Sexy in the City... the Schnoz Version :) - Manhattan, NY

From before and 2 months afterward

Hi all!This is my first post, but I have been reading RealSelf for while, and everyone has been so incredibly helpful that I figured I’d pay it forward and share my rhinoplasty experience with Dr. Guy Watts. This is mostly retrospective, since the surgery already happened, but here is the rough timeline:2/13/14
So after reading some excellent reviews on Dr. Watts and the NYEE Plastic Surgery Fellows (thanks again, RealSelf!), I scheduled a consultation for rhinoplasty with the clinic (in case anyone’s interested... it’s a fantastic program). Filled out some forms, had a quick, painless check-in, and after five minutes, Dr. Watts came out. We went into his office, where he asked me some questions about my nose and what I’d like to change. Basically, since breaking my nose in high school, it had become increasingly crooked, and I wasn’t happy with how it developed. Dr. Watts took some pictures from various angles and was able to show me a rough idea of what he could do. He also had a very good eye, making suggestions to balance out my face that I hadn’t even considered, like shaving off a tiny bit of the dorsal hump that had developed since high school.Normally, I would have waited longer before committing to a surgeon, but I immediately had a good feeling about Dr. Watts for three reasons:1) His personality. I am naturally an extremely picky, fussy perfectionist, and very skeptical of rave internet reviews, so I always like to check everything out myself. I had consulted with two other well-known doctors beforehand and scheduled another one afterwards. One surgeon spent the entire time yammering about his surgical prowess, how well-known he was, blah blah blah. The other immediately tried to push onto me a million other services like some sleazy car salesman (Fraxel for my large pores? Thanks for the insult, but no thanks). Guess three’s the charm... Dr. Watts was patient, professional, and incredibly knowledgeable. He was realistic when explaining what to expect from the surgery. I felt like his only patient – he never rushed me and spent a really, really long time answering my million questions. Dr. Watts was also a fantastic listener and really paid attention to what I was looking for instead of just dismissing my opinion. Trust me, this is rare as finding a four-leaf clover when you’re dealing with hot-shot plastic surgeons. 2) His skill and experience. We all know how cosmetic surgery is an incredibly important personal decision, and not to take any chances with some sketchy back-alley doc with a degree from Tijuana U (no offense, Tijuana.... love your clubs!). That’s why, as a poor student, I was so excited to find out about the NYEE fellows program – an extremely affordable program affiliated with a major teaching hospital and doctors who have top-tier credentials. My nose job was... drum roll.... 3k!!! Like, unbelievably, everything included.I found out that Dr. Watts had not only completed his full medical degree in Australia and his board certification in plastic and reconstructive surgery, but also went on to get not one, not two, but wait for it.... THREE fellowships (that I know of... there very well might be more) to perfectly hone his skills in plastic surgery.He’s also done a bunch of volunteer missions to fix cleft lips and other facial deformities in children in developing countries. A surgeon who is a total perfectionist in the operating room and also has a social conscience? Sign me up!Sadly for us New Yorkers, but lucky for you Australians, it appears Dr. Watts will be finishing his fellowship in Manhattan this June and returning to Australia to open his own clinic with his gorgeous fiancee, who is a nurse and also finishing up at NYEE. If I get anything else done, I swear, I’m not even going to waste my time with these New York doctors. Hope airfare to Perth isn’t too expensive....3) His accent. Be honest girls... how sexy are Australian accents???Anyways, recap: really loved Dr. Watts during appt, so after discussing it with family, cancelled the consult with the other doctor and scheduled the surgery.4/16/14
Went in again for my preoperative consult. I had to get a physical for surgical clearance, and we went over a run-through of what the surgery would be like. Dr. Watts said it would take about 1.5 hrs, and I couldn’t eat or drink anything for 12 hours beforehand. Also, I had to stop my medications two weeks before the surgery. On the day of, I would come in, check-in and pay the cashier, and then be sent up to the floor to get prepped for surgery.Other advice I would give before and on the day of surgery (again, also thanks to the lovely community here):-When they say stop all medications, stop all medications!!! My dear, sweet, silly BFF who had gotten her nose done a few years prior, forgot that aspirin blocks clotting, and took some before her surgery for period cramps. She ended up with major bleeding complications post-op and a jerk for a doctor, but thankfully ended up okay. Remember, over-the-counter stuff, like aspirin and herbs/vitamins count too!-Arrange to have a friend/loved one pick you up, for obvious reasons.-Don’t bring a bunch of valuables. Also obvious, but I forgot and wore some nice jewelry, so I had to have the nurses at the nurse station look after it.-Take arnica and bromelain!! I took them along with grape seed extract 2x/day starting three days beforehand and for two weeks afterward. It’s not that expensive, and cut my healing time in half. I’m not saying that will be reflective of everyone since everyone is different, and especially since my surgery was a minor, closed operation. But in speaking with other friends who have gotten surgery, it definitely seems to have made a difference. -Stock up on supplies beforehand. Water, tissues and Qtips to gently clean out your nose, medical tape, nasal spray, pineapple shakes, which have natural bromelain, and non-salty foods.-Shower and wash your hair right before you come in, if possible, because chances are, during recovery it will be days before your poor body glimpses soap and water again.5/5/14
The big day! The run-down:-9:30 AM: checked in, paid, signed some consent forms.
-10:00 AM: was escorted up to the floor, changed into a gown, put my hair up, and had another doctor and nurse ask some short questions and clear me for surgery. Napped for like 20-30 minutes on the bed.
-12:00 PM: Dr. Watts came in in full-gear to go over any last-minute questions.
-12:30 PM: met with the anesthesiologist, Dr. Scott Horn. Originally they were going to put me under twilight anesthesia (a state where you’re kind of vaguely in-and-out of consciousness but can’t feel anything), but Dr. Horn later decided it would be better to undergo general anesthesia to avoid a risk of aspiration. This means I’d be out the entire time and wake up after the surgery.
-1:00 PM: met a very friendly nursing staff in the operating room before peacefully fading out...
-3:00 PM: woke up feeling kind of stuffy and croaky with a bunch of gauze taped to my nose and tubes hooked up to my arm in a bed. Got rolled down to the recovery suite where a very chill RN named Carlin came and provided a steady supply of graham crackers, water, gauze, and Tylenol. Dr. Watts visited again to check up on me, see how things were, and give me some post-op instructions (like no sneezing, blowing my nose, working out, straining during bowel movements, haha while recovering, etc.), and prescriptions for pain medication, which I ended up not even needing.
-8:00 PM: home, finally! Went right to sleep.5/6-5/11
Week One recovery phase. I’m not going to lie... the first three days were pretty miserable. On the first day, I mostly just hung out, ate, did some studying, and puttered around the kitchen. I was still taking the arnica/bromelain, Tylenol, and prophylactic antibiotics several times a day, so the pain wasn’t awful. I also had a bunch of cool compresses I would hold over my face to bring down the swelling (no ice directly on your face... that can compromise blood circulation to the area!)I kind of looked like I was on the wrong side of a bad street fight and felt uncomfortable and achy and like I was in a fog the entire time. It was difficult to concentrate when I was trying to get work done so I gave up after a while. I also had to change the "mustache gauze“ about once every 4-6 hours because it would soak through with blood.By day 2, the bleeding was mostly over and I didn’t need the gauze underneath my nose, leaving me with just the tape over my nose. I felt super-congested, like when you have a bad cold. After breaking my own rules and eating a bag of salty nachos, the periorbital area around my eyes promptly blew up with like twenty pounds of water weight. I could barely even see – my eyes were THAT swollen shut. Never, ever again. I also started developing some impressive bruises around my eyes – seriously, I’ve had eyeshadows that weren’t that intensely purple. It was like some kindergartner took a purple Sharpie and haphazardly scribbled around my eyes, including my eyelids. Hung around the house and slept a lot. My poor husband was an absolute saint in putting up with me snapping at him all day and dutifully lied about how great I looked already. He’s well-trained, isn’t he?Day 3: I give my husband so much credit... I would have run away shrieking if the person I married mutated into this swamp thing. Same as day 2, pretty much, except now instead of blood, it was mucus coming out of my nose. Also, word of advice: don’t try to scrape off the hardened blood that is crusting around and in your nose because it WILL hurt! By this point, I was on my second box of Qtips, which I would dip in hydrogen peroxide and use to gently clean out my nose. That worked a lot better. Saline nasal sprays work well too.The skin on my nose was also starting to get really oily and clogged up with blackheads at this point but would hurt EXQUISITELY if I even touched it. So I very carefully took off the tape, and ever-so-gently patted it with my astringent wipes, trying not to wince in pain. I then replaced the old bloody tape with some fresh medical tape. On the bright side, I caught up on all the back episodes of The Good Wife I missed! Little accomplishments, right? :)Day 4: Sleeping on your back with your head elevated on two pillows is tough, especially when you’re used to sleeping on your side. But I’m trying really hard. And overall, I think I made the most dramatic progress on day 4, when comparing the morning to the evening. I also took a shower, finally! So felt a little less gross. I also took a quick peek under the tape and the swelling seemed to be going down a bit. Finally, I felt comfortable moving around normally without worrying about a torrent of blood gushing out at the slightest provocation. It was still weird remembering not to bend over or cough/sneeze though, and while I could do basic tasks, like emptying the garbage or whatever, when I tried getting some studying done, my head would start hurting a lot.Day 5: I took off the tape a day and a half early (shh, don’t tell Dr. Watts), and finally felt ready to appear in public. Don’t get me wrong.... my whole family definitely noticed that I was "off" – really swollen in the central face area and that my nose was weirdly turned up, like a chipmunk. But with enough concealer, I don’t think I looked too noticeable to the average bystander who didn’t know me. Even this early, I could tell that Dr. Watts had done a fantastic job with the alignment and shape of my nose. If you think about it, this kind of artistry is incredibly difficult. Not only do plastic surgeons need to accommodate different people’s physiology and operate without damaging the breathing function, but they have to make it appear cosmetically attractive as well. I am so excited to see the final results!Day 6: Mother’s Day. Went out with family and only got one or two weird looks due to the residual bruising and swelling (including a waitress who genuinely seemed like she wanted to slip me a phone number for a domestic abuse hotline).Today, I could finally speak without sounding very nasal, and even start to breathe through my nose okay. Again, I’m so grateful that my doctors were specially trained in nasal airway function through plastic surgery and craniofacial training. Even the daintiest, cutest nose in the world is not worth collapsed vaults, blocked sinuses, or skin necrosis due to a botched surgery.People, make sure your doctors are board-certified plastic surgeons!!! Each state has a registry that can tell you the status of your doctor’s license, whether they’ve been sued for malpractice, etc. I don’t think I’m allowed to link to it here, but if you do a Google search, it’s there. Make sure there are no red flags! Maybe I am overly-[RS bleep], but I work in the health-care industry and my motto is: better safe than sorry. For example, red flags when I was doing research included:-doctors graduating from a Caribbean or Central American medical school (including St. George’s, Saba University, Ross University, American University of the Caribbean)
-DOs (doctors of osteopathy, not MDs). It’s a long story, but with all due respect to the excellent DOs out there, while they are licensed physicians, many of them end up getting a DO degree because they could not get into a standard (allopathic) medical school
-doctors with even the slightest WHIFF of legal issues (court documents, malpractice records)
-doctors who had reviews online saying they were arrogant or had bad follow-up
-doctors who tried to intimidate or pressure me for other procedures in the first consultation
-self-aggrandizing doctors who tried to tell me they knew what was best for my body and did not let me ask questions
-doctors who weren’t board-certified in PLASTIC SURGERY (you’d be surprised how many ob-gyns there are out there doing Botox shots)
-doctors who did not have pictures of patients whom they themselves actually treated... again, ask! There are lots of doctors who just take promotional images of treatment results and let readers assume that those are their patients.. if it looks like a stock photo, it probably is. Do a reverse Google image search if you’re not sure
-doctors who could not provide any patient references
-doctors who did not have admissions privileges to the nearest hospital
-doctors who were not involved in any professional organizations
-doctors who did not have any publications
-doctors who were not well-versed in the latest literature. Ask them what their thoughts are on some of the newer techniques in rhinoplasty. Like, for me, any doctor who strongly advocated outdated techniques like nasal packing, was a no-go.
-doctors who did not know the rest of the surgical team well... know that many of these procedures are a team sport, and that that can absolutely affect the outcome of a surgeryAnal-retentive? Yes. But your body is so worth it. YOU are the one who has to live with your body the rest of your life. Not your doctor.5/12/14
Day 7: Today was my follow-up with Dr. Watts. He was, as usual, incredibly warm and patient, only mildly scolding me for breaking his rules and removing my nose tape early. He examined my nose, took some more pictures, and answered all my ridiculous questions like: "Is my nose going to be weirdly, piggishly turned up like this forever? Am I going crazy or is my philtrum (the groove between the nose and lips) longer? is it normal to have unequal swelling and numbness, like more at the tip of my nose or in the mornings? " etc. Incidentally, I was also incredibly impressed at how prompt Dr. Watts was in responding to my emails before and after surgery. After reading all these stories here about doctors who never returned phone-calls, I was super-paranoid about my surgeon ignoring me the second I was wheeled out of the operating room. Fortunately, I did not have to worry about that.Dr. Watts said I looked like I was healing well, and to keep him updated. He wanted to have one or two more follow-ups, so we scheduled another one for a few weeks ahead.5/13-6/18
Basically, things progressed pretty steadily from here. Some progress notes:-At two weeks, the bruises were basically gone. Compared to other experiences I’ve seen/read about here, it seems I’m a fast healer and that the arnica/bromelain/grape seed concoction probably helped. But I’d say most people would probably be okay to go out in public at this point. I also drank a lot of soothing chamomile tea.-At three weeks, I could touch my nose and lightly wash my face without wanting to scream in pain. I felt like I finally looked normal to even family and friends again (and by "normal," I mean normal with my new lovely nose!), except in the mornings, when my nose and the front of my teeth still felt a little swollen and numb. Nobody could even tell I had a nose job, just that I looked great, with the exception of a few whom I told. Although Dr. Watts told me it would be up to a year until my nose assumed it’s final shape, I was already pretty satisfied.Another word of advice: I realize how impossible this sounds, but try not to scrutinize your nose TOO much at this point. Like, sometimes I would freak out because at lunch my nose was fine but then all of a sudden from one angle at dinner my nose would look crooked again. Chances are, it’s not the surgery – it’s the swelling.And don’t be like me.... LISTEN to what your doctor says about post-op care. Whether it’s taping or icing or strenuous sexual activity (ha) or whatever.-At five weeks, I felt comfortable working out again (mostly elliptical and a tiny bit of weight-lifting... no intense Cross-fit stuff), but again, check with your doctor.6/19/14
This was my last follow-up with Dr. Watts, who (sniff) is leaving next week. Again, he took some pictures, asked me some questions on how I was doing, etc. Honestly, I didn’t even have too many concerns because I feel amazing and can tell that things are progressing beautifully. No issues breathing at all, love how I look in pictures now, and I know it will only continue to get better as the year goes by.I also took this opportunity to steal the last of Dr. Watts that I could, and have him inject some Restylane into my lips (see my other review). They look fabulous, in case you were wondering.7/7/14
Just took my two-month update picture. Actually, it's funny... I thought my nose looked pretty good a month ago. But even comparing last month's shot to this month's, I can see that there was even some swelling then that went down further.NOBODY has been able to tell anything... I've just gotten a few comments on how amazing I look!Final thoughts: Looking over this entry, I know this sounds kind of gushy, haha. But please know that I am a real patient, and to me it’s just a testament to Dr. Watts’s skill and bedside manner that all the reviews I found on him when doing my research (in just his ONE YEAR fellowship) were so overwhelmingly positive. If you guys have any questions, please privately message me and I am happy to talk more about it, even though I’m still a little leery of putting my pictures on the internet. Forgive me for getting philosophical, but unlike many other tangible, physical enhancements – for instance, winning the lottery – plastic surgery, when done well, is actually one of the few concrete changes that can permanently change someone’s happiness. This has been clinically studied in peer-reviewed journals (again, no links but google the European study "Well-Being From the Knife? Psychological Effects of Aesthetic Surgery"). So that’s why it’s so important to be cautious in how you go about it, and to not jump into a situation that you’ll regret. If there’s one thing I’ve learned throughout this journey, it’s how judiciously you have to prep to choose the right physician. This was my first surgery ever and to be honest, I didn’t absolutely need it. I was, frankly, terrified at the idea of being one of those girls who flew too close to the sun and regretted the decision after permanently wrecking her face. I mean, stories about fake doctors injecting cement into cheeks, people who had noses falling off... that is really freaking scary! I got incredibly lucky that Dr. Watts was at NYEE and that the program was so inexpensive, but if we’re being totally honest, I am pretty sure if he charged five times that amount, I would have scrimped and scraped to pay for it, because it would be worth it. Look, I don’t care what kind of amazing special deal some place has or what new fancy equipment they advertise... if they cannot operate well, they could destroy your appearance or even worse, your health. (*Side note to people in Australia – with this in mind, it’s probably a good idea to get to Dr. Watts when he opens his clinic NOW before he is a crazy successful and uber-wealthy celebrity surgeon far too busy to consider us commoners ?). So when it comes to cosmetic enhancements, screw Groupon deals. But also screw arrogant doctors who make you feel stupid. It’s YOUR body. Have a good support system, like a significant other who does not freak out when you look like the swamp creature. Do your research. Buy supplies beforehand. And most importantly, find a good doctor whom you trust. I did, and I am so grateful.Again, let me know if you guys have questions. Will keep on updating!