Septoplasty / Rhinoplasty in Less Than a Week! - San Diego, CA

Cost is after insurance btw, my portion after...

Cost is after insurance btw, my portion after deductible and 20%...in other words, my total out of pocket for the procedure.



I had surgery for a deviated septum when I was 15 due to breathing troubles. Now at 37, it's become clear that my surgeon back then botched the job and failed to fix it (which was confirmed by my new surgeon) and I swear that my nose became bigger since that surgery too...maybe my nose was over-packed after the surgery or I dunno. It just seemed bigger; more bulbous, and has only seemed to get bigger over time. Some of you will think I'm blowing this out of proportion, but when you only have one person to look at in the mirror your whole life, you become quite the critic of yourself, and sometimes the worst enemy to your self esteem.



A combo of my decreasing patience for my breathing issues combined with the onset of Asthma 3 years ago finally drove me to start looking into it in the wee hours of the morning a month or so ago. Now less than a week away from surgery and getting nervous as I type this thinking about it! lol.



I'll post some post Op pics as they become available, and for now, here's my before as taken by the doctor last week =)







Updated on 19 Dec 2011:

12/19/11 11:04pm Had the surgery today! So easy to try to 2nd guess the work and look for perfection on day one through the swelling and bandage, but reading plenty on here prior to surgery let me know not to even bother getting too worked up at all. Surgery was quite lengthy. Went under around 11:30am and was under until about 2:30 or so. Since it was a setpo/rhino combined with a fracturing of the nose and cartilage graft from my ear.



Anyway, my ear is a little sore, taking my meds and just watching tv. Oh, and plenty of internet/facebook! Really wish I could push the fast forward button on my recovery, but I know it's going to take some time. Wish me a speedy recovery and of course, your prayers are welcome!Updated on 21 Dec 2011:12/21/11 3:40pm



Definitely deep into the regret phase of the recovery. Starting to nit-pick the minute details and overplay every minor imperfection. But, as I've read on here before, this IS normal. Looking forward to getting the stitches out and getting a few more days into the healing process. I think not wanting to go out looking the way I do is a big part of my poor mood at the moment, a minor bit of nausea, you name it...just feeling blah. I'll update after the stiches are out on friday. Hopefully by then I'll feel better as well. Supposed to go to work that evening too where I work at a liquor store. May make a little paper sign so I don't have to tell everyone the same story ;-)Updated on 22 Dec 2011:12/22/11 10:22am 3 days post op.



Yesterday evening I finally started to feel better. Decided that being a people person, I'd rather go out and chat with my neighbors outside rather than hide inside the house. Turned out to be a great call. Enjoyed their company, got some free sympathy out of the deal, got my mind off myself for a while and got some fresh december air here in San Diego.



With the ear cartilage graft, not only am I limited to sleeping on my back, but also must keep my head tilted slightly to one side to keep any pressure off the ear. Finally found a pillow setup combination that works for me last night. Sleeping at night was measured in 15-30 minute spans at most the last few nights, but last night was able to get a couple 2 hour stints in as well. I decided to have a snack and take the vicodin in order to help me sleep and dull the minor ear pain and it worked. Feeling somewhat more optimistic now on day 3 regarding my recovery, but will prob feel even better after my appt with the doctor tomorrow morning.

12/23/11 12:00pm Just got the stitches out and...

12/23/11 12:00pm



Just got the stitches out and bandage off and now, the LONG recovery really begins! Feel free to PM me if you have any questions. Right now, hard to see any difference due to the swelling. It of course looks worse for the most part than prior to surgery. Must wait for swelling to go down over the next few months/year until a final verdict can be made about the overall procedure. For now, feeling relieved that all the "scary" parts are over with!

December 28th, 2011 9:50am - 10 days post-op.....

December 28th, 2011 9:50am - 10 days post-op...

Slow recovery. Don't expect big gains day to day...just small increments. Woke up feeling pretty decent this morn. At this point, my columella is still pretty numb due to the "open" procedure I had done. Wondering WHEN my nose will start to feel normal? I know it will take a year to get the permanent look, but my nose is still feeling sensitive and delicate where I can feel it, and curiously numb around the incision and upper lip below the nose.

Starting to really look forward now that majority of the discomfort is behind me. Looking forward to better breathing and seeing my nose take shape!

2 months, 10 days post-op. Sorry to say I can't...

2 months, 10 days post-op. Sorry to say I can't give a "Worth it?" rating yet. Still need more time to see how things settle.

Had some up and downs emotionally and to a lesser degree physically since surgery. But overall, I think it's an improvement. Cool thing is, the girl at my doctor's office had a "rhino" done a couple months before me I assume, and from the time I had my first consult until now, her nose looks much better(swelling subsided).

Nose is still sensitive, and tip and columella partially numb. Seems the sensation coming back will take quite some time.

My nose already looks better post op at 2 months than it did prior to surgery since I had a bulbous type nose. So for me, that is a plus. Someone with a skinny nose that was just trying to remove a hump may feel dissatisfied for a longer period of time as their nose would look wider for a long time until the swelling completely went away.

Overall, it's been a rollercoaster of emotions, hiding inside the house while my nose is taped even now...I think if I knew what I'd be going through again, I may have seriously re-thought going through the process, but now that I'm this far into it...feeling better about things.

110 days post-op. Added a pic I just took with...

110 days post-op. Added a pic I just took with the webcam. Doing ok. Haven't been obsessing with my nose for a while now. Breathing has been better, although there's been some details about that. My nostrils have smaller openings than before making it harder to clear blockages if you know what I mean. So, fairly often, theres a temporary obstruction until it can be blown out or tweezed out.

A higher nostril arch on one side is noticeable, but not killing my social life or anything =P Also, Also, the center portion between my nostrils isn't directly in the center...but still going to wait that out. And on the pic that I've leaning back on, you can see that one nostril opening is a bit larger than the other. Is was more pronounced several months ago, but things are evening out.

I've learned that even if many of our noses aren't the way we'd like them to be prior to the surgery, that many of them are very symetrical. Being that a doctor is human and leaning over the operating table for hours, it may not come out as symetrical as it used to be even if there are improvements to the overall size and shape.

I went in on the basis of breathing difficulties and was diagnosed with a deviated septum. Insurance usually covers these type of procedures. Although there are some details regarding that...I had orig been planning to have to shell out approx $2k for my portion.

9 1/2 months post op: Insurance is looking like...

9 1/2 months post op:

Insurance is looking like it's not covering near what I'd expected or was led to believe. More on that in the future when it all shakes out.

Feeling ok, other than my nose has been itchy since having the surgery. I'm guessing that all the hairs (i know, gross) that used to grow in their natural direction since being operated on have grown into areas inside the nostril which is causing the itching. And so, I have to tweeze them out on occasion as they irritate me.

The nose is looking better and making slow but steady progress towards it's final shape. I think I may be on of those that takes longer to heal. I've been told by my doc that I'll be getting a revision most likely. He indicated that the arches of my nostrils are uneven in their height. I notice it too of course. Solution is to do a short 20 min. in office cartilage graft from my ear and stich it into my nostril arch or do a short series of 2-3 permanent injectables (as he calls them) to reshape the arch of my nostril on the side that is higher. Not looking forward to that.

Anyway, To those that are considering this surgery, REALLY be honest with yourself and ask people to give you honest opinions...preferably people who don't know you that well. This is a good site for that btw. People who know you cannot be objective. Their opinion can be valuable, but really need to get an unbiased one. Also, fully explore the costs of the procedure in advance. It's easy to avoid looking into it completely because it's scary frankly. The recovery time is LONG, at least in my case.

I dunno, I'm having doubts as to whether it's worth it. My wife and kids still love me, my family does, employers could prob care less if I had a less than perfect nose. Women don't seem to care (which is a good thing being married!). And so, just really think it through.

I'll try to take some fresh pics for you guys since it's been a while. =)

Just had a revision done to correct a nostril arch...

Just had a revision done to correct a nostril arch that was higher than the other. Freaking out a bit as now I am worried about how it will heal. Find myself walking over to the mirror quite often looking at my nose and critiquing the surgeon's work and being doubtful. Although, I know better..it's only been 1 day since the revision and it's pretty swollen and I just took out the gauze that had been stuffed up the one nostril pushing it over to the other side. Other thing that sux is that I won't be able to exfoliate my nose for a few weeks while this heals up, even though the incision and stiches are on the inside of my nostril.

Anyway, so easy to worry about these things when you're home with a few days off, in discomfort, and 2nd guessing the surgery and/or the revision. Time will tell, but one thing is for sure...I can breathe easier than I did before, but still have some unsolved breathing related issues due to some sort of allergy, and, my nose looks better than it did prior to a year ago before the surgery.

Still to soon to give a "worth it" rating. I suspect that will come in 3-6 months. Looking at some old pics of myself, my nose's shape prior to surgery was really starting to look smashed like I ran into a wall. Of course I'm exaggerating, but in 5 years, it went from being a bit blunt at the tip to looking a bit smashed and droopy. I do have a pre-op side view pic, but frankly it was so unflattering, that I didn't post it! Lol

So, I guess I just need to trust the doctor. Everything I know and read tells me "rhino" is the most difficult to execute surgeries out there. And yet, part of me thinks that considering that and that the results prior to the revision were better than pre-op, and the asymmetry so unnoticeable to the unaware observer, that maybe I should have declined the revision. Time will tell if my fears were or were not unfounded.

Going ahead, should things turn out looking good, I would say that it was worth it, and yet, doing the surgery in my late 30's...I can't help but think that most of the visual benefit to the surgery due to achieving a near perfect nose, has been wasted on somebody close to middle-age. Lol

Oh well, such is the life of a septo/rhino patient.

Nearly 3 years post op!

Well, it's been a long journey. It has been a year since I last saw the doc. Copying and pasting my Doctor Review here since I just typed that all out:

I wanted to wait before posting the doctor's name until the insurance was all settled and the doctor had done his final billing just in case there were any insurance companies trolling this forum. Anyway, great Doc, friendly, Harvard educated which initially gave me a lot of confidence going in and put me at ease. However, after he did my surgery, a year or so later, it was clear there was some definite unevenness or asymmetry of the flares of my nostrils that wasn't going to correct itself. From one side or another I looked fine, but straight on, there was a problem. It was quite obvious, and made me nearly as self conscious of my nose as before surgery even, and had me wishing at times that I' just left it alone! After hinting about a possible necessary revision in the 6-9 month post-op time frame, I had the revision done about 13 months post op, this time under local, not general anesthetic...traumatic in itself to have someone cutting on your nose and ear while you're awake..and the shots in the nose and ear were quite painful. Another cartilage graft from the ear, very little with regards to trauma and recovery compared to the original surgery. However, after the revision, it was looking as if now I had the opposite problem as the arch of the one nostril that had been way higher was now lower than the other, and flat (no arch). Fast Fwd 6-9 months and I'd had a series of 3-4 (very uncomfortable..lol) silicone injections in an attempt to correct the shape of the arch, along with me using a q-tip 10 times a day (for 5-10 mins) at home for 3 weeks to try and stretch the corner of the nostril at the doctor's instruction. That all made some progress and it was starting to look "good enough" for me. About that time, he started hinting at a 2nd revision. I was quite disappointed, and now feeling a lack of confidence since the initial surgery had somewhat failed, and then the revision, and was now lacking in confidence that a 2nd revision (3rd procedure) would even correct it. And since a 2nd revision would mean more "going under the knife," I had to ask myself how much the imperfection really bothered me. At this point, I stopped scheduling my "follow-ups" and just decided to live with "good enough." Today, 34 months post op, I'm happy with what I have and how it turned out. I wish my nose had been pinched just slightly more, that the arches were even, and that I could breathe! (the main reason I went in, which I know believe was not really a "deviated septum" but an allergy that I have yet to identify). But yeah, basically, it's good enough, and I'm generally happy with the way I look. I'm now 40 years old. If I was 20, maybe I'd bother. But faced with wrinkles, losing hair, gray hair etc now and in the future...no need to try and make things perfect. If it was bad enough, I would have a 2nd revision, but it's acceptable to me, and still looks a whole lot better than before the initial surgery. So, in that sense I'm pleased. I understand my initial surgery was quite complicated as a lot of things were done. And, from what I understand, septoplasty/rhinoplasty is a difficult to master procedure. Wish I could give the doc a 3.5 star, but rating only allows 3 or 4. I'm sure others have come out just fine with a single surgery, but since mine was less successful, I have to give an accurate rating for MY experience.

More Pix 2.75 years post op (After all, it's all about the results!)

Just adding a few more pix. Easy to type, a bit more of a pain to take pix from my phone, email to myself, download, then upload, etc. You can see what I'm taling about with the arch of my one nosrtil not rounding it's way back down toward the tip. But in reality, fook it! Lol. It's good enough, an improvement from the beginning, and for what I paid ($2,300 after all office visits & covered mostly by insurance) it's good enough for me to not mess with anymore. Doc had been hinting at a 2nd revision a year ago and frankly, I wasn't having any of that! He got two chances to get it right. You that old saying? Fool me once, etc!

Anyway, I'm happy, and now just turning 40, hoping to age as gracefully and slowly as possible. Maybe if I was 20 I'd keep at my nose and demand perfection. But with aging, gray hair, etc, and shot at "perfection" is long gone anyway. =P
Dr John Hilinski

I wanted to wait before posting the doctor's name until the insurance was all settled and the doctor had done his final billing just in case there were any insurance companies trolling this forum. Anyway, great Doc, friendly, Harvard educated which initially gave me a lot of confidence going in and put me at ease. However, after he did my surgery, a year or so later, it was clear there was some definite unevenness or asymmetry of the flares of my nostrils that wasn't going to correct itself. From one side or another I looked fine, but straight on, there was a problem. It was quite obvious, and made me nearly as self conscious of my nose as before surgery even, and had me wishing at times that I' just left it alone! After hinting about a possible necessary revision in the 6-9 month post-op time frame, I had the revision done about 13 months post op, this time under local, not general anesthetic...traumatic in itself to have someone cutting on your nose and ear while you're awake..and the shots in the nose and ear were quite painful. Another cartilage graft from the ear, very little with regards to trauma and recovery compared to the original surgery. However, after the revision, it was looking as if now I had the opposite problem as the arch of the one nostril that had been way higher was now lower than the other, and flat (no arch). Fast Fwd 6-9 months and I'd had a series of 3-4 (very uncomfortable..lol) silicone injections in an attempt to correct the shape of the arch, along with me using a q-tip 10 times a day (for 5-10 mins) at home for 3 weeks to try and stretch the corner of the nostril at the doctor's instruction. That all made some progress and it was starting to look "good enough" for me. About that time, he started hinting at a 2nd revision. I was quite disappointed, and now feeling a lack of confidence since the initial surgery had somewhat failed, and then the revision, and was now lacking in confidence that a 2nd revision (3rd procedure) would even correct it. And since a 2nd revision would mean more "going under the knife," I had to ask myself how much the imperfection really bothered me. At this point, I stopped scheduling my "follow-ups" and just decided to live with "good enough." Today, 34 months post op, I'm happy with what I have and how it turned out. I wish my nose had been pinched just slightly more, that the arches were even, and that I could breathe! (the main reason I went in, which I know believe was not really a "deviated septum" but an allergy that I have yet to identify). But yeah, basically, it's good enough, and I'm generally happy with the way I look. I'm now 40 years old. If I was 20, maybe I'd bother. But faced with wrinkles, losing hair, gray hair etc now and in the future...no need to try and make things perfect. If it was bad enough, I would have a 2nd revision, but it's acceptable to me, and still looks a whole lot better than before the initial surgery. So, in that sense I'm pleased. I understand my initial surgery was quite complicated as a lot of things were done. And, from what I understand, septoplasty/rhinoplasty is a difficult to master procedure. Wish I could give the doc a 3.5 star, but rating only allows 3 or 4. I'm sure others have come out just fine with a single surgery, but since mine was less successful, I have to give an accurate rating for MY experience.

4 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
4 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
3 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
4 out of 5 stars Payment process
3 out of 5 stars Wait times
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