I'm 29 and I broke my nose when I was 12. Ever since then, I wanted it fixed. The CT Scan showed that I have septal deviation as well as hypertrophy of the inferior turbinates. I'm having rhinoplasty as well as septoplasty done. I've never had surgery so I'm terrified about that in general. I'm also not sure exactly how I want my nose to look. How do you decide? I want it to look as natural as possible. I still want to look like me. My doctor morphed my photos in 2 different ways; one is more aggressive than the other. I welcome all comments, suggestions and advice Having trouble adding more pictures..it's not letting me add more than 4. So below is what I can add for now. Updated on 17 Jun 2012: I decided on the first set of photos that the doctor sent me (revision 1). It's more natural and not as aggressive. I added more pics showing of my before and after with revision 1. Now, I'm just waiting to find out how much it will cost. Insurance will supposedly cover the septoplasty only. My deductible is $1,500. Updated on 15 Jul 2012: I got my final quote back including what insurance will cover (not much). I added my doctor's name and rated him average so far. I will rate him for real after the surgery. I haven't found any reviews on him. He is not a rhino specialist, but his credentials are very good and he comes recommended (for other procedures). I'm having my surgery in Pennsylvania because it is cheaper. I'm will probably set my appointment for the end of September. Also, I am TERRIFIED. I need to set the appointment soon because I'm afraid I'm going to chicken out. Below are a few tips that I have learned from my doctor. Please help me add to my lists! Things to get: Thin rubber gloves and peas/corn for icing Neck pillow Arnica pills and gel (I don't plan on going crazy with the gel as it does have a drying effect) Tylenol Extra Strength for pain after the hard stuff (No ibuprofen) Bromelain supplement and pineapple/pineapple juice Saline spray Things to avoid: I will try to avoid taking ibuprofen for at least 2 weeks prior to surgery Try to avoid salty foods the week before surgery No straws No glasses for 6 weeks I don't think I can play soccer for at least 3 months. I'm going to be very nervous about playing again, as I have been hit with the ball twice in the nose in the past few months. Updated on 25 Sep 2012: I've been hoping to schedule my appointment soon, but before I rush into it, I wanted to make sure that the estimate the dr. gave me was correct according to what my insurance will cover. Has anyone had any luck getting insurance to cover a rhinoplasty if they were injured in the past? Mine will only cover septoplasty except for a few certain circumstances that need to be documented by an ENT. I'm also interested in pursuing other doctors because the office has not been returning my last few emails regarding pictures of the doctors work and clearing up a discrepancy with my deductible. I'm going to look into going to an ENT, if anyone has any recommendations in the NYC/NJ or even Eastern PA area, let me know. Updated on 18 Dec 2012: I decided to check out where I live in NYC. Any personal recommendations appreciated! Updated on 3 Jan 2013: Anyone know of Dr. Guy Lin? I'm going for a consult. I'm hoping to find a doctor soon because these consultation fees are quite pricey. Updated on 7 Jan 2013: I had my consultation with Dr. Guy Lin today. The consultation was $200 + $20 copayment. It went pretty well and he was very thorough. He did do me the favor of pointing out all of my asymmetries. I guess that was done to point out that fixing my nose will not make me perfect. That is not what I'm expecting. I'm waiting for an estimate, but I know that the rhino will be $7,000. The estimate I got from a doctor in NJ/PA was $5,800 for both rhino and septo. I definitely feel more comfortable with an ENT/rhino specialist than just a plastic surgeon. However, I may need to push the surgery back to save more money. I'm apprehensive about surgery, but it's something that I really want. I have wanted it for so long. I really just want to pull the trigger and get it over with already. If anyone has any info on costs in NYC or this doctor, please share! Updated on 13 Jan 2013: Thanks for all the comments. This process is very daunting. Once you find a doctor, how can you decide on how you want your nose to look. It's such a huge deal. I have 2 morphs from 2 doctors. I'm not sure about either of them. I definitely want a natural nose. I guess I will discuss more with the doctor of course, but all comments appreciated. I have added the morph from the first doctor. Updated on 29 Nov 2016: So it has been 3 years since I first had a consultation! I'm finally moving forward with a septo/rhino. I was hoping to have most of the surgery covered by insurance since my nose deformity was caused by an injury. However I'm being told by the doctor office that I have to pay the faciality and anesthesia fee out of pocket which is $1800 along with a $7500 fee for the doctor. Then my insurance will cover the septo/turbinate fee. Is this normal? It seems odd to have to pay out of pocket for the hospital fees. $7500 also seems very high for the minimal amount of cosmetic changes that we discussed. Any feedback would be greatly appreciated! Updated on 15 Dec 2016: My surgery is for next Tuesday. Here is what I'm planning on having for recovery should I get anything else? Arnica Cream Biotene mouth spray Saline spray Extra Strength Tylenol Cough drops Pineapple Frozen peas and rubber glove for icing Cold eye mask Green juice Apple Sauce Soup Crackers Dairy Free ice cream Also, has anyone else had issue getting cost for their surgery. It's been a nightmare. The hospital and doctor office are telling me different numbers each time I speak to them and I have to call someone else to find out the anesthesia cost. The whole process has been a mess.
The problem with bone grafts is that they are not as dependable an alternative as cartilage grafts. Large surgical case series show that cartilage grafting in the nose produces long lasting dependable results. I think you can tell this from the consensus of opinions among the other surgeons. I also agree that 5 hours is likely too long as far as operative time is concerned even for revision surgery.
I concur with many of the comments made thus far. Performing osteotomies (breaking the nasal bones and resetting the bones) is the best way to achieve a natural narrowing to the nasal bridge. Augmentation of the nasal bridge is useful in situations when the nasal bridge is both lacking definition and height. The photograph shown does not reveal enough to make specific comment on the question posed.
I think that a filler procedure is ideal for the circumstance described. The loss of volume (reduction of fat) after blepharoplasty creates hollowing under the eyes. This is best addressed with a filler agent that can "volumize" the hollow area. I agree with comments noted by other physicians that this is safe and effective but highly dependent on the skill of the person performing the procedure. Another option for longer-term results is fat injection.
I'm not in favor of this practice. Occasionally the nasal bones can slightly displace after rhinoplasty. It is in this case that i will encourage the patient to massage the bony portion to try to narrow it as it is healing. Otherwise, I don't think that massage assists in healing process during the post-operative phase.
My answer is consistent with what other doctors have answered: A very small hump can be filed down without "infracturing the nose". If the hump is sizable and filed down without fracturing the nasal bones, the nose will appear too wide. Cost of rhinoplasty is highly regional and surgeon dependent...and thus has a wide price range.
