24F: Septorhinoplasty was the best decision I've ever made!

Hey RealSelf! To start off, I'd love to talk to...

Hey RealSelf! To start off, I'd love to talk to other RealSelfers who have undergone rhinoplasty, or are planning to (and everyone else, too)! I don't know ANYONE has had any type of cosmetic surgery, so I'm really looking forward to becoming part of this community.

So, as I know is very common, I have hated my nose since I was in middle school. I have always felt 'almost pretty'.. like my face was just a little off. I have a feminine personality, and I want my face to reflect that, but my nose is droopy, long, crooked, wide-bridged, and has an undefined tip & large hump. I have very thin lips that look even thinner when I smile, and the tip of my nose droops down making my top lip essentially disappear. I'm a petite girl and I feel like my nose overpowers my entire appearance.

A couple of weeks ago I had a consultation with Dr. Choe of the Choe Center for Facial Plastic Surgery in Virginia Beach, VA. I had already done extensive research and I was very impressed with him and his staff, so I scheduled a rhinoplasty with him for March 25, 2014. My pre-op appointment is March 10. On the day of the consultation, I paid $5,648 for the surgery, which is the price AFTER a discount from his front office for paying in full right then and there. I will also receive a discount when I pay for the anesthesia in cash, which will bring the fee down to $877.

$5,648 (Surgery) + $877 (Anesthesia) = $6,525 (Total Cost, with discounts)

These are the SURGICAL GOALS that Dr. Choe and I agreed on:
1) Add definition to the tip of my nose. Less droopy, more feminine & elegant please! Hopefully this will take away the 'long' appearance of my nose, especially when smiling.

2) Reduce the dorsal hump. This should greatly improve my profile.

3) Narrow the bridge of my nose. Ouch! This is going to make a big difference in my overall appearance, which I am really excited about.. but I'm definitely scared about voluntarily having my nose broken!

4) Projection.. ??? I can't even remember if we discussed this! Thank goodness for the pre-op appointment!

During the consultation, I brought up some of my SECONDARY CONCERNS:
1) As I've mentioned, my upper lip basically disappears when I smile, and even though modifying the tip of my nose will help how my lip appears, it won't physically change my lip's volume. He said that while I am under anesthesia for the rhinoplasty, he could do a very conservative amount of LIP FILLER (such as half of a syringe). I am assuming that we will discuss that again at the pre-op appointment, as it wasn't decided on when I left the consult. Do you ladies have any THOUGHTS/ ADVICE/ EXPERIENCE?? I honestly have always wanted to try a lip filler, but adding it to the cost of the surgery - and knowing that it will only last a few months - has me torn.

2) I'm only 24, but I have definitely noticed a loss of volume in my face over the last year or two. I know that this is primarily weight-related (5'4, 106 lb.), but putting on a few pounds (ex- I had the same issue when I was 114 lb.) doesn't help at all. The lack of volume under my eyes makes it look like I am always tired, and I can't stand it! Unfortunately, the rhinoplasty might emphasize that lack of volume, so Dr. Choe said that he could also do injections in that area, along with my cheeks. As much as I would like to add that to plan, all I can hear are a few resounding CHA-CHING$.

Overall, I am extremely excited for my surgery! Definitely nervous too, though.. I have never had any type of surgery before, and my pain threshold is laughable at best.

I need to make a decision about the fillers before my pre-op appointment, as well as research more about the rhinoplasty recovery process. I'm super lucky that my mom is actually going to be able to help take care of me afterwards! Any advice, tips, etc. would be sooo appreciated!

My thought is that you should hold off for a bit on the fillers. There is quite a bit of facial and upper lip swelling post-rhinoplasty and depending on the person, it may take a while to dissipate. So, it may look weird to have fillers added too. You may find that your upper lip is swollen for a while just because of the surgery, without any fillers. IMHO, it may be prudent to let post-op facial/lip changes settle a bit before doing the fillers. Just a thought :)
Hi, I also have my revision rhino scheduled on March 25.

Wish pics!

This is the fun (but somewhat stressful) part! My surgeon actually didn't ask that I bring in any example pictures.. is that typical? Though I feel like we are definitely on the same page about the changes I want, the only visuals that we looked at together were the 'before' pics he took, and the 'after' that he created using some VERY BASIC photo editing program right in front of me (not the typical simulation that I have seen lots of RealSelfers post). I don't think I will feel 100% ready for surgery until we look at my wish pics together.

Will the pre-op be a good opportunity bring pictures in, or should I schedule an additional appointment?
I think they don't ask for sample pictures, so patients wouldn't get a false idea that they are getting THAT nose. Obviosly all noses are different and doctors work with what we have:)
Hi! I had some issues with my nose (wide bridge, drooping tip, depressed tip upon smiling) that sound similar to your case. It might help you to look at my photos or skim my review! I went to two consultations and neither surgeon asked me to bring sample photos of noses I liked. One surgeon drew on photos they took of me and thought predictive imaging had too much potential to mislead, whereas the other surgeon I ultimately chose used predictive imaging software with me in the office. Since I was wary of getting a nose that was too petite for my face, some type of predictive imaging was very reassuring that my surgeon was on the same page as me. If you can't use any more sophisticated software, then I think bringing example nose photos to your pre-op certainly couldn't hurt! Just be open to the possibility that your surgeon may not be able to match them exactly and is still limited to working with what you presently have. I asked my surgeon about refining a lesser concern I had regarding an area of my nostrils, and he said that he wouldn't do any work there because there was too high a risk of damaging the nose's structure. It was actually nice to hear that there were things he said no to, because it affirmed that the things he did guarantee were possible. Lastly, in agreement with others, I personally would hold off on any injections. Above my upper lip was by far the most painful area during my recovery. Adjusting to only my nose's changes has been dramatic enough, and I think the addition of changes to my lips and eyes would have made my emotions even more extreme. Best of luck! :)
Meg, you are a godsend! Thank you so much.. this was exactly the info I was looking for! Other than just the physical recovery, I do agree that fillers AND rhinoplasty would be a lot to emotionally adjust to all at once. I tend to be pretty emotional with big changes as is, so I don't want to overwhelm myself.

General Anesthesia or IV for Rhinoplasty.. the Great Debate

I am so thankful for RealSelf! One other decision besides "to fill or not to fill" (ok, injectable fillers.. I was trying to be creative haha) is the anesthesia.

The anesthesiologist that will be monitoring my surgery usually uses IV anesthesia with LMA (honestly, no idea if this is the right acronym..? basically it is some type of mask/airway device that is an alternative to the breathing tube). Until my consultation, I always imagined that rhinoplasty would be performed under general anesthesia, but from my research on here, it seems as if it is almost an even split of IV vs. General.

My surgical team will do general anesthesia if I ask for it, so I am trying to make up my mind.

-I am an anxious person. Ok, that is probably an understatement. I have an anxiety disorder that I take medicine for, and have had a handful of panic attacks in the past. Is IV anesthesia going to really going to knock me out enough?? I am scared that I will still have some consciousness or memory of the surgery.. oy!

-General anesthesia makes for a more difficult recovery. I obviously want as easy of a recovery as possible.

-My uncle, who is an Ivy League educated cardiovascular anesthesiologist, initially told me that he was very surprised that rhinoplasty would be performed without general anesthesia. Granted, anesthesia for plastic surgery is not his area of expertise, but his response definitely gave me some doubts about going the IV route.

So did you ladies have general or IV anesthesia?? Were you happy with your choice?
I underwent rhinoplasty yesterday morning under general anesthesia. I believe its a must but God it made me sososososos sick ... Goodluck!
I wouldn't do the lip filler. Im surprised your doctor didnt mention your upper lip will be fuller and so is your upper lip frim swelling and will be like that for 1 to 2 years. If you get fillers during surgery it will give u extra swelling and grinch/ monkey look. Im against rhino but if thats what u want then do it without lip filler. Wait till you heal, which will be a long process good luck
I had general both times and was happy I did. The second recovery was pretty easy, really and waking up after being under general wasn't hard for me (though I know it is for some). Here's what some doctors say about general vs. IV sedation. Ask your dr. about fast acting anti-anxiety meds, too, if you need them before surgery (some folks get Xanax, etc., to help them calm down, but do discuss with your dr. first.)

Good luck!

T Minus 23 Days.. and I keep thinking about the $$$

I have an anxious personality to begin with, but I have really been stressing about the cost of my rhinoplasty. I know it is 'rude' to talk about finances, but that is a major part of the decision-making with cosmetic surgery, so I am going to go ahead.

I have a good job. I have a new-ish car, so I'm not concerned about saving up for another one any time soon. My student loans are paid off!!! I don't have credit card debt. I pay off my card in full every month.

I rather fortuitously opened my second credit card in January and was amazed at the line of credit they gave me.. way higher than I expected. The card has 0% APR for the first 12 months. I figured I would put gas purchases on this card, that would be it. Then it hit me: "NOW IS THE TIME! GET THE RHINOPLASTY!" I could put it on my new credit card and didn't have to worry about financing through the surgeon or completely depleting my Emergency Fund and checking account, which were my two options until January.

So I put $5,648 on the credit card. That is the surgical cost.. I have to bring $877 in cash to the March 10 pre-op for my anesthesia. I am going to take the $877 out of my checking account, and I already put $1,000 towards my credit. At the time when I did the 1k payment, I was thinking, "ok, put more toward it now, then $600 or so a month afterwards." Then I realized that taking $1,000 out of my checking a couple of weeks before taking out $877 felt very difficult to me.

I don't think that money is happiness or anything like that, but I am frugal. I was admittedly a little spoiled growing up, but since becoming financially independent I haven't splurged on myself at all. I had a hard time buying myself a $110 wallet even after getting a raise!

I know that I am financing the surgery responsibly, but there is major sticker shock. Other than student loans, I have never had debt before (thankfully). Now all of a sudden I feel overwhelmed.. but I know 100% that it will be worth it. This is what I have wanted for fifteen years, and I do feel some pride in being able to pay for it myself.
Im a little concerned that your doctor is giving you options to if you get anaesthesia or not! THATS A REQUIREMENT! mine were given to me via an IV. I was knocked out cold, took them an hour to wake me afterwards.
Since you are in the same area as me, did you ever even do a consultation with any other Surgeons in our area? Also I completely understand your feeling about cost, but just think of it as the one major thing you are doing for yourself for the year and that you will make the money back, just be very responsible with your payments.
Thanks for the input! I read your review and I think the surgery I'm having will be very similar to yours. Hope you're feeling well, and congrats!

Better understanding of anesthesia

I forgot to update on this, sorry! I called Dr. Choe a few weeks ago and expressed my concerns about IV anesthesia. He explained to me that anesthesia works on a spectrum, and I WILL have general anesthesia, whether through the IV or the traditional 'gas' method. He uses the IV technique because it makes for an easier recovery, but my airway is still protected and I'm unable to respond to stimuli, etc.

I feel way better. IV seems like the way to go! And maybe an anti-anxiety med before that?? Haha I such a baby even about getting an IV. I still have my mom come with me when I get blood drawn!
Hey Ehmann143! I never did a consultation with another surgeon, which I know is generally a no-no. My family really urged me to have surgery with a Facial Plastics surgeon, not a surgeon who operates on both body and face, and there are only two Facial surgeons in the area. I tried to set up a consultation with the EVMS surgeon, but was extremely frustrated by how impossible it was to get through to them to even set up an appointment. That was a big red flag to me, but when I went to Dr. Choe, I could't have been more impressed. I read through your updates, and we are definitely on the same page about the cost. You are SOOO RIGHT! This is one major indulgence that I will appreciate every day for the rest of my life, so it's a great investment. How have your friends and family been responding?

My experience so far with Dr. Choe

Sorry for all of the updates today, but I just have to say that Dr. Choe and his office staff are amazing. Besides just being a very professional team, they are so communicative and I truly feel like they are "on my side".. not like this is a business transaction. Between phone calls, emails, and Dr. Choe spending much longer than the allotted appointment time for our initial consult, I feel like I am in good hands and they really care about making this the best possible experience for me.

And I have to mention, Dr. Choe's office is GORGEOUS! It looks like a beautiful, high-end spa, and let's face it: if I'm going to voluntarily have my nose broken and cut open, walking through the doors into a soothing environment is much less intimidating than feeling like I'm in an emergency room.

And here's a funny story: my mom came with me to the original consult and when we were walking out, we both commented about the spa-like feeling. She turned to me and said, "Do you think there's a room back there for pedicures?!?" ....No, mom!!
Our surgeries are on the same day! I have my second consult with my surgeon after tomorrow. I wrote down all the questions/concerns. I am getting excited and nervous. How are you doing?
Your surgery is the day after mine! I know I'm pretty excited. Nervousness hasn't kicked in yet.
I thought yours is March 25 like mine!

Rhinoplasty Tomorrow (March 25)!

I've been taking a little hiatus from RealSelf because I am trying not to overthink the surgery or psych myself out. I do want to update though and say that my pre-op appointment went really well and reconfirmed for me that I was in good hands. In fact, the appointment went so well that while I am definitely anxious for tomorrow, I am much less scared than I expected. That's not to say that tonight I won't be tossing and turning, but I am 110% confident in my surgeon and his staff, and absolutely positive that rhinoplasty is the right decision for me.

Obviously I am a little nervous about recovery though. Like I mentioned before, my pain threshold is embarrassingly low, and I know that it isn't going to be a walk in the park. I have all of my post-op supplies & snacks, my prescriptions are filled, and I have taken time off of work. I can't believe that tomorrow is the day!!

I'll definitely be updating after surgery and throughout recovery, and I'll post pics as often as I am able to. Any last minute advice??
Good luck for today
Honestly, there is no pain.
Good luck to you tomorrow!

Surgery & Post Op Days 1-3

It's done!!

I am so excited and can't believe that not only have I already had my surgery, but I am on Post Op Day 3!

The morning of my surgery, I honestly thought I was feeling pretty calm... ha, I was wrong! I had a panic attack in the pre-op room where I was talking to the anesthesiologist and a nurse. All I really remember is freaking out about the IV, which in turn made it harder to actually insert the IV. Everyone was incredibly compassionate and kind, and next thing I knew, I was waking up in post-op. I felt disoriented and my throat hurt from the dry oxygen, but my face/nose was in absolutely no pain. I was confused and not 100% with it, and I remember complaining about my throat a ton. The nurse took such good care of me - she fed me ice and gave me lozenges and reassured me that the surgery went well, that the sore throat would subside soon.

I have been very fortunate that so far my recovery has been smooth and easy! I've switched from Vicodin to Tylenol and have only felt pressure, but no pain. My diet has been a little weird.. pudding, smoothies, peanutbutter sandwiches, etc. have all been easiest because the more effort it takes to chew my food, the more uncomfortable I have been. Today might mark me getting past that though, so I should be switching to more regular meals soon.

I've already had two post-op appointments, including getting my sutures removed today. Everything is on track so far, though I need to irrigate my nose more often. Despite swelling, I can already tell that my nose is no longer droopy. It's surreal and exciting to think that I get my cast removed on Tuesday!

I'll update more and add pics soon!
I am glad your recovery is going well. We had surgery on the same day. Wow you already had 2 follow ups. My follow up is on April 2. Can't wait to get the cast off!
Glad recovery has been pretty smooth so far! I'd love to see pics if you're feeling up to it. :)

Cast comes off tomorrow!

I CANNOT wait! Recovery has been so much easier than I expected. It had been relatively pain-free and there haven't been any major complications or anything like that. I absolutely was more worried/scared than I needed to be about this entire process. I haven't needed Tylenol or painkillers in days.

There have been a couple hiccups along the way though. I was the (almost) perfect patient for the first few days of recovery, but then it was one mistake after another!

1) I accidentally hit myself on the nose on the early morning of Post-Op Day 5. I was in bed with my eyes closed and was reaching up to mess with my hair or scratch my forehead or something, and smacked my nose with the palm of my hand. I teared up because it hurt for a minute, but I decided not to call my surgeon because it wasn't a major trauma and I am seeing him on Post-Op Day 7 anyways.

2) Also on Post-Op Day 5, I was dabbing a tissue to around the outside of my nose after I used my saline spray and there was some fluid dripping out. I also was trying to get a little bit of the dried blood off of my skin because it was crusted onto a very visible area. I think I got too aggressive trying to clean up though and I'm worried because I wasn't supposed to "pick" my nose at all. I am pretty sure I felt a stint or something. Oops.

Hopefully all goes well with my appointment tomorrow and neither of those are a big deal.

I should add that the one complaint I have is the sleeping situation. I normally sleep on my stomach or side with one pillow or none at all (weird, I know!), so sleeping with two pillows and trying to keep my face up has been difficult. I have been using a U-shaped travel pillow on top of my other two pillows to try to keep my neck in the right position, but I catch myself rolling over as I fall asleep and have to readjust.

Anyways, very excited for tomorrow and I will definitely be updating with side-by-side Before and After pictures to document the changes in my nose!

A few of the post-rhinoplasty essentials:

-Humidifier. I've been sleeping with a humidifier on at night, and it has been so helpful in preventing the dry mouth that comes with relying on mouth-breathing. Plus it is important to keep your nose moist post-op, so it can't hurt the healing.

-U-Shaped Travel Pillow. This has probably been the #1 essential for me. I've been using this in addition to my regular pillows so that when I sleep, I minimize the risk of rolling over onto my face. Plus it has been really nice to prop up on the couch when I was resting and watching TV for the first couple of days.

-Straws. For some reason, it has been way easier for me to drink water/everything else out of a straw. Maybe I am just super clumsy and would otherwise be spilling water on my face or having ice cubes fall forward onto my nose?? No idea, but I've been using straws like it's my job.

-Donuts. This isn't ENTIRELY just an excuse to indulge my sweet tooth. For the first three or so days after surgery, trying to chew 'real food' was definitely uncomfortable. Soft food was a must for me, and you can only eat so much pudding. My patronage at Dunkin Donuts over the last week has been enough to single-handedly keep them in business.

-Vitamin C. This has been such an easy recovery process, and my bruising has been much less than expected - I really believe that Vitamin C has been a miracle for me. I started taking 1000 mg of Vitamin C three times a day 2 weeks before surgery and have continued doing so.
Awesome advice!! I hope you love your new nose. Remember when the cast is removed it will be swollon so don't freak out. This is what I heard. I have my surgery in October so its great to hear a positive experience. I'm proud you went through it after all the jitters:) and your doing so well. Take care
So excited to see your nose, but not as excited at you must be of course :P

I GOT MY CAST OFF! Post-Op Day 7


This is surreal. My surgeon reminded me that my nose will still go down about 20% in size, but I am already amazed with the result. I am pretty positive this is how I've wanted to look for years.. so much change to digest!

*I do have to say that I cannot wait to be allowed to get a facial. My skin is kinda gross!
Just wanted to say that I've found your reviews really helpful. I am booked in for my rhinoplasty procedure in June 2014 and my nose is very similar to how yours was before. I just hope my result is as good as yours because I'd be over the moon with your post op pic! Hope the rest of your recovery goes well! :)
Wow! Great profile. I get my cast off tomorrow. I hope I get good results as well.

Post-Op Day 12/13: I'm not a new person; I'm me, but comfortable in my own skin

I can't believe it has already been almost two weeks since my surgery!

For starters, I feel great. I am amazed by how quickly the recovery process has gone by. I don't have any bruising left, and my nose does change just a little bit every day which I think is the swelling going down (not that the swelling is noticeable at all). Seriously, I know that the 'final result' shouldn't be expected until 9 or so months after surgery, but I would have been thrilled even if the end result was how my nose looked on Day 7.

So far everyone who knows about the surgery has said how natural my nose looks, which I agree with completely.. it just fits with my bone structure so well. It's funny, because even though I kept looking in the mirror the first day or two after my cast was removed, I really haven't been doing that a ton anymore. Obviously I am excited about the change and feel the warm fuzzies every time I look at my new profile, but I don't feel like a new or different person, I just feel happier and more comfortable in my own skin!
Anymore new photos? Its wonderful to hear you are happier in your own skin. I hope I feel the same after my surgery:)
looks awesome !! I read your section about what you wanted fix about your nose and that sounds very similar to what I would want! also I am the same age as you and have the same problem with volume in my face. if you read my posts you will see that I had fillers put in my cheek area and my chin. I loved it! problem is they didn't last long at all and now I want them again but don't want to keep spending the money haha maybe you could give it a try though to see how you like it. I'm so jealous that you got your nose done, I would love to get mine. thanks for the post and congrats on the new nose!
Good thing you didn't have any bruises! I also didn't get any bruises. It's amazing how our noses change everyday. Today I also noticed that my nose has de- swelled on the right side. I am looking forward to having a facial. Do you have any idea when one can have a facial? I forgot to ask my doctor. Thanks for the update.

5 Weeks Post-Op!

I'm 5 Weeks and 1 Day Post-Op and I still absolutely love my result!

I have had a few random days where either the bridge of my nose will feel pressure, or the tip will feel especially sensitive, but most of the time I don't even remember that I just had surgery last month.

For my 4 Week Post-Op appointment, Dr. Choe reminded me that my nose will still decrease about 20% more in size, with the final result being around Thanksgiving. It's amazing how much the swelling has gone down already since the cast came off - I remember thinking that I couldn't see any swelling at all, so I wondered what it would look like over the next few weeks. I love my nose more and more as time goes on.

I'll post a more detailed update later, but I just wanted to share some pics!
Can you share some front view pictures? I love your side view results. You are very pretty.
Are you happy with how it looks from the front? Post pics :)
You look good! Great results!
Virginia Beach Facial Plastic Surgeon

I really cannot sufficiently express my gratitude to Dr. Choe and everyone at the Choe Center for Facial Plastic Surgery. I am beyond happy that I chose Dr. Choe as my surgeon and recommend him highly. He spent a lot of time with me during the Consult and Pre-Op Appointment discussing what to expect and what results I was going to achieve with the rhinoplasty. What really stood out to me was how available Dr. Choe made himself. He even called me a couple of times before the surgery to check in because I had mentioned that I was anxious. When I called with a question, he took his time and made sure I understood everything about the procedure. The surgery went exactly as described, and if anything, was far easier than I anticipated. Because of Dr. Choe's artistry and exceptional surgical skills, the rhinoplasty results have surpassed my best hopes and expectations. Dr. Choe is caring, talented, and has made this an amazing experience for me.

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