Sigmund L. Sattenspiel, MD

Question: More Visible or Upturned Nose?

Answer: Removing the hump itself will not affect the nostrils or turn up the tip of the nose.
The position of the tip of the nose and nostrils are related to work on the tip
cartilages and the end of the septum. You should discuss your concerns with
your surgeon.
 

Question: Why Do Some Say Lumigan is More Potent than Latisse?

Answer: Latisse and Lumigan are the same product. The only difference is the type
of application and indication for appropriate usage. If you have specific
questions about potency, you should probably contact the manufacturer, Allergan,
but they will most likely give you the same answer.
 

Question: Smoking after rhinoplasty?

Answer: There is no specific answer regarding when it is safe to smoke after rhinoplasty.
Most likely, your nose will not suffer any drastic complications because of your
smoking. However, smoking is never safe. Chances are, smoking will ultimately
reduce your quality of life and, statistically, it will most likely shorten your life.
No ethical conscientious doctor would use the word safe and smoking in the
same sentence.
 

Question: Dark triangles from bruises under my eyes 6 weeks after lower blepharoplasty?

Answer: Your surgeon is correct and you should give it more time. Sometimes, the dark pigment from the bruising lasts for a relatively long period of time. Occasionally, it lasts for a number of months but it almost invariably diminishes and disappears. In the meantime, do the best you can with cover up make-up.
 

Question: Besides tip work, do you think I need my bridge lowered/narrowed to get my ideal nose?

Answer: If I were your doctor, I would most likely not want to operate on your nose. This is because of the way you phrased your statements and questions. The bridge of your nose has nothing to do with the distance of your eyes to each other. The term “prefer to drastically narrow the tip of my nose” is completely inappropriate. Also, “cheaper” should never be a determinant of the type of cosmetic procedure perform on a nose. Lastly, there is no such thing as an “absolute perfect nose.” Anyone who insists on absolute perfection will never be happy with the results of any procedure and, accordingly, would not become a patient in my practice. Sorry to be blunt with my response but I speak the truth! My comments are made with your best interests in mind.
 

Question: Did bumping my nose 8 days after rhinoplasty ruin my result?

Answer: There is no way to make this determination online. The determination can best be made by your surgeon. If your surgeon feels that you did not create a problem by bumping your nose, then you should take the surgeon at his word. Nevertheless, if you are not happy with your results at five months, you should address these concerns with your surgeon. The results of a rhinoplasty are not final at five months post-op. There is still some edema or swelling and the nose will continue to refine and define itself over the next year or even several years.
 

Question: Revision Rhinoplasty – less expensive if I use the same doctor?

Answer: It is always best to initially follow up with the surgeon who performed a rhinoplasty. If indicated and desirable and if the surgeon feels that an improvement can be achieved, an ethical surgeon may offer to revise the rhinoplasty. Most surgeons who revise their own rhinoplasty will reduce the revision fee although there is usually a facility and an anesthesia fee as well.
 

Question: Will insurance pay for my rhinoplasty to address breathing problems?

Answer: If you truly have breathing problems caused by an anatomical obstruction of your airway and, if this can be proven to the insurance company, and, if the insurance company accepts the story, the insurance company may honor and may pay for a portion of the procedure. Basically, insurance companies are very skeptical. They understand that the majority of people desiring a rhinoplasty do so for cosmetic purposes. Today, it is very difficult to convince an insurance company that the rhinoplasty is being performed for functional and not cosmetic purposes. If the insurance company does agree to pay, they will most likely pay very little with the vast majority of the procedure to be paid directly by the patient. In all fairness, looking at the picture of your profile, it appears that you are desiring a cosmetic rhinoplasty, even if there is a functional component. Having said this, looking at your picture, I feel that, you have the potential of looking beautiful with a well performed rhinoplasty as well as the addition of a chin augmenting mentoplasty to give better balance to your profile.

Question: I had BOTOX® 11 days ago, I can still furrow my brow, Is this normal?

Answer: At 11 days I would expect a substantial improvement from the BOTOX®.
There are several possibilities for the furrowing of your brows. You may have very deep or very superficial furrow lines involving the superficial area of the skin that is only partially treated with BOTOX®. The addition of a judicious filler might be of help. Secondly, the BOTOX® may not have been placed in a manner that would maximize the results in the region between your eyebrows. Also, if the remainder of your forehead was not injected with BOTOX®, it is possible that contraction of these forehead muscles could be enough to produce some furrowing as well. It is always best to address your concerns with the doctor who performed the BOTOX® injections.
 

If it is truly a very mild viral cold, you might be the lucky and have a successful rhinoplasty without problems. On the other hand, if this “beginning” of a cold develops into a more serious upper and lower respiratory infection with sinusitis, bronchitis and even pneumonia, surgery and anesthesia will compound your problems both systemically and locally regarding the surgery of the nose. When there is doubt, it is wise to postpone the surgery until you are well. An ethical surgeon will understand and you should not lose your deposit.