Fixing my deviated septum was first suggested to me by a doctor back when I was a preteen, and getting my nose cauterized because of frequent nosebleeds. I was first told I need a nosejob by my grandmother when I was 16. I had inherited her witch-y bump, which she, and all her daughters, had gotten removed. Fast forward to the winter of my 34th year. Horrible allergies -beyond my typical ones- are so bad, I find myself seeing an allergist, just to find out if I've developed an allergy I never had before. When I tell her about the constant headache I've had my whole life, and the fact that I can probably count on my fingers and toes the number of days in my whole life that I've had airflow through both nostrils at the same time, she suggests I go to an ENT. After talking to me and a CT scan of my skull, ENT suggests fixing my deviated septum, trimming the turbinates inside my nose to increase airflow to my narrow nasal passages, and doing a balloon sinuplasty to fix a little minor narrowing of my sinuses. Remembering what my grandmother said, I ask if he can also trim down the wicked bump of the west. He said he is only an ENT, and doesn't do cosmetic stuff, but refers me to Dr. Waters, a local ENT AND plastic surgeon who can help me. Dr. Waters collects my information and submits to my insurance, and lucky enough, insurance decides to cover the whole surgery, even the rhinoplasty portion. Surgery was 4 days ago. I am still quite swollen, though bruising has been minimal, and right now it just looks like I'm a fan of the smoky eye. Updated on 13 Sep 2016: It's been a few days short of a month since surgery. I was quite nervous for surgery, since I had talked to a friend who had the same surgery, and she told me, in exriciating detail, that it was agonizingly painful. Either my pain tolerance is waaay higher than hers, or she was grossly overestimating how much it hurt. Compared to every other surgery I've had, this was the least painful. I didn't even end up finishing the bottle of narctoics they sent me home with. I switched to Tylenol only a few days after surgery. The bruising was very minor. Attached is a picture taken the second day after surgery, the one day bruising was even visible. That picture was as bad as it ever got. If any darker bruising happened, it must have come and gone the previous night, and I missed it. Taking the cast off and the splints out was an interesting experience. I was overly eager to see them go, since the splints had clogged shortly after surgery, and I had had to breath only through my mouth for about a week. Removal was painless (but felt really weird). I had done some research, so I knew what to expect of the splints. If I hadn't done that, they would have seemed impossibly huge. Even having researched, and even watched a video of someone having theirs taken out, it was surreal seeing something that big emerge from my tiny nose holes. The doc confirmed what I've read online by saying that swelling can last 6 months or more, so my follow-up appointment with him isn't for a long while. That may seem like a ling time for swelling to be an issue, but it's also true what I've read online from others: the swelling goes down enough by two weeks after surgery that pretty much only the patient can still notice it. My wife and parents say it looks like my swelling is gone, but I still see (and definitely feel) it. I had the baloon sinuplasty as well, and I have noticed an increase in the severity of my headaches post-surgery so far. I'm also suffering from worse allergies than normal right now (I just got a new puppy. I knew I was allergic, but I love dogs more than I hate my allergies, so he's worth it). I don't know how, if at all, the surgery will affect my headaches. I do know that pre-surgery, in an appointment with Dr. Waters, he suggested I see the allergist about treatments to more effectively control my allergies, since he can create more space in my nose and sinuses, but that won't stop my runny-nose allergies from stopping me up. Not only was my septum badly deviated, but I have unusually very narrow nasal passages, so Dr. Waters told me that, if this surgery doesn't open me up enough, a more extensive surgery including a cartilage graft from somewhere else in my body to make my nostrils themselves wider would be an option. I'll just have to see. The very base of the my septum is still completely numb, and the rest of the underside of my nose, from the bottom of the tip toward my face, and even streatching to my upper gums right where my top two teeth are, is partially numb. It feels weird to floss those top teeth. The only other issue I've had is I'm not supposed to wear glasses for 3-4 weeks after surgery. I'm practically blind as a bat. In the week after surgery (the week in which I still had the cast on), I just used medical tape to tape the bridge of my glasses to the middle my forehead so that they hovered above rather than touched my nose. Not only was this not an option for leaving the house, but the tape didn't hold all that well, and the glassed kept falling. It wasn't a problem with the cast on, but I knew that once the cast was gone, they would be falling right onto the most painful part of my nose, right where my bone and cartilage were shaved down. The day I went to get the cast and splints removed, I put my 30-day continuous wear contacts in. I don't wear contacts often, because dry eyes are an issue for me, and the dry air-conditioned air of my house in the summer exacerbates that. It's incredibly nice not having to fumble on my bedside table to find my glasses when puppy wakes me up to go out in the middle of the night, but...well, lets just say, I'm considering buying stock in whatever company makes these rewetting drops I use. Their profit margin must be way up this month. I would post before/after pictures, but I so hated my nose bump, it could be tricky to find adequate before pictures. I wonder if I can get copies of the before pictures they took at Dr. Water's office.
I have been aware of my nose shape ever since about seventh grade when my nose started changing. I inherited my dad's nose (thanks, Dad!) which consists of a dorsal hump with a slightly drooping tip when smiling. I honestly love how my nose looks from the front, but looking at pictures of me in 3/4 or profile view makes me squirm! Rhinoplasty has been crossing my mind from time to time ever since I realized that real people had their noses surgically altered, and not just celebrities (about 15 years old). I am now 23 years old and have about twice as much in my savings account as I'll need for the surgery, so I figured now is the time to make my dream a reality. I am starting a teaching job at the end of August, so doing the surgery before my students and colleagues know what I look like is going to be a great timing opportunity. I have spent the last 3 months researching in depth. I scheduled my consultation in the middle of May and the soonest I could get in was today (June 26th). I ended up scheduling my surgery today for August 8 after the consultation. My surgeon is a very down-to-earth, easy to talk to, and honest doctor. He answered my NUMEROUS questions in depth and took over an hour with me to go over everything with me. I also like that he is relatively conservative in his aesthetics. He really wants each patient to have a natural looking nose that fits their face, body type, and even height! My procedure will be a dorsal rhinoplasty, meaning only bridge work. I was happy to find out that he does not anticipate having to break the bones around my nose - he believes that my hump is small enough to be removed by cutting and rasping the hump itself through a closed procedure. He also doesn't think my tip needs to be messed with - which I fully agree with. I am very happy with the shape and angle of my tip. The one solution that we came up with to address the drooping while smiling is cutting a nasal depressor muscle, so hopefully that will help at least a bit. Has anyone had experience with this?? I wouldn't mind if it doesn't work though - I would much rather have a slightly dropping tip than a pig nose! My surgeon is located about 2 hours from my house. I actually live in a bigger city than where I am traveling to have the surgery. There are 4-5 surgeons in my city that do rhinoplasties, but they are either ENTs (meaning more structural than cosmetic in my eyes) or full body plastic surgeons. Although my rhinoplasty is relatively simple on the complexity scale I really wanted someone who I trusted. My surgeon is a facial plastic surgeon who has been doing about 1 septo or rhino per week for 15 years. I thought it was very important to find a FACIAL plastic surgeon. Since he is located in a more "rural" setting it is also less expensive than going to someone in my town. Does anybody have experience or advice for traveling? I am a little nervous about it, even though it is only 2 hours away. I'll add photos once my PS emails me them! Updated on 3 Jul 2012: 5 weeks until surgery! Here is a list of things I have or am planning to buy for my recovery process: -fresh pineapple (supposedly helps with swelling) -Arnica cream AND tablets - I bruise very easily so I hope this helps -Bendy straws -rubber gloves and frozen peas - Vitamin C (500mg). I have already started taking this once a day, but once I am two weeks out I am going to start taking twice a day per instructions of my PS. Vitamin C is needed for wound healing. After surgery I am going to continue taking 2x a day for about 2 weeks as well. -Qtips and hydrogen peroxide -Ocean or NA-SAL spray -Naked smoothies (YUM!) Hopefully I'll find one with lots of pineapple in it! -U-shaped travel pillow -Valium and other prescriptions -Tons of books, magazines, and of course, Netflix! -Laptop tray. My laptop gets so hot on my lap, and with school starting only 2 weeks after my surgery I will be doing lots of planning hopefully! -Flavored water Am I missing anything from the list? I am definitely a planner, so I have tried to think everything through and I'm sure I will have everything purchased waaay earlier than I need to! Updated on 11 Jul 2012: 4 weeks and counting! I have started thinking of movies/books I will want for recovery. I am already on book 2 of the "50 shades" series so I don't think it will last me until August. Plus, you aren't supposed to raise your blood pressure, ha! Has anyone else read those? So scandalous! Updated on 23 Jul 2012: Today I had my pre-op appointment with my primary doctor. I only had to do one blood test due to a medication I am on. I also paid for my surgery today...EEEEKK! I paid $4050, because my $90 consultation fee was taken off of the total cost. So my total fee for surgery is $4145, which ended up being a lot less than I expected while researching! I have a question for all of you that have had surgery: How long after surgery do you think it's safe to start shopping for glasses? My insurance starts coverage on September 1st. There is an awesome sale at LensCrafters that ends on September 9th. I don't want to pick out my glasses before my surgery because my hump always keeps glasses on my face, which is maybe the only benefit of having a hump! That will change after the surgery. I am worried about trying on glasses while I still have swelling because they may not fit after the swelling subsides. Do you think I should wait longer or just risk it? I would be saving a lot of money! Updated on 30 Jul 2012: Well, I only have a week and a day to go after tonight! I thought that by this point I would be starting to feel nervous or regret my decision. I can say with 100% certainty that I am ready for this and just cannot wait for it to be here. I am ready for my new nose and it has consumed my thoughts. I can't wait until I don't have to think about my nose anymore and I can take pictures from any angle. I can't wait until I can drive my car without covering my profile and order a drink at the bar without thinking the cute guy next to me is staring at my profile. I am SO ready! Now the next step is for the surgery center to call me to get my medical history 2-3 days before. I will get my surgery time the day before. I am hoping for a very early time. I don't do well without eating/drinking anything, plus I would like to get a hotel the night before so I can just relax and not have to worry about getting up super early to drive 2 hours. (Just an FYI, since there are no captions anymore (why is that anyways?!) the first 3 photos I have are befores and the fourth one is a simulation done by my PS. I will only be getting bridge work.) Updated on 5 Aug 2012: Only THREE days to go! I can't believe it is almost here! I got a call from one of the nurses at the surgery center on Thursday. She asked me about my health history, medications, and health habits. I requested to have my surgery right away in the morning if possible. She gave me a tentative check-in time of 7:15am. I will get another call tomorrow or Tuesday to confirm my check-in time. I have reserved a hotel room for the night before so I don't have to get up at 4am to drive. It will be nice to relax in the hotel room with my mom and sister and watch gymnastics the night before knowing I am only 5 minutes away from the surgery center. Nerves have finally set in. I have faith that my surgeon will give me a good result and the surgery will go smoothly, but I am still nervous. I think it's a normal emotion to have though! I am planning on going grocery shopping tomorrow to get some Naked smoothies, Ensure, pineapple, and frozen peas. I already have all my meds - but planning on just taking extra strength Tylenol for pain since I get bad reactions to prescription pain meds. I have arnica pills and cream. I feel ready! Updated on 7 Aug 2012: Well, tomorrow is the big day! My check-in time at the surgery center is at 8:15am. I got done with work 2 hours ago and since I have been doing things like removing nail polish, jewelry, tweezing eyebrows...things that I won't remember to do tomorrow! I am leaving my house shortly to drive to Baxter and check into the hotel we are staying at. AHHHH! I feel both excited and nervous! Just a side-note: I started taking Arnica pills yesterday. 2 tablets, 4 times a day. I have the Hyland brand 30x dilution and I have to say that I can tell it works already! I had a HUGE bruise on my leg that was taking a long time to fade. I woke up this morning and it is almost gone! I hope it works on my face bruising just as well. I'll try to update tomorrow after surgery. Thanks everyone for all the support and encouragement! I love this site! Updated on 8 Aug 2012: I had my surgery today! And it went WAY better than I expected. Last night and this morning I was extremely nervous. I had a hard time sleeping and also a hard time not drinking anything after midnight. I usually start my day with a huge glass of water! Luckily my check-in time was 8:15. Within 5 minutes of my arrival I was in the pre-op room where I put on a gown (with an inflatable warmer pouch!), surgical cap, and booties. The nurse took my vitals and gave me an anti-nausea pill with a sip of water and also put a 72-hour patch behind my ear which is apparently supposed to help with nausea from the anesthesia. She also started my IV. THEN, she surprised me by saying that I would be undergoing general anesthesia. I was anticipating twilight. I talked to my anesthesiologist about my concerns and he said he wouldn't use any of the gasses, just use the IV type and insert a breathing tube after I was already out. I was brought back to the operating room at 9:15. I was very surprised at how fast everything moved, especially since I have had foot surgery before and had a 3-4 hour wait time between checking in an being brought to the OR. I laid down on the table and the prep team got to work right away with hooking me up to things. Then I asked my anesthesiologist when I would be falling asleep and he said in a few seconds. I remember staring at the ceiling thinking I was going to try to stay awake for as long as I could and within 15 seconds I was out! :) I woke up in the recovery room around 11:30. My actual surgery went from 9:30-10:20. Here's the kicker: I felt totally normal. I did tell the recovery room nurse that my pain was a 7 on a 1-10 scale when I was still loopy before 11:30, but once I moved into another recovery room I felt great! It's strange because I have had anesthesia twice before (and not general) and it took me HOURS to feel not drunk anymore. Not this time! The car ride went great (2 hours). At home I feel great...I just took 2 extra strength Tylenol for pain as the local anesthetic is beginning to wear off. I have been drinking lots of water, took Arnica twice since surgery and ate a small dinner of hot dish and raw broccoli. It's a little strange feeling to eat, but doesn't hurt. I'm hoping that day 2 and 3 don't kick my ass, as I hear that can often be the case :/ But for now, AWESOME! I'm surprised because I haven't slept one wink since recovery around 11:30am. I'm just not tired! I'm icing every hour for 20 min. and I just rest my eyes then but don't actually drift off. The 20 minutes icing feels like 2 hours because it's so booooring. AAAAANNND I LOVE MY PROFILE ALREADY! I love the cast they gave me because it has breathable holes and is small and thin, but still hard and protective. They heated it and molded it to my nose. I can see that my hump is completely gone! I only have an incision in my left nostril, so I'm noticing most of my bruising to be on my left side. I can tell it's going to be bad! It definitely looks worse than it feels like most people say. I can even breathe through my nose through my drip pad! Breathing has been clear since surgery and is about 9 hours later now. If you are getting a rhinoplasty and are scared, DON'T BE! Updated on 9 Aug 2012: Day 2: Slept through the night last night only waking up once. I slept in a recliner. The only pain I woke up with is a stiff neck from sleeping in a chair. I woke up with 0 pain and I was breathing through my nose. I took Tylenol this morning just in case. I am noticing that swelling and bruising today are slightly worse than yesterday. I am so surprised how easy this recovery is for me after reading other stories on here! I have been eating normal foods with no nausea (thanks to my patch I think) and haven't had any nausea yet. WHOOHOO! I am noticing that my tip looks a bit upturned, but I know that is due to swelling and probably having my drip pad on all day yesterday. No need for a drip pad today! When I woke up I sprayed each nostril 4 times with Ocean spray and then applied Bacitracin with a q-tip...that part didn't feel the greatest. Overall I am happy I did this so far! I can't wait to see my results and I hope I am happy with them. Updated on 10 Aug 2012: Day 3: I woke up this morning unable to breathe though my nostrils, so my mouth and throat were feeling pretty dry. I sprayed my nose with saline solution and applied Bacitracin to try to clean it out. I can now breathe a little out of my nose. My bruising under my eyes is already beginning to fade - a testament to the miracle of Arnica tablets! I am a little puffy today, but nothing too crazy. This whole thing has just felt like a head cold. No pain to speak of. I am not even taking Tylenol anymore. It does feel a little strange to have a cast on my nose, but it just feels like a bit of pressure when I eat or talk. I am very happily surprised, as I was expecting to feel like crap this week. I am now working on school stuff and feel like I could go out to do something by tomorrow if I didn't still have my cast on. I go back on Tuesday at 10:30 to get this cast off! Updated on 12 Aug 2012: Not much to update...I get my cast off on Tuesday. I am anxious to see my results. I am trying to prep myself for the swelling that is bound to happen once this cast comes off. Recovery has been a breeze. I think this is even better than having a cold. I am feeling like myself now on Day 5 and feel like I could do anything, but I'm still taking it easy. I uploaded 2 pics from today. Updated on 12 Aug 2012: I just noticed that in my photos my nostrils look uneven. This is probably because my surgeon went through my left nostril for the majority of the surgery. I will probably have uneven swelling for a while. Updated on 14 Aug 2012: In the car on the way home and I am THRILLED. I can't post photos on my phone, so I will update late afternoon/evening. Can't wait to show everyone! Updated on 14 Aug 2012: CAST REMOVAL DAY! I have very little swelling and still a little bit of bruising, but I think Dr. Waters was even surprised by how good I look today. I am breathing clearly through my nose and still don't have any pain. Cast removal was a bit uncomfortable, but nothing too crazy. When he handed me the mirror I was in shock. No more bump! And I am not very swollen either. My tip I can tell is holding some swelling, but my bridge feels pretty normal. My nose looks smaller and it will just continue to shrink as the "swelling" goes down. I feel so beautiful and confident now. After the cast removal my mom and I went out to lunch and I purposely positioned myself so others in the restaurant would see me profile :) Before I would have been conscious of where I sat and who could see my profile. I got home and tried to wash my face. My nose is extremely tender to the touch and still sticky and flaky from the steri-strips. But no breakouts or blackheads, which was a huge surprise since I struggle with acne. I then put on some makeup and started running errands. My life feels totally back to normal now. Let me just say that if you are in the state of MN and are looking for a good facial PS Dr. Waters is your guy! I had such a good experience from scheduling my initial consultation up to my post-op appointment today. His surgery consultant, Sheila has been a dream to work with. She is so helpful and caring, and even booked my hotel stay the night before surgery and got us a special rate. PM me if you have any questions!
Giving your age the submental fullness may be primarily fatty tissue that could be addressed with limited liposuction and/or cool sculpt. Your skin can typically conform and adapt at your age for the reduction of fat alone. If there is skin redundancy a limited submental incision with minor skin removal and/or full necklift would be required. I do not think the minimally invasive skin tightening procedures we have adequate results for most individuals.
The cost for nasal dorsal surgery in addition to tip surgery can vary dependent on your surgeon and where you have this done. He certainly want to find an experienced rhinoplasty surgeon although for those of us that do a fair amount of rhinoplasty this is a fairly standard procedure. Nasal dorsal hump takedown with tip reduction from a closed approach would typically take approximately an hour. Your cost will also be dependent on facility and anesthesia fees that would be less in the surgery center setting than a hospital setting. This can range from $4000-$8000 in our area.
You certainly have some asymmetry and it appears you have a component of brow ptosis with the left brow sitting in a slightly lower position than the right. Whether this is the only thing contributing to slight asymmetry vs some levator dysfunction would be dependent on an active exam that could be performed by a physician who performs ptosis correction. Not all plastic surgeons perform ptosis correction so do your research to find a facial plastic or oculoplastic surgeon who is proficient in this.
Certainly scarring has the ability to be a hindrance dependent on the degree of scarring however enhancing volume with fillers and/or fat transfer should not be an issue. Fat transfer may be an option but typically would require multiple stages. Volume fillers such as Voluma and Bellafill would also be a good option to give more immediate volume enhancement.
