Primary Rhinoplasty with Dr. Most - Palo Alto, CA

I've never been a fan of my nose… I feel like I...

I've never been a fan of my nose… I feel like I've bounced back and forth between thinking it was OK to totally hating it throughout most of my adolescence and adult life. I have finally decided to bite the bullet and I am hoping for a nose that I will love in photos/the mirror and when I catch a glimpse of my profile!! As a nurse, I am very confident in my physician choice!

T-5 days... ????

Five days to go! I'm super excited but definitely nervous. It certainly is reassuring to see some of the beautiful outcomes of some fellow members… I've got all of my postop prescriptions ready and have my post-op "go bag" of supplies pretty well set… Will definitely be picking up some gauze and extra Q-tips. I have a travel neck pillow that I plan to use to help keep my head aligned and from rolling over onto my side and a couple of extra ice packs already in the freezer. Bought some popsicles and stuff to make smoothies… I need to figure out some sort of Netflix series to binge watch… In between napping of course. I even picked up a comfy button up flannel shirt to wear home postop… I'm fairly certain I could get a pullover shirt on with no problem but I figure I will do as the nurses recommended.

A couple of people at work that I am close with knew that I have been planning this and today I mentioned it to a few others… I work in a small unit and figured it might be obvious to my medically savvy coworkers. Hoping to be pretty well back to normal aside from some residual swelling by the time I return to work 12 days postop.

Will try to stay on top of postop updates! Would love to hear from any of you who have just gone through or will be going through this at the same time!

I did it!!!

Just got home. I was scheduled for a 1p checkin and guess I was probably under by 23p0 or so. Surgery took about 2 hours and Dr. Most said things went perfectly and that he was very happy with the result! Can't wait for my post op appt next Tues! Cast will come off then. Doc said I had minimal bleeding. I half expected to wake up looking like a puffy raccoon but so far minimal to no obvious swelling. I have one incision as it was an open rhino. I did not wind up needing the temporal fascia graft that Dr. Most thought might be necessary. I can already see an improvement in my side profile. Minimal drainage and pain is manageable... I'd say I woke up with 3-4 out of 10 pain. They gave me a little IV fentanyl before I left and after eating a few crackers I was able to take a Norco for (long-2 + hour) drive home. Pain still very much under control. Had some soup for dinner a little while ago and now watching a little Netflix with the hubs. He's been so great today! Perfect little nurse. Planning to try and take the pain meds round the clock for the first day so I stay ahead of the discomfort and hopefully get some solid rest. Will continue to update over the next couple of days!

POD #1

I had expected to wake up looking like a puffy, purple faced raccoon but the swelling has been minimal and I have no bruising at all!!! (Unless some is hidden beneath cast). Maybe this is because I had nothing done to a hump or bridge of nose... Just the tip really.

Dr. Most corrected the slight crookedness in my tip (which really I hadn't noticed much until I started thinking about rhino and starting more at my shnoz). He slightly lifted the tip (I didn't want it drastically raised... I thought it would be too much distance Btwn my lip and nose and I still wanted to look like me after rhino. I know it's too soon to tell but from front view I wonder about the nose to lip dist... Though I do love the side profile so far.). He also slightly refined the tip.

Last night was definitely not very easy to sleep. I am able to breathe through my nose but it definitely is congested. I mouth-breathed all night... Waking up from my short "naps" for sips of water. I drink tons of water anyway so the dry mouth thing drives me nuts--I'm always thirsty. I slept propped on 3 pillows and iced for 20 min here and there when I woke up to pee. I had very minimal drainage-- changed moustache dressing in middle of night but more for hygiene than necessity. I haven't saturated any dressings. Around 230a I did wake up with a headache and pain at my incision site. That was prob the most discomfort I've had and it was only like a 5/10. Took a couple of Norco and was able to snooz til 6a.

Feeling pretty good this morning... Washed my face w one of those face wipes and applied some topical arnica cream. I'm also taking Arnica Montana tabs and Bromelain. I started these Fri prior to procedure...not sure if this has made a difference in swelling/bruising butt figure it can't hurt. I've been cleaning my incision and 1/2 inch into each nostril with peroxide & water mix as instructed with a Q tip and then applying bacitracin that I was sent home with. Planning to shower a little later today (shoulders down). My husband has agreed to help me wash my hair in he sink in a day or two when I can't stand it anymore. He's been amazing!!

Anyway, here's a few more updates pics from this morn. I'm propped up on the couch with a few pillows, the tv remote, water and some lollipops. I need to find myself a good new Netflix series to entertain myself. If I continue feeling this well I will be totally stir crazy by the weekend. Not that I ought to complain!!

POD #2

The first half of yesterday went pretty easily… But after taking an afternoon nap I woke up feeling pretty crappy. Had a headache… And lots of congestion. Kind of felt like having a sinus infection. I could not breathe through my nose at all and had a lot of discharge. Not so much blood… More like a super runny nose that you would have with allergies. (Maybe it was allergies? I took 25mg Benadryl.) I iced some more and took a couple of Norco and went to bed early around 9 PM. I slept until my alarm went off at 2:30 for antibiotics and then fell right back asleep until about 6 AM. Much better sleep than last night! I woke up with a headache but I'm feeling much better a couple of hours later! I threw in some laundry and picked up a little bit around the house. I rinsed off in the shower and put on a little lipstick to feel a bit more human. The hubs went into work today but should be home around 2 PM and then has the next week off with me. Thinking that if I keep feeling OK maybe we will get out of the house and run a couple of errands or something. There's only so much TV watching and Internet surfing I can do. Will be careful not to overdo it. Here are a couple pictures from today. Nostrils are definitely swollen… But not too bad. Very minimal drainage today... No mustache dressing!

POD #3

Slept well last night aside from having to wake up at 230a for a dose of antibiotics. It's seems that I feel my best earlier on in the day (after cleaning my nose a bit with q-tips & peroxide/water mixture). My husband washed my hair for me this morning. #husbandoftheyear Pretty sure I couldn't have done that myself without getting my cast wet. We have a handheld shower head so I just sat in the tub with my head back and a ziplock bag taped across my forehead and hanging down over my nose to help prevent splashing -- I'm sure that would have been quite a pic.

I felt great for a few hours, even went to Trader Joes and Target with my husband for a couple of things. No one seemed to even notice me walking around with a cast on my nose... Or if they did, they were polite enough not to be obvious. Felt good to get out of the house. I felt a little fuzzy despite having only taken Tylenol this morn... My eyes felt kind of light sensitive and I just felt foggy, like you do when you have a head cold. Once I got home, I started to have a pretty nasty headache. I've got no real pain in my nose anymore.... Just some discomfort from the difficulty breathing through it. And I keep having itches beneath the cast which clearly I cannot scratch...That's pretty annoying! The headache feels like a cross between a sinus infection and the morning after too much wine. Just took a couple Norco for that. Still have some swelling in my forehead, eyes, cheeks and upper lip. My upper lip isn't moving like it's supposed to but based on everything else I read on here, that's pretty normal at this point. My nostrils are obviously swollen. Trying not to over analyze my nose at this point and hoping that I can keep that up when the cast first comes off because clearly what I first see won't be representative of the final outcome. Just hoping I look normal-ish when I return to work a week from Monday. Here's some updated pics from today with clean hair/normal clothes/and a little lipstick:

POD #4 & #5

Pain free.... Minimal if any drainage... Still stuffy... Not taking any mess.

I think maybe the swelling peaked on day 3ish and seems to be on the way down. Cast comes off and stitches out tomorrow at 130p. I will post more photos then!

While I can barely see my rhino incision itself... I do notice that the skin at the incision site and around the sutures is a little whiter in color than the rest of my skin and appears a little more swollen. I initially when I came home I didn't really notice any bump at the columellar incision site but now on side view I do see one. Hopefully it is temporary or from the way the tape/cast is holding the tip of my nose. I wouldn't be surprised if it is swelling... I just hope it goes down! So excited to get this damn thing off my nose and also scared to look in the mirror. Ahhh!!

Cast Off... Stitches out... Still look like me just improved!

It's been a long day! Was supposed to have my post-op appt at 130p with one of Dr. Most's partners as he is out of town. I got a call this morn that I could either come at 1015 or 245 as his surgery schedule for the day had changed. There was no way I could make it by 1015 (we live 2 hours away IF traffic is good)... So 245 was the plan. My husband and I waited... and waited... One of the chief surgery residents finally came in at like 430p and told us the doc was still tied up I surgery. At that point I was willing to take the sutures out and cast off myself. A bit disappointing not seeing the doc, but it wouldn't have been Dr Most anyhow.

The cast came off and immediately my breathing improved like 30%! That sucker was def compressing my nostrils and limiting air flow. I just feel mildly congested now.

The columellar incisional sutures coming out were not bad at all. After reading reviews on here I had expected it to be way worse. I mean it pinched a little... But what do you expect?!

The resident handed me the mirror and I was scared to look (I quickly looked at my hubs before the mirror and he didn't appear horrified so I figured it must not be bad). It's still super early, but I am so happy with the results!! There is definitely still swelling across the bridge and in the tip... But it looks like me!!! Just a little better. That was the goal!

I'll post more pics in the upcoming days with eye makeup etc... But I mocked up a quick side by side from my pre procedure shots for reference. The tip of my nose is definitely numb. And my smile is not normal yet... My upper lip is kind of droopy but that is normal for now. I was also a little concerned about the distance between my upper lip and nasal tip when the cast was on. It still is different looking but much less alarming. I've been reassured by other members and the doc that this is also to be expected at this juncture. Pretty sure if I hadn't told anyone at work last week that I was doing this that they would never have noticed come next Monday. The scar even looks great so far! All in all I am thrilled with Dr Most and my results!!

Some more recent shots!

I'll have to take a current front and side view photo and put it side by side with my before photos... but for now. Here's some from the last few weeks. Scar not visible at all! One of my best girlfriends who I see a half dozen times a year now recently visited and didn't even notice. (Which I was fine with bc my goal was to still look like me, just a bit better). The tip is still hard to the touch and I know there is still some swelling. I also still notice a little bit of numbness across the columellar but it is much less than it had been. Dr Most was very pleased at my 1 month follow up... he is letting me follow up at 6 months rather than 3 since everything is healing/looking so good! (Thank goodness bc the 2+ hour drive each way is not fun)
Bay Area Facial Plastic Surgeon

8/4/2016 - I had my preop appointment today! Probably a little sooner than most due to an upcoming family wedding on the East Coast and my work schedule for the month of August. Today's appointment was very reassuring. Dr. Most has such fantastic staff! From the receptionists to his aesthetician to his nurse… Everyone exudes a sense of warmth and very genuine compassion, as well as knowledge and confidence. Having been a nurse for 12 years myself in critical care and currently in a Cardiac Cath Lab, I am probably a more discerning critic than most. I have the utmost confidence in my physician and his staff. I did a great deal of research before deciding on surgery with Dr. Most. I am certain that I have chosen someone who will create an aesthetically pleasing nose that fits my face well, while not changing what I look like completely. I am fortunate to live within a couple hours drive such a world-class doc! Today's appointment consisted of signing my consent forms, reviewing my medical information/allergies/issues with previous anesthesia. The nurse went through all of my pre-op and pos-top teaching. This will also be reviewed again with myself and my husband on the day of surgery. Dr. Most called in all of my necessary post-op prescriptions so I will have them ready to go... ( antibiotics and pain meds) I will certainly post more photos once I have surgery on Wednesday, August 31! I have about 12 days off from work post-op. My husband will be off with me during this time. My follow up appointment is exactly one week after surgery and I am hoping that if I am feeling well enough maybe we can use the last few days of our vacation to drive up to Tahoe or out to the coast to make a little bit of a vacation out of this (maybe I'm being a little too ambitious)... I'd like to think I heal fairly quickly and have a very reasonable expectation of pain and discomfort. I know if we go anyplace that I have to be careful not to overdo it… But I think it would be nice, especially for my husband, to get away after a week of being cooped up! I welcome questions and any advice or suggestions! Very scary but super exciting!

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 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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