Male - Septo / Rhinoplasty - Gothenburg, Sweden

I've always had a large nose. Growing up I kept...

I've always had a large nose. Growing up I kept hearing that I would 'grow into my nose'. I don't know what that meant, but what I ended up with is a nose with a really high radix, a hump, and a large tip.

I went in for a consultation some 15 years ago with a plastic surgeon here in Gothenburg, Sweden. The surgeon told me he couldn't lower the radix, and that he would only remove the hump. He showed me a simulation of this, which I wasn't happy with at all.

In addition to my large nose, I've always had trouble breathing, and have seen several doctors for this, to no avail. This past fall when I was recommended to go se Dr. Westin for my breathing issues. Not only did he identify the issues causing my breathing problems, he also recommended rhinoplasty to change the look of my nose - lowering the radix, removing the hump, refining the tip, a narrower nose altogether.

Dr Westin doesn't do Photoshop simulations. Instead he asked me what I wanted and told me what was possible or not. My being a graphic designer, I brought my own Photoshop simulations to show him.

We agreed on a look and feel (obviously as a goal, not a guarantee), and set a date for the surgery. Everything went smoothly, except I became nauseous due to the anaesthesia. I threw up several times after the operation, but felt better after a nap and a couple of sandwiches.

I am now 3 days post op.

Day 4. Still swollen.

I'm still very swollen all around. In fact, I got some swelling around my jaw line, which I find odd. My eyes are less swollen, and the bruising is going away steadily. I'm having the cast and tubes removed in 3 days. I can't wait! My doctor has been pretty upfront with me about the swelling, so I'm prepared.

These days I'm up and moving about, playing with the my kids and helping my fiancee with the daily stuff.

As for meds, I'm taking
- 3 x 50mg /day Diclofenac Kalcium (Voltaren) for the pain
- 3 x 750mg /day Flukloxacillin (Heracillin) antibiotics

My doctor also prescribed some stronger kodein-based meds for when I need it, which I take at nights to be able to sleep through the night.

Last day before cast is coming off

The cast and the tubes are being removed tomorrow, finally. I feel incredibly congested even after flushing the tubes with saline solution.

The bruising around the eyes is almost gone. I know I used to have a big nose before surgery, but with the swelling my new nose is even bigger than before. As part of my surgery, my PS strengthened my alar cartilages, which increases the swelling.

I can breathe!

For my first post-op my PS removed the tubes and tamponades, as well as the stitches, but he wants to keep the cast on for 10 days. So, the cast is coming off on Thursday.

After removing all kinds of stuff from my nose, Dr Westin told me to breathe through my nose. My whole life I've been able to breathe maybe 10% through my nose. I took a deep breath through my nose, and let me tell you, it feels absolutely amazing. I can breathe through my nose with such ease that I'm almost in disbelief. I'm so happy!

I also got a transcript / journal of the surgery. It's really interesting reading in detail what was done to my nose.

Oh, I may be developing a small infection near the columella and have been prescribed a cream for it.

PS...
I'm hoping this review is of some help to others, particularly other men. Feel free to ask if you have any questions.

Holding pattern

Today I decided to try and get som work done. Luckily, I can do my work from home so I don't have to go out in public. I feel like I'm in a holding pattern in anticipation of Thursday - my cast removal. So I though I'd update my review with some before photos.

My nose is stuffed today due to all the dried up blood, which is a bummer. Funny side note, today I had coffee for the first time since my surgery and it tasted nothing like before - tasted more bland, less flavor. I wonder why that is. Anyone else had things taste different after a rhino/septo?

No more splint / major swelling.

I finally had the splint removed. Here are my initial reactions.

I've been on this website for several months now, reading review after review, looking at photo after photo, and nothing prepares you for the first time you get to see your new nose.

I was prepared that my nose would be swollen, but not this swollen. There is no way of knowing what my nose will look like based on what it looks like today. It's simply TOO swollen.

We're miles off from my simulated Photoshop photos. I'm a little worried about my profile. It looks like it's not a straight line, rather more of a convex line. But I'm happy none the less!

My dr gave me the plastic splint and told me to wear it at night, simply taping it on top of the nose to make sure it heals straight. At least for a couple of weeks.

Let the healing begin.

Day 12 - Photos

Still major swelling. Trying to get a hang of taping. It's slowly starting to sink in that my nose will be swollen for a very long time.

Splint

I'm having an adverse reaction to the adhesive on the Micropore tape. Actually, I've tried other brands and get the same allergic reaction - I get red blotches on my skin around my nose.

So instead of tape, I'm using the plastic splint for support, and to hide the swelling. I'm technically only supposed to use it at night, but my nose looks a bit unsightly without the tape.

Have anyone else had a negative reaction to the tape?

On a side note, I was out walking and got a severe case of dizziness and had to sit down. I'm seeing my dr tomorrow for my dizziness.

Liking my nose more and more

Just a quick photo update with angles. Lots of angles :)

I'm getting more excited about my nose by the day. It's still swollen, but I'm liking the shape.

3 week update

Adding a couple of new photos. As you can see, my nose is looking better and better from the side, but from the front it's still very swollen.

The swelling is uneven and it's starting to worry me. I'm hoping this is just a case of uneven swelling, and not an indication that my nose is healing unevenly. What do you think?

Really happy with my profile

Posting some comparison shots. Sorry about the uneven color values. Took these latest photos at night.

I remember telling Dr Westin that lowering the radix is a deal-breaker. If he can't do it, I won't go through with the surgery. He assured me that it is possible, and that he would lower it several millimeters. 26 days in, I can finally say that I happy with how my nose looks from the side. And it's only going to get better as the swelling resides. Dr Westin told me he had to cut into the 'frown' muscle above my radix and removed some of it. One side effect is that I won't look as angry when frowning :)

Front view... what I can I say. My nose is still swollen and will be for a very long time. I still have blemishes from my allergic reaction to the tape. I'm seeing my PS on Thursday. I'm hoping to get some clear answers about the unevenness.

Day 37 - Photos

My last update was about two weeks ago, so I thought I'd write an update. The swelling at my radix is subsiding which is awesome, but the swelling on the sides of my nose near the eyes, and all around the tip is all still there. I almost don't want to show the front shot... with all the uneven swelling.

Profile comparison.

Not liking my profile lately. The convex line is ever more present. Also, I feel the tip is rounder than I wanted. Really hoping this is stil swelling and that it'll straighten out as time progresses. Having said that, I am getting positive feedback from old friends who hadn't seen me since before my surgery.

2 months post-op

I can't believe it's already been two months. I'm liking how my profile is progressing, minus the slight convexity - perhaps it's here to stay, perhaps it'll change when the swelling goes down. I'm happy either way. The front view is another story. I still have major swelling, although it always looks worse in the pictures due to the camera flash, I reckon. I won't be quite happy with my nose until the swelling goes down tremendously. 2 months down, many many more to go :)

Thanks for reading!

Vacation update

Here are some selfies from our vacation in Cyprus. Still swollen. Nothing new.

3 mo update

Obligatory 3-month update.

My nose tip has actually dropped to where it was before my surgery. The angle between the nose and my upper lip is no longer at the 90 degree angle that it was right after surgery. Going to have to ask my surgeon about that. Other than that, my profile has improved greatly. Some of the convexity has straightened out, which I'm really happy about.

Still swollen all around really. Also, the top of my nose feels lumpy to the touch.

Question: When do you generally schedule a post-op appointment with surgeon to show your progress? Mine simply said "see you in a couple of months" after removing the splint.

Progression

You can clearly see how the tip is dropping back to its original form, from the initial somewhat straight angle to the more bent angle.

4 month post op

Not quite happy with the results yet. I don't have the straight dorsal line that I'm looking for. And from the front, there's till quite a bit of uneven swelling. I can also feel a bump where the dorsal cartilage ends and the softer tip begins. My nose tip is bigger and rounder then before the surgery. I know, I know, it's too early to tell.

One year - possible revision needed

It's been a year since my surgery, and my nose has healed well. However, I am not happy with the results. I now have a larger, more bulbous nose tip than before. My nose has a dent on one side, and there are small bumps here and there. I went in for a new consultation yesterday, and met with my doctor, as well as another specialist at the clinic. Both agreed that I am in need of a revision - at no cost to me. The revision is for a straighter profile, reduction of the tip, fixing the dent as well as filing down the small bumps.

I had hoped to get satisfactory results the first time around, but here we are. I am prepared for a revision, hoping for the best this time :)

Revision booked

My revision surgery has been scheduled for September 6th, 2016. I have a laundry list of things that need to be addressed. Will add more details and my morph when nearing the date of surgery. Have a nice summer.

4 days post-op (revision)

I have now had my revision and am recovering from the surgery. No osteotomy this time around, so there is less discomfort. But my nose is stuffed shut.

The surgery went well, but was very complex. Cartilage from my ear had to be used in my nose. I have an appointment on Tuesday. Hoping to have the splint and tape removed. I will have updates then, and hopefully a photo or two.

Progression

Here's a photo of me before my first surgery, one from before the revision, and finally one from today - after my revision surgery.

1 week post revision. The splint is off

The unveiling of my nose, post-revision was a nice surprize this time around. I am super happy about the profile. I have major swelling on the sides, and in my forehead area. Besides that, the profile is exactly as I hoped.

My dr has decided to begin the injection of steroids (after 4 wks) to reduce the swelling early on. My middle-eastern skin has a tendency to generate major scar tissue, which was the main cause for the uneven healing and bulky-ness of my nose last time around.

I'm still waiting on the transcript of the surgery.

New photos

The swelling is quite apparent, but it is much less today than before. I have a small concern about the area around the stitches in the columella. There seems to be a small crevice (lack of a better word) where the columella was stitched together. Hoping it will heal evenly.

Numb

2 weeks have passed. My nose is healing well, but I still have visible bruising. Also, the tip of my nose is completely numb to the touch. Is this normal? I don't recall it being numb for several weeks last time time.

Update

Over a month has passed since my revision surgery. I'm pretty happy with the results so far.

Today I got my first steroid injections. Didn't hurt a bit. Probably because my nose is still fairly numb. I've also made an appointment for addressing the scars on my nose. I'll be getting fractionated co2 laser treatment to minimize the scar tissue. Does anyone here have any experience with that?

Had my first steroid injections.

There's hardly any swelling on my nose these days. Such a difference this time, compared to my primary surgery. Maybe it's because of the steroid injections. There's still some areas that need to be evened out, and I have the scars. I have an appointment for dealing with the scars on Nov 2. Getting PRP (Platelet-Rich Plasma) as well as fractionated CO2 laser treatment.

Sorry about the photo quality - taken at a low light.

Before primary / After Revision

PRP (Platelet-Rich Plasma) and fractionated CO2 laser treatment

Just came back from my PRP and fractionated CO2 laser treatment.

First, the dr applied numbing cream on my nose, a thick layer of it. They also drew blood for the PRP treatment. The cream needs a good 45 minutes to have an effect.

Once my nose was numb enough, I had the fractionated CO2 laser treatment on my nose. It stung a little, but it wasn't too painful. Actually, it started hurting a little bit after the effects of the cream wore off. Also, my nose got visibly red after about an hour.

They decided to keep my blood in a freezer for future treatments. I believe, I will be getting a total of three sessions of PRP and laser treatments.

I'm also going back in 3 weeks to have my second set of steroid injections.

It is pretty clear that my nose has a lot less swelling this time around. I can sense a slight hump developing on the bridge of my nose. Hopefully we can minimize its appearance with the injections. If not, I don't really mind it, as it does give my nose a little bit of character.

I'm very happy about the fact that my doctor is taking things seriously, and providing all these various treatments this time around. If you are in Sweden, I would definitely recommend Dr Westin and his colleagues. They are highly professional and easy to talk to.

Major bruising

One day after PRP (Platelet-Rich Plasma) and fractionated CO2 laser treatment... some major bruising going on here.

And we're back to normal.

This is now day 5 after the laser and PRP treatment. On day 4, I was basically clear of all bruising. My nose is smoother than ever. Most of my pores are clear and my skin is very smooth to the touch.

It's too early to tell whether the fractionated CO2 laser and PRP treatments have had an effect on the scars. It takes a while for the collagen regeneration to kick in. And most likely, I will have to have multiple treatments.

Another session of steroid injections

Had my second set of steroid injections this last week. Also, my dr recommended a silicone stick for my scars. The Pro-Silâ„¢ stick is pricey, but not too pricey for a 15wk scar treatment.
Dr. Thomas Westin

Very professional and seems knowledgable.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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