Open rhinoplasty - 27y female - 4.5 months post-op - Gold Coast, AU

Going into surgery in 3 days... the time has...

Going into surgery in 3 days... the time has absolutely flown and I can't believe it is going to be so soon! I haven't really started to feel nervous yet - I think just because I've wanted to do it for such a long time and I've been extremely busy with work.

I've hated my nose since I was about 12. I'm not sure exactly when I first realised I didn't like it but I can distinctly remember hoping that I'd somehow break it so I'd have an excuse to have it fixed. How horrible! I'm 26 now and have decided that it's time to do something about it. My family and partner have been extremely supportive which has made the whole process so much easier.

What I'm hoping to achieve is to straighten the hump on my bridge and have the tip reduced so that it appears more sculpted. Most of what I dislike is visible from the side view - I feel like I have a witches nose. Front on has never particularly bothered me. As silly as this sounds, I've found that the way I feel about my nose has had a big impact on the hairstyles and makeup that I wear. Everyone in my family is lucky enough to have a nice, proportionate nose so I hope that once this is all over I'll feel the same :)

In preparation for the surgery, for the last two weeks I've been on a reduced salt diet and have been taking vitamin c, arnica pills and bromelain. The reduced salt has been great actually since I usually find I'm quite fluidy in general and I haven't had that issue for the last week. I'll be continuing this routine for a while after my surgery in the hope of keeping swelling down, etc.

In my consultation with the PS, he took a 3d image of my face and made some adjustments that he felt were achievable. I was happy with everything that we discussed! I didn't get to take the images home though, so I had a bit of a play around in photoshop to try to emulate what I had seen.

I'll keep everyone updated as I go through the healing process. Wish me luck!!!

Today's the day!

Well, the day is finally here and I'm starting to feel quite nervous and a bit emotional. My surgery is in the early afternoon, so I'm going to spend the next couple of hours trying to keep my mind off it as much as possible.

I can't believe the waiting is finally over! All the years of wishing and wasting time looking in the bathroom mirror hating my nose are hopefully behind me. I'll post an update once I'm up to it after surgery :)

All done!

All done! Now for the recovery..

Everything went well as far as I can tell - I was extremely nervous going into the hospital and even got teary in front of a couple of the nurses. Everyone was really lovely to me though, and it was over before I knew it.

I count myself extremely lucky as I didn't have any kind of bad reaction to the anaesthetic, so I haven't felt nauseous at all. I also have very minimal pain, which is mostly on my stomach as I had a scar revised at the same time as my rhino. It's amazing that something so major on your face could be painless! I have been a bit headachey but the painkillers I was prescribed have taken care of that. I've been sleeping upright in a recliner chair which has also been a lot easier than I expected.

I am starting to swell and bruise up around my eyes now which is more annoying than anything :) I think it was inevitable though because I had an open surgery and also had the bones broken in my nose. I looked pretty much normal when I got home from the surgery, but by today (morning of day 2) my eyes are quite puffy.

I have a bit of uneven swelling on my nostrils which I'm hoping will resolve itself. I'll be mentioning it when I go in for my post op appointment next week. Apart from that, I'm really excited about the result I can see so far - not that much is visible from underneath the splint! But I can see that the tip is definitely different and looking more attractive already. I'm excited about seeing how it all turned out :D

I'll post more pictures as the days go on. Hopefully the swelling will go down a bit :)

More swelling, day 2

I can't stop laughing at my face.. I'm starting to look quite ridiculous with one eye half shut from the swelling :) everything else is going fine though. The bruising doesn't seem to be progressing any further now but I'm starting to get chipmunk cheeks.

Hopefully I'll start deflating soon!

Day 2 continued

Photo from last post

Day 5 post-op

I have started deflating! Which is very welcome because I was having trouble seeing out of my right eye when the swelling was at its worst. My bruising has also started to dissipate, so now I am getting yellowing skin in places and some patchy 'eyeshadow'. I am also starting to regain semi-normal movement in my top lip. The chipmunk cheeks are still there a little bit though.

I have my first post-op appointment with Dr Layt tomorrow morning, at which point hopefully I'll be getting all of my stitches removed (including my stomach scar revision). The tape holding down my cast has lifted quite a lot, so I will see if they will fix it up at the same time. I have just added some extra tape in the meantime. I will also be asking about the unevenness with my nostrils. I go through phases of feeling positive about them and then having a bit of a freak out. I know that it is really early days so I am trying my best to put it out of my mind. They're not really that bad and are only visible from underneath and I am reasonably short so I don't think it will be super noticeable. Still, I don't think I'd be keen for them to stay like this forever! So fingers crossed they even out :)

Other than all of that, I've been feeling pretty good for the last couple of days. I am just taking panadol occasionally as I'm getting on and off headaches.

I'll post another update once I've had my appointment tomorrow :)

Day 6 post-op

I got my stitches out today! It wasn't painful, but it wasn't the world's most pleasant experience either. It all happened pretty quickly though and the only uncomfortable part was just the quick pinching feeling as each one was taken out. While I was there the nurse commented that I was much less bruised and swollen than she was expecting which was nice to hear! I can put that down to all of the arnica and bromelain that I've been taking. The inside of my nose was very clean, so I didn't need to have it cleared out. My post-op instructions were to clean my stitches with cotton-tips and cooled boiled water, then to apply an antibiotic ointment. Just doing that seems to have been enough to keep things looking tidy :) I cannot wait until I can blow my nose again though. Not being able to do that has been the most torturous part of the whole thing haha.

The scar across my columella is looking great already - it's pink, but very smooth and I think it is going to fade away just fine. Same goes for the scar revision on my stomach - it is swollen, but looks very neat so I'm hopeful it will heal a bit better this time around - I had a mole removed a few years ago and the scar ended up being very stretched with stitch marks right around it. I have heard that Dr. Layt is excellent at leaving minimal scarring, and from how I have healed so far I think he will be my go-to if I ever need another mole removed.

I asked Dr. Layt about my nostrils being uneven, and he told me what I was expecting to hear - it's not really possible to judge this soon after the op. He also said that he didn't change them at all, so the size they are (minus the swelling) is what I was born with. To be fair, they were ever so slightly uneven to start with so I am inclined to take his word for it. I am going to try to be patient and see what happens after some time. I have also seen a bit of improvement over the last couple of days so hopefully they'll keep getting better.

I will be getting my cast off this friday (4 days away!) which is exciting and scary at the same time. I am really nervous about how everything is going to look. I almost feel like it doesn't matter how I look right now, but once it's off it all becomes real. I'll keep everyone posted :)

Cast off!

Well, it's done! I am now officially cast free. I'm not sure how I feel about it all yet. I know it's early days, but I can still see some of the things that I was hoping to address. On the other hand, it's a huge improvement. So we will see! My nostrils seemed to have evened up quite well which I am relieved about. The photos are from about an hour after getting the cast off. I seem to have gotten a bit more swollen in the tip now (half a day later).

Day 15 post-op - Feeling good!

I'm starting to really like the change - I have heard it so many times that you can't judge things until the swelling has gone down and that there will be a lot of changes, but actually experiencing the recovery process can be hard. I go between liking it and not liking it multiple times throughout the day, but at the moment I'm mostly feeling good about it.

During my post-op appointment, Dr Layt told me that my surgery had ended up being less straight forward than he was expecting, but it all went well. In the end, I had an open rhino, the bones broken, hump removed, tip work, septum work further back in my nose and a cartilage graft along the bridge.

I can still see a hump on my bridge, which I really hope is just swelling although it is quite hard. It was visible on the left side on the day of my cast removal, and it has since come up on the right as well. I was also originally hoping for the tip to be a little more raised, but hopefully once the swelling goes down I'll be happy with it. I still feel like it's a massive improvement from where I was! I no longer feel like I have a witches nose and have been feeling prettier which makes the whole thing worth it!

The scar along my columella is pretty much gone. It just looks like a very slight pink spot now and is entirely smooth. I am really surprised that it looks like this after only 2 weeks! After my surgeon originally told me I'd be having an open rhino, I had come to terms with the thought of having a scar there. But it honestly looks like I had a closed rhino at this point.

I'll post another update soon. Things seem to be moving pretty slowly these days so there's not much to report!

Comparison pics

Here are a couple of side-by-side comparisons. I found it really hard to find decent images to compare because I have hated photos for so long! Most of the photos that would have shown my old nose properly would have been deleted on sight

1 month post-op - even more swelling!

Not much has changed since my last update, apart from I'm even more swollen than I was - I've stopped avoiding salt as much so maybe that's what's contributing?

I had a post-op appointment with Dr Layt yesterday to check on some bumps on either side of my bridge. They're small and feel like they're underneath the skin, and show if the lighting is right. I originally thought they were just part of a breakout, but they haven't gone away since my cast removal. He told me that it can sometimes happen as a result of the bones being broken and I can expect them to go down after a while. I found someone with a similar issue here http://www.realself.com/question/hard-lumps-side-nose-bridge and the answers seem to be along the same lines as what my surgeon explained to me. So I'm feeling a bit better about it now!

I still have a bump along my bridge which I really hope is just down to swelling - it looks more or less prominent depending on the lighting and is mostly visible from the side profile. Dr Layt told me it'd definitely improve with time and that it was all straight when he'd finished the surgery. I just hope that it goes away altogether! Having the hump removed was probably the biggest part of why I had the surgery in the first place. I wish it didn't take so long to see the final result!

My nose is starting to feel a bit more normal.. but it still feels like there's pressure (from swelling I guess?). The underside of the tip is still totally numb as well. My columella seems to have dropped a tiny bit (which I am happy about!) and the scar across it has gotten a little bit more pink since my last update. I've started applying a scar gel as well as papaw ointment to keep it from getting dried out.

I'll post another update soon once there's more to report :)

2 months post-op

I thought I'd share a few comparison pics - things are coming along well, still not that many changes though. Overall I am happy! I am totally glad that I went ahead with the surgery because it has done a lot for my self confidence. Even though there are still things I don't like about my nose, I honestly believe that my new nose is a big improvement on the old. However, for the sake of being open about all that is going on, here are a few things:

The bump along my bridge is still there which is disappointing! From what I have read, it may be a callus that was formed from rasping the bone and there is still a chance it will go down after a couple more months. I just want it to go away! I see so many people on RS who come out of surgery and they have perfectly straight noses and I wish that was the case with mine as well.

About a week ago the bumps on either side of my bridge felt a lot less pronounced which was promising! They've come up a bit again since then, but it was my birthday so there was a bit of alcohol and salty food happening :D Once things settle again hopefully they'll keep reducing.

The swelling in the tip seems to have reduced a little bit - the under side seems to have come up a tiny amount, which I am happy about :) After I got my cast off I felt that my nose wasn't up-turned enough but I feel like it is heading in the right direction.

Right now my favourite angle is the 3/4 view. Which is good! Because before I had no favourite angles haha. If the bump on my bridge goes away then I think I will be entirely happy. My 3 month post-op review with Dr Layt is in 3 weeks, so I will see what he says about everything. I am sure that I will be told it is still too early to judge... so we will see.

I am still feeling pretty stuffy and I am snoring while I sleep (apparently haha). I didn't snore before the surgery, so I hope this goes away! My fiance is so patient and never complains but I feel sorry for him! Another odd side effect of the surgery is that my nose is really ticklish now! If I touch the underside of the tip where it is still numb, I get a phantom tickle somewhere inside the tip of my nose. It is a really weird feeling!

Hope everyone is going well! I will probably update again after my 3 month review / if there are any more changes :)

4.5 months post-op

It's been a while! So I thought I'd give a quick update. I am loving my new nose from the front and 3/4 angles but not 100% from the profile view. I still have the bump that I was so hoping to get rid of and at this point it looks like it's here to stay.

I saw Dr Layt the other day and he felt that I would need an additional surgery to smooth it out. It will just be a closed surgery this time to rasp the bone - all done under general. I asked him if he did the procedure as an in-office surgery and he felt that it was too traumatic on the patient. Tbh I think I wouldn't have had the guts to do it while awake! I admire anyone who could :) He told me he wanted to see me in January at which point we'd make a decision about if we should go ahead with the revision.

There are always risks when undergoing a revision, so I want to make absolutely sure that I'm ready for it if I decide to do it. I don't want to end up having the parts of my nose that I like currently changed, but at the same time the residual bump does really bother me. We shall see!

I do feel a bit disappointed that I am needing the revision. I had been trying to stay positive throughout the whole recovery process that it would eventually smooth out by itself because that is what I had been told every time I had gone for a checkup. I know that everyone heals differently though, and there's always a possibility that it won't turn out perfectly the first time.

Apart from the bump, as I said I am really happy with the way it is looking. It's a huge confidence booster to not have to hate something about your face!

I hope everyone is well!
Brisbane Plastic Surgeon

My meetings so far with Dr Layt have been good - he has put me at ease about the procedure and I trust that he's a perfectionist and will be able to do a great job. I had a few specific requests and questions and I was happy with the way he addressed all of them.

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