Primary Rhinoplasty with Dr. Cochran - Dallas, TX

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Hello, my name is Doro, and I would like to share...

Hello, my name is Doro, and I would like to share my rhinoplasty experience with you. It took me a while to decide whether I want to tell people that I underwent nose surgery or better keep it secret. I am not sure if it's the hydrocodone pain meds that are giving me the courage (today is day 6 after my surgery; I haven't taken any pain meds for almost 24 hours now), or my strong believe that people should be open about the need to improve their looks when they are unhappy with them. My love and hate relationship with my nose started when I was twelve years old. A dear family friend, a 10 year old child at that time told me out of nowhere that my nose looked like a witch's nose. I was shocked; until then I was pretty sure I had a cute and small nose like a button and that my friend was probably just teasing me. However, as weeks were passing, I realized that there was something to his words. My nose wasn't cute as button anymore. Never ever again. At the age of twelve, it didn't look as big and crooked, neither it did at the age of 16 or even 18. My nose looked larger and more defined than the noses of my friends, more like on a Roman or Greek sculpture. It was very slim from the front, with a little longer than wanted columnella, but still very acceptable. I thought I looked good from the front. What bothered me the most, was the over projected profile, and worst off, when smiling, the tip of my nose pointing down. Slowly, but surely, as I entered my twenties, there was more of hate relationship than love. I tried to accept and love myself for who I was and how I looked, yet I dreamed about having my nose fixed. I am 36 year old Caucasian white, however, my nose has a very ethnic look. Pardon me, had. After a decade of researching rhinoplasty surgeons and building up the courage to actually do it, the timing seemed right. I had my second baby 11 months ago, I run my own business from home, and I am not planning any exhausting travels for the next year. My parents were coming to visit me for long time to help with the children, so the only important, if not the most important remaining factor for my surgery was my surgeon. As I said, I spent the last ten years finding the right doctor. Fingers crossed for me, since I am still sitting here in front of my laptop with a cast on my nose thinking about my uneven nostrils and my nose seeming to slightly point towards right. Cast removal is in two days, yeay!!! I chose Dr. Cochran from the Gunter Center because I liked his work best. The noses he creates have definition, are proportionate to the face, look elegant, and very important - don't change the overall look of his patients much. I still want to look like me, just me with more refined and pretty nose. I finally scheduled my interview which went really well. I brought some pictures from magazines showing what I desired for my nose to look like. Dr. Cochran showed me a simulation image of what he could do, and eventually we agreed on the final look. I appreciated his honesty about what he can and can't do, or shouldn't do. Also, important to mention is my breathing. Not only was my septum deviated, but my nostrils were basically lying flat at the columnella creating a difficult passage for the air. When sleeping on my side, I only got partial air, as well as during the sports when correct breathing is crucial! Dr. Cochran and I agreed on rebuilding my deviated septum, shortening the nose from the profile, and widening the nostrils a little bit. I already had enough definition in the cartilage in the tip of my nose, however, the tip was too long as well. I scheduled my surgery to be in one month, today it's 6 days ago. I am not sure yet how my nose will look like and how difficult it will be for me to get adjusted to the new looks. Even though my profile already looks fantastic, just like my mother's nose that I wanted so much to have inherited but didn't, I look like a different me. From the profile I look about 10 years younger, no kidding, like my mom when she was young and whose beauty I adored. From the front my nose is swollen and shorter and wider than it used to be. It will probably always remain somewhat wider because my nostrils should flare out a little bit. As of the moment, with the cast still on my nose and splints inside, I do not like myself all that much yet. I am very positive that this will change, hopefully sooner than later. The experience of the surgery was great. Not only the staff at the Gunter Center was professional and courteous, but also everybody at the Texas Institute for Surgery. From the receptionist, through the payment assistant, through the nurses and the anesthesiologist, to Dr. Cochran, everybody made me feel as comfortable as it got. I totally felt like I was in good hands and that I could absolutely trust them. I do not trust many people and I am quite critical. I can be difficult to please. There were numerous complaints I had at the hospital where I was delivering my both children at the aftercare, but I had no single complaint the day of my nose surgery. So far, my experience is very positive.

The Healing Process

Before I was wheeled off to the operating room, I was given some pill that makes me forget the time between being wheeled off and waking up. It really works! After I said bye bye to my surgeon, my husband and my old nose, I don't remember anything until after waking up from the anesthesia. I didn't even hear my name, but the name of the lady waking up across the room. They called her about 10 times and she wasn't responding probably, so my first words were asking if she was alright? I was told she was alright as was I :) Good news! I had a new nose!
I was really happy to be alive, awake, and to hear from my husband that my surgery went well and that Dr. Cochran did not have to break my nose. I did not get to talk to my surgeon after my surgery, but he talked to my husband. It's probably better that way because I don't remember much, only that my throat was really hurting and that my male nurse was absolutely compassionate and well taking care of me. We talked about Germany and how we miss the food.
The trip home, about 30 min car ride was miserable. I wasn't nauseous at all, probably also because I almost never get nauseated and never vomit either. I was, however, uncomfortable, dizzy, not myself, and that throat! The throat pain was from the breathing tube inserted in my throat during the surgery. I kept on drinking, but didn't have the strength, nor the will, nor the right mind. My husband stopped at McDonald's to get me a shake to feel better. It went straight to the freezer when we came home. Yesterday, 6 days after my surgery I drank it after dinner, with no smell and no taste sensation, its freshness didn't matter anyway.
Before I fell asleep after we came home, I noticed very important observation in the mirror - my nose was tiny and my nostrils were symmetrical - picture perfect! This was before the swelling started taking part. The first days went by when I had to take the prescribed pain meds for super sore throat, painfull swelling in the face, and really painful bridge on the nose. I altered every 4 to 3 hours, for the first 2 days. My second evening after the surgery was the worst; my face swelled up too badly around my nose and eyes. The following days brought some relief as my swelling started subsiding, however, new nuisance appeared. My nose got stuffed up and started running. I remember the words for the aftercare - NO BLOWING YOUR NOSE, NO SNIFFLING, AND NO SNEEZING! Well, what to do then??? I called up my surgeon's nurse, who, such a sweet and helpful lady recommend decongestant that does not contain any ibuprofen nor aspirin. Remember, do not take ibuprofen or aspirin after your surgery because it can cause bleeding and who knows what else. So I sent my husband to Walgreens to get me Sudafed. He came back with Sudafed, but the type that contains ibuprofen which I couldn't take. Great, so I had to wait until he was willing to get me something else the next morning which was Claritin. Claritin did not work for me at all. We called the nurse again, and she said that at this point almost every patient has stuffed up and runny nose and that frankly, decongestants do not help that much. My last hope was Vick's DayQuil Sinex 'Daytime Sinus relief' containing acetaminophen and Phenylephrine. It worked about 85% of getting rid of my terrible symptoms. If you had a nose surgery and about after day 3 your nose gets really stuffed up and running, the chances are high that you didn't get a cold or flu, your nose is just trying to heal and this is normal. I didn't feel sick and I don't have any allergies either, so I knew for sure it had to do with the surgery. Also, instead of blowing my nose I found that running a Q-tip along the rim inside my nose takes away the excess mucus and leaves me feeling almost as if I blew my nose.
Today is day 7 after my surgery and my cast removal is tomorrow. I have mixed feelings. With splints inside my nose, I don't even remember how it feels to have empty nose. I am excited to have the cast and stitches removed, to see my new nose, to see the swelling start going down the following days and weeks. On the other hand, I lived 37 years with the way I looked, so who knows how hard it will be excepting a new me even if it looks much, much better than my old me.

Few more pics

Pics before cast removal

The Cast Is Off!

I was told today by the nurse at the Gunter Center that I actually didn't have a cast on, just tape. So since my nose wasn't broken, I didn't need a cast. Makes sense. Splints removal, which i feared so much, wasn't that bad at all, just uncomfortable, and it only took about 6 second per nostril. My nurse was really gentle.
After she was done removing the stitches and after she informed me about the aftercare of my nose, Dr. Gunter came to check on me. Dr. Gunter has established the Gunter center, however, he is not my surgeon. It was really nice meeting him and hearing his professional opinion. He also explained to me, rather insensitively, not to be too critical of my nose yet, and he reinforced it by taking away the mirror the nurse just handed to me. On the positive side, he explained to me what was done to my nose in the surgery by my actual surgeon. Even though I was excited to have met Dr. Gunter, I wish I had seen Dr. Cochran who was my surgeon. I did not get to see him after my surgery although he spoke to my husband in the waiting room, and I did not get to see him at the cast removal when the patient is seeking the surgeon's approval of his work and encouragement. I was not told why Dr. Cochran wasn't there. My next appointment is in 4 months.
My nose looks great from the profile, not as great from the front which only makes sense since it's still swollen. The swelling is uneven. It seems to be more swollen in the left nostril and then in the right side of the bridge. I have my highest hopes up that my nose will look better soon.

Two Weeks Post op

Some Changes in my Nose

I noticed some changes in my nose during the week after the cast removal - the tip of my nose which was a little upturned has dropped and it's a little bit longer, and I have a noticeable bump on my nose. I know there is still a lot of swelling going on, actually, quite uneven swelling. Let's see what will have changed in one week.

Swelling Up and Down

I noticed that my nose goes between more and less swollen stages, depending on my water intake, the type of food I eat, and daily activity. The more physical stress, the more my nose swells up. I am not working out yet, not that type of physical stress, but being up on my feet longer and caring for my little kids all day long.
Here is a picture of me with least swelling so far, at 17 days post op.

Three Weeks Post Op

It's been a little over 3 weeks post op, and my nose is slowly decreasing in swelling. While it looks more narrow in the bridge, I think the swelling is moving into the very tip of my nose because from the profile, my nose seems a bit larger than it was 1 or two weeks post op. I also noticed smell coming from my right nostril, and I was advised by my surgeon's office to start using saline spray. Sooo.... I'm taking saline spray now about twice per day and let's see how this will affect me.

4 to 5 Weeks Post Op

Ok, the smell from my nostril turned into a sinus infection with some pain in the low sinus area. I got prescribed a course of antibiotics for seven days. The pain went away within less than 2 days, but the smell is still lightly noticeable. My surgeon explained that because my sinuses were swollen from the surgery, they weren't able to clean themselves as they normally would and hence the infection.
The nose is still quite swollen from the front - I can't wait for it to start slimming down:)

6 Weeks Pics

My nose is still very wide in the bridge, and tends to look better in the morning, but by the afternoon it gets more swollen again. It's been only 6 weeks since my surgery, yet it feels like I have had this new nose for a much longer time. I totally got used to it and don't even remember how my old nose looked like ; )

7 and 8 Weeks Post Op

Very interesting - I met with a good friend of mine after not having seen her for a year, and she didn't even notice my new nose! I tried to explain and show what everything was done to my nose, but she just didn't see a difference. Then she asked "What was wrong with your nose in the first place?" In a way I was happy to hear that she didn't consider my nose in desperate need of plastic surgery before, and also I liked the fact that she thought I looked the same. As I mentioned earlier, I have decided not to make it a secret, so if somebody asks if I had surgery, I will admit. I'm curious how many people will not notice at all.

8 Weeks Pics

10 to 11 weeks Post Op

I do not see much difference between the previous pictures from my 8 weeks post op. I think the swelling is subsiding very, very slowly, if at all. Some days my nose feels slimmer, other days it feels like a blob on my face from the front. I love the profile and my smile profile - they're better than I could have imagined.
At this point, I am concerned with three issues:
1. scar tissue formation inside the nostrils, at the tip. I can touch it right at the entrance to the nostril, and also see it from the bellow view. My surgeon's nurse believes it is still swelling, but she hasn't seen it yet, so let's hope she is right. I rely on my surgeon's office year long experience. I bet they have seen it all :)
2. callus or some type of bump on the right side of my bridge. It has been here since about 2 weeks post op and can be seen in my 45 degree angle or when light is coming from above.
3. swollen area above the tip of the nose. My nose from the front still feels very wide and shapeless. I am hoping this is all just swelling as I have olive skin which is said to be thicker than other skin types. I am including a few pics to see what I am talking about, one of them is a picture before the surgery that shows how narrow my nose used to be compared to now.

Overall, I am still very happy that I have gone through with the surgery, and I can't wait to see my nose start shaping up.

3 to 3.5 months post op

I have been doing well, especially because my nose is starting to show more definition. Part of it is probably the steroid shots I received at 3 months and one week visit. Dr. Cochran said that I was with my healing where I was supposed to be, he acknowledged my scar tissue inside the nostrils, but believed that it was a stage when it grows and swells, but eventually diminishes. He didn't think it was necessary to inject steroids into the scar. Instead, he injected both sides above the tip that were quite swollen and still, at 3.5 months post op are. The injections were surprisingly painful, but don't we have to suffer for beauty?
It's been a week since then, and I started noticing the swelling go down a bit more. It can take up to 8 weeks apparently to take full effect - can't wait!! :))

3.5 months post op Profile

6 months post op

The bump I had on my right side has definitely decreased with time, however, I can't say it's all gone. Now I am 6 months post op and my nose has what seems like a little bump on each side, which are not really bumps, more of a defined bridge from the front view.
It appeared at 2 weeks post op as my nose started slimming down and probably decreased at 4 1/2 months post op. Now I'm sure it was uneven swelling that made it stand out.
Still, my nose fluctuates in swelling even at 6 months post op. Nobody, including my husband, sister, or my mom notice, even though to me it's a big change. What makes my nose swell up is elevated heart rate from stress and excitement, coffee, alcohol, not enough liquids and foods made with flour like bread and pasta. Took me long time to figure this out. Exercise decreases the swelling. Anyway, trying to keep my nose from swelling, I lost about 10 pounds avoiding above mentioned foods and exercising, so it was good for something after all :)

more pics of 6 months post op

14 months post op

Ok, this is long overdue, but the reason I have waited and waited is that I was hoping for more change that never really came. My nose hasn't changed much from about 7 months post op. There are still days with a lot of swelling, especially when I stress out and walk outside in the heat.
Every morning I wake up with a swollen nose, and by the end of the day, some swelling goes down. Some evening are better than the others.
Am I happy with my results? Not really. Especially when my nose has swelling that lasts several days, I feel like I look masculine. Then there are days when swelling goes down and I get in better mood, however, I think my nose is still very bulky in the bridge and in the tip, as well as has bump on the right side of the bridge.
Doctor Cochran took care of the problem ares which was an overprojected profile and a droopy columnella, however, now my nose is much more wider and feels like not enough nostrils show from the front. At my 12 months op appointment I pointed out what bothered me. After he checked my nose, he said there was still some swelling, but not so much anymore, at the supratip, and the top part of the bridge. He offered to file down the bump on the bridge under full anesthesia, but didn't offer anything about the tip. We agreed to wait 6 more months, until January 2015 to see if there will have been any changes. If there won't be any changes, I am planning on having the bridge narrowed down and hopefully the tip lifted up because I think it's quite droopy.
Another negative side of the rhinoplasty that happens to almost everybody, and is worth mentioning is the change to the upper lip. Because the nose gets shortened and made smaller, it doesn't hold the upper lip up anymore, and the upper lip sinks down. Before the rhinoplasty, when I relaxed my mouth, my upper teeth would show. Now they don't show anymore. Also, my upper teeth showed when i talked before the rhinoplasty, and now more of my bottom teeth show. I am trying to train my muscles to lift the lip a bit more, but it's hard work :) My smile is also gone.
The positive side of the rhinoplasty is that my profile looks quite pretty. I don't have to think about it every time I meet new people. Even though my nose is wider, it still looks relatively normal compared to my old nose. I also like my right 45 angle, not so much my left angle because of the bump. Some pictures are included, they show my 4 months before surgery and 12 months after surgery.

14 months post op pics

here are some more pics 14 months post op.

narrow nose before surgery

I just want to show a few pics of my old nose, when I was 26, exactly 10 years before my surgery. Even though my nose has grown some since then, it still stayed narrow with a very refined tip. I miss the tip and the narrow bridge. Definitely do not miss the profile! When I smile now, my nose is really chunky and bulbous which wasn't the case at all before the surgery.

17 months post op

I am considering a revision.
I do not like the front view of my nose very much. There is a heaviness around my eyes caused by the wide bridge with a bump on the right side. My supratip is bulky and my tip lacks definition it used to have before the surgery. My profile looks better after post op, but I miss my front view. Not sure if it helps to mention - my husband likes my nose and says there is no difference at all (??), but my parents and sister miss my slimmer nose from the front.

19 to 21 months post op

Not very much has changed - I must be one of those rare cases who still get swelling on a regular basis at almost 2 years post op. My nose can swell up within minutes and unswell the same way. In the morning I wake up with a lot swelling, and by the evening the nose gets slimmer, however, not the slimmest I have seen it. From observing, when I am totally relaxed for example when painting, my nose gets nicely defined and relatively slim. When I get cold standing outside in cool weather, and them inside, a lot of the swelling goes down within that short period of time. Living in Central Texas, this is not going to be the case most of the time though :)
When does my nose swell up within minutes? When I get stressed out, during cardio activities, gardening, cleaning up, and during my periods.
I have attached a few pictures below to show my nose how much the swelling fluctuates. One day the nose is ok, and the next it looks like a potato. Then next evening, it's totally slim.....
I am not sure how to handle it other than wait it out. I went to see an ENT that was recommended to me by my plastic surgeon, Dr Cochran. The ENT scheduled me for a ct scan that revealed normal results - no swelling of my sinus walls or any unusual water retention. I do not need to take my steroid nasal sprays anymore. This basically explains that my swelling is related to healing and not to allergic reaction or problems with sinuses.
I am scheduling myself for a 2 year post op in May and will consult a revision with my surgeon. I will ask for the hump to be filed down and also supratip reduced. I will keep you posted how the consultation goes.

Three and a half years after

Hello, I haven't been here for over a year but honestly, much hasn't changed with my nose.
I am still undecided about the surgery. Can you believe it? I am weighing the pros vs cons. Better profile, better angle, wider front, bulkier tip, bridge side bump, lower upper lip.
Yes, after rhinoplasty your upper lip will sink lower, showing less of your upper teeth when smiling or talking.
I am posting a few cropped pics of myself that other people took as these seem to look different from selfies. I think they are more truthful.

It seems like my nose has many faces based on the swelling and its severity as well as angle and me wearing makeup. It always looks better when I wear heavier brow or eye makeup.

I will appreciate your comments.
Dallas Facial Plastic Surgeon

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