Who will perform a rhinoplasty on someone with ITP? + General feedback (Photos)

I have wanted surgery for the longest time, but a few doctors will not do surgery on me because of my ITP (despite having the okay from my hematologist and being on steroids, which brings my platelets to the normal range). I have met with one doctor that will perform surgery, but I want to visit with other doctors. Can anyone recommend a doctor that will perform surgery on someone with ITP? Also, do you think my nose could look like the pictures I added?

Doctor Answers 4

You have strong tip cartilages. See the morph I made. I leave the ITP question to the hematologist.

Click on the "Web reference" link, just below my response, or go here:

FacialSurgery.com/RealSelf/RealSelf_newnosewanted.html

I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands. I narrowed your strong tip cartilages and elevated the tip. Typically, when tip cartilages are strong, making the tip look wide, their strength also makes the tip look like it droops.

Actually, though, the photos you submitted weren't great for an online consultation like this: mostly, they were taken with the camera well below your face, and the camera was looking up at your face. The very bottom of the Web reference link gives information on how to take great photos for an online consultation.

I tend not to worry about medical issues like ITP. I punt them to the internist or hematologist. If the doctor caring for you understands what will be done and has no problem with it, then I tend not to have a problem with it, either.

You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.


Omaha Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Rhinoplasty on Patient ith ITP

As long as you have clearance from your hematologist I feel almost all experienced rhinoplasty surgeons would do your surgery. Your expectations seem realistic.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Who will perform a rhinoplasty on somebody with ITP?

First and foremost is that you have clearance from your hematologist and that your bloodwork is normal prior to undergoing elective cosmetic surgery. A rhinoplasty procedure can accomplish your goals of decreasing the overall projection of the nose, reducing the bulbous tip , and improving the dorsal aesthetic profile by shaving down  the hump. The model photographs also demonstrate strong chin profile, so consider a chin implant in combination with the rhinoplasty procedure, which will help facial balance and proportions, especially with respect to the overly projected nose from the side profile. For more information  and many examples of this combination, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Rhinoplasty with ITP

In most cases, people with ITP clot normally and do not bleed excessively. I would need to have a telephone discussion with your hematologist, but chances are you are a safe candidate for surgery.

As for your images, they do appear to be overall realistic.  Computer imaging at the time of consultation will help clarify what you can expect.

I think you would be very happy with rhinoplasty, and would love to do a consultation with you. 

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 170 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.