or consider another procedure. I should add that my esteem for Dr. Lichtenberger is unchanged as I understand everyone reacts differently to treatments. He and his office have been nothing but wonderful throughout. And Kybella might indeed be "Worth It" for others and obviously is. But I feel like I should see *some* change at this point, even a meager millimeter, no? Opinions? Updated on 8 Aug 2017: After 3 sessions of 8 vials spread over six months, there is literally *no* discernible difference to my chin. This is NOT, I should say, for lack of Dr. Lichtenberger trying. He has been exceptionally helpful and supportive throughout. It's simply in my case, it didn't work. Each time, I had the reaction and was full of "liquified fat" [sic], but it just couldn't overcome my neck's natural shape. So for me, it's a thumbs down. But I believe with the right person under the right circumstances, it could still produce results.

Dr. Lichtenberger and the staff made me feel welcome. Dr. Lichtenberger did a really good job of explaining several of my options to me. He answered all of my questions and helped me understand the outcomes of each of the possible solutions. I would definitely go to Dr. Lichtenberger to have this procedure done.