Open Rhinoplasty Scheduled for December 15. Netherlands, NL
Tomorrow I will undergo an open, full rhinoplasty....
Update 1 day post op
At home I was fully prepared for the swelling and bruises, but until now it is only very minimal purpleness under my eyes and my face feels a little puffy and stiff. I must say I started to take Arnica pills and ananas 2 days before and am still taking them. Also I have pain medication and I don't feel pain at all. I don't feel the splints in my nose, I have only the discomfort of not being able to breath through my mouth. The very worst part for me so far was last night..pffff no chance of sleeping because I had my head lifted 45 degrees as was recommended. I really can't sleep on my back, so the night was horrible. Also a very very dry mouth. But so far, it's all worth it!
Tomorrow I have an appointment, then the splints will be taken out. Hope that will be a relief!
Internal splints are out!
The swelling and bruising is still minimal, only purple stripes under my eyes. I really believe it is the Arnica, or the gentle techniques of my surgeon. I will upload some photos later today.
The stitches also are healing well, so I can continue recovery with a good feeling.
Still going well
Cast off tomorrow
Bruising is almost totally gone.
Tomorrow the cast and stitches between the nostrils will be removed. I am looking forward to that very much, although I know I will see a very swollen nose. I feel under the cast my nose is healing, which itches a lot. So time to get rid of that damm thing.
At the moment I am worrying a bit about the stiffness of the face, especially in the upper lip. I can't smile, like I injected botox. When I try to smile, no upper teeth are shown. Fortunately, I read on Realself that this will resolve over time. It has to do with the work that has been done on the base of the nose and the depressor muscle that was cut.
I am taking it very easy these days, taking a lot of rest, don't do anything that raises my blood pressure. As they say, time heals all wounds, so I will wait. Luckily I have two more weeks of holiday.
Next update will be without the cast!
Feeling a bit like Rudolph
Today I also called the clinique and asked if taping is necessary. The surgeon did not mention anything about this and I forgot to ask. The answer was that the best thing I can do now is cleaning the nose with the saline. The first week I did not do this because getting salt water from a glass into your nose is not so easy. Last monday they finally gave me syringes so then I started right away. So my advice to any of you: clean the nose as soon as the internal packing is out!
So I will clean my nose some more days and hope at least the majority of the swelling will be gone in a few days.
By the way: the profile of my new nose underneath is very very nice so of course that is most important in the long-term! I am sure the doctor did a very good job.
Swelling is going down
The area around the bottom of the nose and upper lip bothers me the most. There is much stiffness and this part feels a bit heavy, especially when turning my head to the side. To support the tip a graft was placed and this is, next to the swelling, the cause for the stiffness. My smile is still messed up, but slowly I can see more of my upper teeth every day. My surgeon said that it would take 3 weeks for the smile to return, so I have to be more patient. Next monday I have to start working again and it bothers me that not being able to smile obstructs me in my daily interaction with other people.
Nose is still a bit stuffed, so at night I still have to breath through my mouth mostly. Tomorrow I go back to the clinique to have some remaining sutures removed.
Time flies when healing
Furthermore I still notice extra swelling in the morning when my nose is more puffy than the evening before. My smile now is 90% normal; my upper lip still doesn't exactly elevate as high as before surgery. Since this is a little worse in the morning I expect it to be still swelling that is not entirely gone yet. Also I can still feel a tiny bit of stiffness in the columella where the strut was placed. My surgeon confirmed that it will take some additional time for my smile to return to normal, but eventually it will. Well let's hope so! Unbelievable how much time it takes to completely heal from rhinoplasty. Of course I know that it can take a full year though.
Happy healing to you all!
Waiting for the tip to decrease in size
I keep wondering why there are so few people that notice my nose has changed, which is actually a good thing. For me it is a huge change, especially in profile. There are people that asked me if I gained weight, probably (I hope) because of the swollen tip ;-).
Now we are in spring season I am being very careful exposing my nose to the sun, scared of the hyperpigmentation which means getting permanent dark spots after a sunburn. That would be a dramatic surprise after drinking a beer at a local bar on a sunny terrace. Fortunately I don't think this is an issue anymore, since most surgeons on here advise max. 3 months or less to stay out of the sun (which my surgeon confirms).
When I see my swollen tip I read Q&A on RealSelf again and again, just to assure myself I should wait until 1 year has passed (of course I already knew lol). Do you recognize?
Six months have passed
Good thing also is that my nose becomes more flexible every month. The first weeks after surgery I couldn't move my nose at all (it looked and felt like a doll's nose), but now it is only the tip that is still hard. My nose looks more natural now. The first months there was a lot of skin peeling off like a had a constant sunburn, which was very annoying. I think this stopped at about 4 months.
So with regard to the healing, I am half way there and still happy with my decision so far! Can't wait for the final result and the tip to define itself. Good luck to you all!
Is this the final result?
My upper lip still hangs a bit lower than before surgery, and again I have to accept this is permanent. From the research I have done on RS this could be caused by the depressor septi muscle that has been cut, but my surgeon still says this will improve over time.
But what is bothering me the most is that I still have a lot of morning swelling, making my nose 1,5 times as big as in the evening. This is stable since June as well, I don't really notice an improvement of this symptom over the last months. My surgeon says this is still normal healing and thinks my result is too good to inject steroids. I really really hope that after 6 more months or so this swelling is all gone and I don't have permanent lymph damage or something like that.
So to conclude: I can't say that I regret my decision until now, but there are really some negative side effects of rhinoplasty I didn't expect and my surgeon didn't tell me about. I still hope for a bit improvement in de coming months, especially with the swelling. So in my experience, I tell to all people that are planning a rhinoplasty: be prepared for the side-effects. Personally I underestimated these. As our famous soccer player Cruijf in the Netherlands said: every advantage has his disadvantage!
Is this really the final result?
Last week I saw a Belgian surgeon (Hoeyberghs) who performs 15 rhinoplasties a week. However he always performs closed rhinoplasties. When I showed him my problems with my tip, he said this is the typical effect of an open rhinoplasty. Because the tissues were lifted from the bone and cartilage, scar tissue will form as soon as the skin is reattached. Also the nose tip will never be as refined (bound to the cartilage) as before surgery. That's why he never performs open rhinoplasty and other surgeons shouldn't do them as well, in his opinion. When I asked him about steroid injections he said no because of the dents that might develop. He also advised me to leave my nose as it is and not seek revision surgery because if will make it worse. Don't end up like Michael Jackson, who should have stopped after his 2nd rhino, he said.
Well, so of course I am still thinking about a 3rd opinion, especially about the steroid injections. I have read a lot of experiences from people with the same tip problems where it actually helped. Or maybe just let it go, which is difficult :-).
Well, I have my own ideas about this. The new shape of my nose I can accept and be satisfied with, but the swelling which restrains my smile the first hours of the day is problematic for me. I am looking for other solutions first, like ultrasound therapy, to treat the scar tissue. Hopefully it helps. Revision surgery to remove scar tissue and rebuild the cartilage in the (supra)tip is also still an option for me, but not now because I will have multiple consultations first.
Now I am awaiting the effect. For me it is time now, 2 years after the surgery, to accept my new nose as it is including the morning/heat edema. I will try now to focus on other things then my own and other people's noses ;-). Easy to say, but let's do it!
Maarten Fechner is one of the best, if not the best, plastic surgeon for corrections of the nose in The Netherlands. Even his colleagues recommend him in case their family or friends need surgery. He is very experienced and friendly. Also he operates on the more difficult noses, for example that have been broken several times.