Finally, a normal looking nose! - Chicago, IL
- updated 1 year ago
I had my initial rhinoplasty in 2001 when I was...
- 29 Jul 2012
I had my initial rhinoplasty in 2001 when I was 23, and while it was an improvement over the old nose, I was never 100% satisfied with it -- the doctor left a hanging columnella and slightly over-rotated tip. In addition, the nose seems still a bit too projected for my (small) face. So after much research and time, I am finally taking the plunge and getting a revision done by Dr. Anil Shah next week! I met with several doctors and his suggestions and imaging best matched what I originally wanted my nose to look like. Updates and photos forthcoming...
I had my surgery yesterday! More details below. I...
- 8 Aug 2012
My pre- (one week before) and post-op vitamin routine has been 500mg of vitamin C and 50mg of zinc once a day. I think that has really helped the bruising, my first rhino I had two black eyes for two weeks! Anyway, detailed surgery reviews are below.
Week before surgery
One of the nurses called to review pre- and post-op instructions. So far the staff have been very friendly and informative, despite it being clearly an extremely busy office. I had one more in-person meeting with the doctor four days before surgery to review the surgical notes from my first rhino and to make sure we were on the same page about expectations and outcome. I do not want any surprises this time! It was a brief but good meeting and I felt confident that he could give me the results I was hoping for.
Day of surgery
We arrived very early in the a.m. and I was the only patient in the surgery center during the whole procedure. My nurse (Rommel) was fantastic. He had such a positive attitude and friendly disposition, really important for a nervous patient! Dr. Shah arrived on time, we went over everything once more, they started the IV for antibiotics, and another nurse walked me to the OR. The OR got me a bit scared, plus it was *freezing* but I could see Dr. Shah had posted my photos with his notes on them right next to the operating table, which I really appreciated. A nurse put warming wraps on my legs and the anesthesiologist gave me the stuff. I recall shivering and wondering when it would kick in, and then woke up to Rommel's smiling face preparing me for the recovery room. The heated blanket was amazing! Meanwhile Dr. Shah had visited my boyfriend in the waiting room to tell him that everything went well. I stayed in recovery for about 2 hours, during which the nurses fed me applesauce, juice, and a pain pill even though the pain was minor--mostly sinus pressure and a dull headache. I wanted to talk to Dr. Shah again before leaving, but we had to wait a while for him because he was already in the clinic seeing other patients. However, when he arrived, he seemed very positive, and said everything went smoothly. There had been a chance of having to use ear or rib cartilage but he said he didn't need to do that, and just used septal cartilage for the tip graft. I was VERY pleased to hear that. Also he mentioned there was a lot of scar tissue from the previous rhino, which he removed. So then they wheeled me out, we took a cab to the hotel, and I slept on and off most of the day. My boyfriend was very diligent about doing the 20-min on, 20-min off ice routine. We also had to change my gauze "moustache" a few times because there was a small but steady blood drip. I ate some frozen yogurt (Pinkberry!), chicken broth, and a Naked smoothie. Also took the pain meds every 4 hours, although nose pain was minimal. My throat did hurt a lot though, both from mouth breathing and the breathing tube they used during surgery.
I woke up with no nose pain but a very sore throat and some body aches. It's essential to keep cold water and straws around for the throat, and Aquaphor for dry lips. I decided not to take any Vicodin because while being bandaged up is obviously uncomfortable, nothing really hurt. Pain was maybe a 3 on a scale of 10. Both Rommel from Gold Coast and Mia from Dr. Shah's office called me in the morning to get updates on how I was doing. Since there had been no nausea, minimal pain, and only a bit of bruising (under the right eye), they seemed very pleased about the progress. We drove home (90 minute drive) in the afternoon, and I did take a Vicodin for the car ride, assuming it would be unpleasant. Riding in the car was actually fine at first, but towards the last 30 min or so, all the bumps were making me headachy, nauseated, and generally feeling bad. We made it back home and iced me right away, which helped a lot. We've been doing the frozen pea method, which works great. There's been a reasonable amount of bloody mucus in my throat that I've needed to cough up today, but draining on the "mustache" has slowed. It seems to drip more after I've been walking around. Nose pain level is still very low, a happy surprise! Bruising aready changed from purple this morning to more reddish in the evening. Had lentil soup and watermelon chunks for dinner; trying not to eat anything too chewy. Honestly I am just thrilled that I can finally drink coffee again tomorrow :)
More updates to come...
Days 3-6 Nothing too major happening on these...
- 13 Aug 2012
Nothing too major happening on these days; pain has been mostly nonexistent except for some stinging/tenderness around the stitches after cleaning with saline solution. The upper lip area feels kind of stiff, and I'm trying not to smile or laugh much, but that can be hard! I've been off the Vicodin except for taking a half-pill on day 3. I'm going to be honest, one of the main reasons for going off Vicodin asap is that the combo of that and antibiotic makes it basically impossible to go "number two"...yeah I said it. ANYWAY so the bruising has improved significantly (now mostly greenish), but my face did still look and feel a bit swollen days 3 and 4. Inside it still feels swollen. I finally put contact lenses in on day 4 and also stopped icing. The past two days my nose has been pretty itchy around the stitches, and I'm getting a lot of tingling sensations on the tip (this should mean the nerves are healing in the tip graft). It also alternates from constantly dripping clear mucous (I had to make another moustache) in the morning to feeling more dry and open in the evening. The doctor's office said all this was normal. They have been really fantastic, calling every day to check on my progress. Overall recovery is going smoothly; day 4 was when I pretty clearly started to feel more like myself again and am feeling better every day.
Cast comes off tomorrow!!
So the cast is gone. Everything around my nose...
- 14 Aug 2012
Day 10 I posted some new photos. It was so...
- 17 Aug 2012
I posted some new photos. It was so swollen and drippy and sore on cast removal day that I couldn't bear to take any pics. Swelling has subsided only the tiniest bit--- basically it feels like there is an alien appendage on my face. :) Obviously still quite a ways to go with healing. Forgot to mention that I am doing Type 2 taping at night, which seems to help with swelling. Ever so slowly I'm regaining sensation in the tip area, but smiling still feels weird. Overall the nose shape is looking ok, and I'm very pleased with the columella/alar retraction fixes...but the whole thing also looks/feels pretty big yet so I'm hoping to see it get a bit smaller & more refined as time goes on.
Week 3 Had my 3rd week appointment with Dr....
- 29 Aug 2012
Had my 3rd week appointment with Dr. Shah yesterday. He seemed like he was in a good mood and said that everything was healing well. One gets the impression that he gets a lot of complaints about the healing process, though, because he really emphasized how long swelling can last, etc. All of us at RealSelf should know this by now, right? I am trying to be pretty relaxed about it but it was helpful to listen to him spend some time talking about the recovery timeline and its somewhat protracted course for revisions and more complex procedures. This experience has been very different than my first rhinoplasty, and of course the first one was long enough ago that I don't remember as many details. For anyone else considering a revision (or even a first-timer), it's so important to keep in mind that each experience is different and the recovery process is highly variable, depending on the doctor, the complexity of the procedure, open vs closed rhinoplasty, and other individual differences. I try to remind myself of these when reading about other experiences and thinking about my own healing process.
The only real problems I'm having are excessive runny nose in the mornings and when I take walks, and increased numbness & discomfort during walks (haven't been cycling or doing heavier exercise yet). This is pretty frustrating because I can't blow my nose or sniffle too vigorously, but Dr Shah suggested regular irrigation with saline solution. I've sneezed several times and it seems fine if a little uncomfortable, and I try to let the sneeze come out through my mouth, if that makes sense. Tip sensation has improved but has a ways to go, and he doesn't want to do kenalog injections yet. Also, on a couple of days I taped a little too firmly and got a minuscule bump where the tape was. I've been told that all of this is normal and will disappear... sooner than later I hope!
Finally...before I start nitpicking about swelling, tips, perfection, and so on (as will surely happen in the coming weeks/months), I'd like to note that the result so far is natural enough that it's almost too easy to forget how bad it looked before. Look at those photos. My original rhinoplasty was BAD. Even at this early stage in the healing process, I can say with confidence that Dr Shah took my hack-jobbed nose and made it look normal. For that alone I am so thankful and happy.
One month down. Do things get worse before they...
- 13 Sep 2012
Hard to believe it's already been two months. I...
- 8 Oct 2012
I chose Dr. Shah after years of debate on whether it would be worth it to get a revision, and finally meeting with 3 facial plastic surgeons in various cities. Although Dr. Shah is young, his training in facial plastics, co-authors and mentors, number of publications, and comprehensive website as well as the detailed reviews on realself convinced me that he would be the best choice given my location and needs. Also, his photoshopped version of the expected outcome was the closest to the photoshopped picture I'd made myself and brought in. This made me confident of two important things: that my expectations were reasonable and that he felt capable of fulfilling them. All this said, it's clear he is at a prime stage of his career and trying very hard to keep building his name by taking in a lot of patients. The office can be very busy, and speaking with him sometimes feels a bit rushed, but other times is more relaxed and informative. It's clear that he has a lot of knowledge and takes his work seriously. The staff has been excellent and very quick to respond to questions. I'm still healing, but so far have been happy.