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Lucian Ion, FRCS
Specialist Registered Plastic Surgeon
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One Month Update – Advice For Shiny Skin?

On Friday it was one month since my rhinoplasty. I was waiting at least a few weeks until revealing how I felt about the final result and I am thrilled to finally say I love it! In my opinion Mr Ion has done an amazing job and I am so grateful that every aspect of my new nose is better than I could have hoped for. I realized that in my previous posts I did not really mention what was changed other than briefly mentioning the dorsal hump. I think this may be useful to detail for those of you considering using him as a surgeon. You can see the following in the ‘before’ photos that I have uploaded today – I had a deviated septum which I had not actually noticed before Mr Ion pointed it out in the consultation (after knowing this it suddenly appeared really visible to me!). You can see in the photo that the bridge of the nose curved over to the left. You could see this asymmetry in the nostrils as well when I tilted my head upwards (unfortunately I don’t have a picture of this). In between my nostrils the tip dipped down quite a bit so this was lifted in the operation to give a smoother and more flattering shape. The nostrils were also brought down a little bit so that they weren’t so visible front and side on. As well as having a dorsal hump that was visible from the profile, I also had a lump in the bridge visible from the front. The hump was got rid of from both the front and profile views. From profile view I didn’t like the way my nostrils appeared so long and thin. In the operation they were shortened and lifted. I had several concerns before the procedure, mainly that my nose would look artificial and strange after the operation but I am delighted at how natural it looks now. I really understand when people say that they feel they finally have the nose they should have been born with. It feels like a weight is lifted now and when I look in the mirror I don’t always feel that I would look so much better if not only for my nose because now I feel much more pretty and feminine.

I really wanted to write in this review as well that surgery is a bit decision and it doesn’t always go right. It made me feeling really bad thinking that some of you out there may read my review during you making your own personal decision and assume that every surgery will go exactly as you wish. I read the reviews of so many heart-broken patients on here who are devastated with what their surgeon has done to their nose. Therefore it is so important to research research research and read as many things on this website and others as you can so that you are as prepared as you possibly can be in knowing as much about your surgeon and the procedure as possible.

Secondly – SWELLING! I like so many others on here has such a flurry of emotions when my cast was removed feeling like I looked more like a strange animal than a human and a sense of panic wondering if my nose would ever change, and IT DID! I really felt unsure how things would turn out but as the weeks have gone on the results have got better and better. I remember especially when my nose was still in the cast it looked so upturned and piggy-like and the nostrils were so thick that I didn’t see how it could ever possibly change to look like a normal nose again but please just have patience and spare yourself the anxiety! I would even wear my drip gauze constantly after my nose had stopped dripping just because I didn’t want to have to look at it in the mirror because it made me feel so worried every time I caught sight of it.

Finally a few slight changes and observations I have had over the past few weeks – the skin on my nose and my face in general appears much more shiny than before the operation. Perhaps this is baby oil left on my skin which I use to remove the tape adhesive (I wash it off but maybe it is seeping into my skin) – Does anyone know of any good tips to keep shine at bay during the day? I use a pressed powder which use to fight shine and grease all day but this just doesn’t seem to work now. Sensation is still a little odd in the tip but is definitely returning. The tip itself feels very hard when I squeeze it so I guess there is still a lot of swelling. There is still swelling inside my nostrils but this doesn’t bother me at all. My bruising is still here which is strange because the bruises were so small to begin with. Most others I see on this website have way larger and darker bruises which clear up in 7 to 10 days and mine are still here after one month. That being said, it is only a tiny bit of the bruise under my left eye which remains so it should be gone soon. All bruising from my eyelids and right eye have gone. On day 19 my dissolvable stitched began falling out which was a relief as you could see them when you looked closely coming out a little from my nostril (I’m sure no one would have noticed though). When I flushed out my nose with saline solution some of the stitches would fall out stuck to the blood and mucus clumps (gross, I’m sorry!). The scar is not really visible most of the time but if I have been out all day it tends to get quite red and I am a little paranoid people can see it and tell I’ve had a nose job – no doubt the redness is as the scar stretches from talking and laughing. I don’t want to put any makeup on it yet in case I cause any infection. I have been a little anxious to meet with friends who I haven’t told about the procedure. Although I love the results, I don’t feel that my smile and range of facial expressions has quite returned to normal yet and think my face looks a little stiff sometimes. This hasn’t put me off going out but has maybe made me put off a few meetings with friends until a later date when I feel my expressions will be back to normal.

That’s all for now. I have a check-up this week so Mr Ion can review my progress. I am excited to keep seeing the subtle changes in my nose as things heal. I hope you found this useful and please share any makeup tips you have (specific products etc) for fighting shiny skin on the face following surgery. Thanks and good luck to all of you awaiting an operation and happy healing to those who have already had it!

New Nose’s 2-Week Birthday!

I realized that although I had described by my week post-operation in detail I hadn’t uploaded any photos of before I had the cast removed and feel that these may be helpful. I had a few photos of me during the first week to show the gauze I wore and the swelling and bruising I had. I think I was relatively lucky on the bruising front (although the small bruise that I have is clinging on for dear life and still here with me on day 14!). As you can see from the photos my swelling and bruising were worst 2 days after surgery and mainly around my left eye. I guess some people may be curious to see what the scar and stitches look like after an open tip rhinoplasty so I’ve included a few of those too.

WEEK 2 GENERALLY: As for updates from week two nothing major has happened really other than the swelling going a little bit each day and by day 11 I was feeling human again! I read on someone else’s rhinoplasty diary on here that they said there nose didn’t really feel like part of their face after the surgery and I think this is very true. It feels so numb that you almost feel like it is just an object stuck to the front of your face. By day 11 or 12 I was feeling like my nose was mine again. It both looked a lot more normal as the swelling was really going down and it also felt like it was attached to my face again. The sensation in the tip obviously has not returned yet but I feel much more comfortable when I touch it now than when I first got the cast off. I can now touch it and get a slight sense of pins and needles but not really a feely of discomfort any more.

SCAR: As for the scar, I have been cleaning it 3 times a day with saline solution (warm salt water) and Savlon applied with a cotton bud and am making sure not to touch it so that I avoid getting dirt in it and causing infection. I am really pleased with the way the scar is healing up and although I can still see it, it really isn’t that noticeable. I was a little worried that when I went out in public people would look at my face and see it straight away and therefore know I had a nose job but I went out with a friend yesterday and was talking about the scar and I had to point to where it was because she couldn’t see it, which was great! You can see from the photos how faint it is now.

SWELLING AND BRUISING: Swelling has got less and less each day (apart from one day where it flared up briefly – I think this may have been because I ate a pickle which is made with a lot of salt). I have read on so many people’s diaries that they are shocked when the cast comes off and find it hard to see past the swelling and I can echo these views completely. I couldn’t help feeling disappointed when I looked at my nose from the front right when I got the cast off. It was strange because even though I trust my surgeon completely, I felt so weird looking at a nose on my face that just looked so strange. I felt like I looked more like a small woodland creature than a human being. Something that really kept me going was a quote I read in tothineselfbetrue’s posts that said “Trust the process”. It reminded me to just have faith in the ability of my surgeon that although my nose may look kind of crazy at that moment, eventually it would begin to take shape, and it did. It was only on day 10 when my dad said that I was really starting to “grow into my nose”. I could tell that he wasn’t too impressed when the case came off but he says now that he never worried as he knew Mr Ion was going to do a great job. Although some people love their results the minute the cast comes off, I think a lot of us don’t and this does not mean that the surgeon hasn’t done an amazing job, it just takes time. I cannot stress enough the importance of being patient during this process – TRUST THE PROCESS! I have been taping my nose every night using 4 strips of overlapping surgical tape. In the morning I soak in baby oil for a couple of minutes to help remove it with a cotton bud. The tape is supposed to help with the swelling. My surgeon told me that if the swelling hasn’t gone down much by my one-month checkup I will have a steroid injection in the tip on my nose. The bruising, as I said, hasn’t been bad. I have one small dark purple bruise under my left eye which doesn’t want to leave me. I can pretty much cover it with makeup if I layer on concealer and foundation but end up with a white-looking patch because of the thickness of the concealer over it which looks like a little strange but isn’t too bad. I have a small yellowy bruise under the right eye and a small bit of purple bruising remaining on my left eyelid also.

SMELL AND TASTE: Until I had the internal splints removed from my nose I had absolutely no smell or taste. It was very strange eating food and only sensing what it was by memory of what that food tasted like and by feeling it’s texture on my tongue. On day 7 when I had the cast off and internal splints pulled out I could finally breathe through my nostrils again. I went home and could smell and taste again, it was amazing! But by the next day I had started to become congested again and only a small bit of air could be breathed through one of my nostrils. I was unsure what was causing this so shined a flashlight up there to see what was going on. There seemed to be a build-up of blood and general nose gunk in both of my nostrils even though I had been using sinus rinse the previous day as instructed. I didn’t really want to mess around in there as had been told not to poke around in the nostrils. A few days ago I gently cleaned with a cotton bud soaked in hydrogen peroxide and water which cleared it partially for a few hours but now it feels very blocked up again. This is slightly annoying but not anything too major so I’ve decided I will keep cleaning daily and anything major can be removed at my one-month checkup.

STITCHES: The stitches along the scar at the base of my nose were removed at the one-week checkup. I had not realized that there were dissolvable stitches in my nose also. When I was cleaning my nostril I thought they were small strings of dried blood and was trying to clean them out with a cotton bud and then realized they were actually stitches.

NAUSEA: I have been lucky enough not to really experience much nausea during this process. I have however noticed that as I am doing more getting up and walking around that I get dizzy quite easily. I was applying a hair mask two days ago and noticed that even when I tilted my head at a gentle angle it would make me feel a little dizzy and like I needed to sit down.

SLEEPING: It hasn’t been as horrible as I was anticipating but it has been difficult. Initially I was sleeping with a large pillow type thing with short arms that would prop me up in bed. Recently I have been using this as well as a flight pillow and it definitely takes me longer than usual to fall asleep but I have been getting a decent amount of sleep each night when I finally do get to sleep. I haven’t had much of a problem with dry mouth as I apply Vaseline to my lips every night before going to bed. My tongue does feel really dry and scratchy when I wake up but after drinking water it feels fine again.

CONSTIPATION: Not such a problem now as it was initially. I definitely am not as ‘regular’ as before surgery but this is most likely due to decreased physical activity. I am ensuring to drink lots of water and find that drinking a green tea with lemon every morning helps somewhat.

AFTER CARE: Mr Ion’s nurse has called me 2 or 3 times since the surgery to check how I am doing and see if I had any further questions which I thought was great. It was helpful to have a professional there to ask any questions that had come to mind after the initial check-up.

SKIN: Luckily so far I have not had any major break-outs or skin problems since the surgery. I have however noticed that the skin on my nose was peeling a little. I gently removed it with a face wash and it seemed like a thin layer of skin was shed from the whole of my nose. This may have just been left-over adhesive from the cast as opposed to skin, I’m not really sure. I do have small blackheads by the sides of my nostrils and tip of my nose. They are visible when you look close but don’t really bother me too much and I don’t want to disturb the nose so am not going to try and remove them. I will leave them for now and speak to my surgeon about caring for my skin when I speak to him at my next check-up.

OTHER THOUGHTS: I just had a little tip that you have probably read before but I thought I would mention it just in case. I found it really useful during my consultations to bring (a) pictures of noses that I liked from profile view (b) pictures of noses that I disliked from profile view (c) pictures of noses that I liked from front view (d) pictures of noses that I didn’t like from front view. And more importantly to think about what aspects of these noses it was that I liked or disliked, rather than just the nose as a whole, so that I could describe this to my surgeon and ensure we were thinking the same thing.
I have found it is hard not to be paranoid after the cast comes off. I try to avoid everything that may disrupt my nose, even when people hug me I get a little worried they will hit my nose. When I drive I dread my airbag smacking me in the face! But luckily (touch wood) nothing has caused it any damage this far. I have read on other’s diaries that their surgeons have told them to avoid laughing or smiling too much of this will cause the tip to drop. I have not heard this yet but am following the advice just in case. I guess with these things there is no need to go too over the top but a bit of caution can’t go a miss so I am trying to avoid anything which may adversely affect my results.
Lastly I would like to share some thoughts about my surgeon and how he handled me as a patient before I had my surgery. I never felt like he pushed me into anything and he let the final decision about the changes to my nose and whether I went ahead with the surgery or not be completely down to me. He made the risks of the surgery very clear, explaining that surgery is not an exact science and I really appreciated that he does not create unrealistic expectations in his patients.

So this week I have included a fair few photos. The last ones are the swelling in sequence from the day of having the cast off up until today. I wanted to show you all that the swelling does start to go eventually! I hope it is useful to see that changes are subtle and take time. That is all for now. I guess from here on out it will be minor changes but I will be sure to jot down anything noteworthy that happens over the next couple of weeks so that I may share them with you when I write next. Thanks to everyone else for sharing their experiences and words of wisdom - as many others, even after the operation I find it interesting to read how others are getting on with their recoveries.

Good luck to anyone who is awaiting their operation and I hope that something in this ridiculously long review has been of help to you!

Swelling - We are all in the same boat!

After debating whether or not to put photographs up I decided it was unfair that I had found reviews with accompanying photographs so helpful both before and after surgery and yet I had not done so myself. So here they are, and I hope that some of you who read this will find it helpful.

I am not on day 10 post operation and like I read on countless other reviews, am also waiting for my swelling to go down. As you can see from the front view photograph the swelling on the bridge has gone down considerably already but the tip is still very swollen and relatively shapeless. I have found great comfort in reading the posts of others who experience the same and a few weeks later and delighted with the results and have faith that this will also be the case with me as I trust my surgeon. Other than the swelling I don't have much else to report. I still have quite large scabs in the tips of my nostrils which I am dabbing with hydrogen peroxide and water solution a couple of times a day but they don't seem to be budging. I guess it's just a case of leaving them be and not disrupting the healing on the nose.

As for the swelling has anyone found anything that has really helped? I am doing pressure massages and taping at night as instructed. I understand that it is more of a waiting game than a quest for a magical cure so I guess me, and many others of you out there going through the same thing, need to just hold tight!

Provider Review

Specialist Registered Plastic Surgeon
Aveling House, 1B Upper Wimpole St., London,
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