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Amy “Nose” Best. A Journey through my Rhinoplasty Revision Surgery and Recovery
Having worked in the plastic surgery industry for the past 10 years I have been a part of the planning, preparation, and counseling/ after- care for 1000's of surgical patients. Ten months ago I underwent my own procedure – a revision rhinoplasty. My original rhinoplasty was years ago and my experience with the first procedure left me extremely nervous and hesitant to proceed with a revision. It was the confidence and trust in my surgeon and my desire to improve my breathing and the external appearance of my nose that led to my decision to proceed with surgery. Below is an account of my experience with prepping, having surgery, and aftercare. Everyone heals differently and may experience recovery in their own unique way, but it’s nice to get a preview into the process and some helpful hints to add to your arsenal.
Preparation for the surgery
I am a stickler for the rules and therefore was very diligent with my surgical instructions / directions. Starting 4 weeks before surgery I stopped drinking alcohol and started limiting sodium in my diet. Although saying goodbye to a glass of chard and my lean cuisines for a month was tough (insert sad face), I believe it positively impacted my recovery and results. I purchased the Sineech pre-surgical Arnica packet and began taking it a day before surgery. I found this particular brand helpful because the directions are very clear and specific; the capsules are taken three times a day for four days, starting the day of surgery. Arnica is a homeopathic supplement that is known to reduce bruising and swelling post-procedure.
I had an adult coloring book (who thought of this? – such a great idea), a number of new books and magazines, and a bunch of my favorite movies on hand to provide some distraction and to keep my mind occupied. All of my medications and supplies were set up and ready at the house for my arrival home from the hospital.
Surgery Day
A bit of nerves on the morning of surgery. I went to the wrong hospital! After all of my pre-planning and preparation you would think I could have gotten the address and location correct lol. Everything worked out just fine and after the check-in process I met my anesthesiologist, surgeon and nurse and was ready to rock. 7.5 hours later and I was in recovery chatting it up with my mom and the nursing staff. With the effects of the anesthesia and pain meds still on board I felt surprisingly good for the first 24-48 hours.
Day 3
Ugh. Chatty Amy has left the building. Day 3 was my toughest day. I looked like a chipmunk and felt like I had been in the boxing ring for a couple of rounds. The icing and pain medication helped with the discomfort. I had a pretty constant headache and overall feeling of heaviness on days 3 and 4 especially. Sore throat was another one of my complaints post-surgery. I found that cold pudding and popsicles were helpful in alleviating the dryness. Lozenges helped with throat pain. Tracking my meds, nose cleaning, and water intake was a good way for me to stay consistent and feel organized (OCD much?). I strayed from my low sodium diet to eat a small McDonalds french fries (don’t tell the doc) because it sounded good and I needed a little comfort by way of the golden arches. Lots and lots of water and tea.
Photo on the left taken in the OR before surgery and the photo on the right taken on the couch 2 days after surgery
Day 6
The big reveal day was 7 days after my procedure. Time to get all the gear off! Detachol was poured onto the cast to loosen the adhesive. I felt a bit of pressure as the external plastic cast was removed but no pain. The tape easily peeled off. The suture removal was not bad – a slight feeling of pulling every now and again. The internal stent removal was the most uncomfortable - feels a bit like having the inside of your nose waxed. The stinging went away shortly after the removal. It is a bit shocking to see your face and nose so swollen. I could see that the shape was going to be a big improvement but I definitely had to use my imagination a bit due to the swelling and slight bruising. Took the rest of the day off to rest and headed back to work the next day.
6 months Post-op
WOW! What a difference a couple of months can make. I am thrilled with my surgical outcome and continue to see small changes from month to month. I knew with a revision I could expect to see swelling persist for 12-18 months but seeing truly is believing. I notice more swelling in the morning after not having my head elevated and also in warmer weather. I am sure it is not noticeable to anyone other than me….perhaps I am spending too much time in front of the mirror.
HELPFUL TIPS:
I was very attached to my travel pillow post procedure. It made me feel safe and secure (from bumping my nose or falling asleep on my side).
I put frozen peas in individual zip lock bags and threw them in thin socks in the freezer. It was easy to pull a pair out and mold them around the nasal area (not on the cast).
Warm prune juice a couple of times a day to promote a bm (sorry TMI). That combined in the later days with Colace was necessary.
Got up several times a day to do a little walk around the house and to stretch my muscles. Nothing major but a bit of a break from sleeping and binge watching Netflix.
The power of positive thinking! Without sounding hokey or like I drank the Kool-Aid I will say that positive thoughts and affirmations before and after surgery promote a much more positive outcome. I’m not saying that I was all smiles and rainbows during my recovery but I was consistently reminding myself that I was lucky to have had surgery with such a brilliant and compassionate surgeon and that the outcome wouldn’t be immediate but it would be impactful and pivotal in my life.
Choosing my surgeon
As I mentioned earlier in the blog, I had a primary rhinoplasty many years ago. The entire experience left me feeling sad, mad, and with an outcome that negatively impacted my breathing and appearance. It wasn’t that I went into the process blind; it was more that I didn’t spend enough time doing the research and ignored some red flags. I based the majority of my decision to proceed with my original surgeon on the projected images – red flag #1. I am now very aware that the ability to make changes on a photograph(s) is like using an advanced version of photo shop. A surgeon can very easily over promise and under deliver when presenting projections. I looked like Angelina Jolie in my morphed photos – needless to say, I did not end up with that outcome and am not dating the newly single Brad Pitt. Red flag number 2 was the fact that the surgeon was very dismissive of my list of questions and desired areas of improvement. He said I would look like the image presented and that was that.
After having gone through my primary rhinoplasty experience I was unsure I would ever address a revision. That was until a number of colleagues and friends talked to me about Dr. David Kim. He was consistently referred to as a rhinoplasty specialist and surgeon that was kind and approachable. I heard from quite a few nurses that he was really great to work with and that he was a perfectionist in the OR. Working in the industry allowed me to meet Dr. Kim and that eventually led to the opportunity to work with him in his clinical practice as his patient care coordinator. After observing Dr. Kim in surgery, working with his patients before and after their procedures, and seeing him teach and present to other surgeons around the world, I became extremely confident that he was the only person I would allow to perform my revision. So glad I made the decision to have my revision with Dr. Kim!
Important Factors when choosing a surgeon
1. Board certified (preferably double board certified as an ENT and Facial Plastic surgeon for rhinoplasty procedures)
2. Extensive experience and training with rhinoplasty
3. Feeling comfortable with the surgeon’s bedside manner and surgical plan
4. Understanding exactly what is going to occur during your procedure and why (basically an explanation of the techniques employed based on your anatomy and desired outcome)
5. Imaging
Preparation for the surgery
I am a stickler for the rules and therefore was very diligent with my surgical instructions / directions. Starting 4 weeks before surgery I stopped drinking alcohol and started limiting sodium in my diet. Although saying goodbye to a glass of chard and my lean cuisines for a month was tough (insert sad face), I believe it positively impacted my recovery and results. I purchased the Sineech pre-surgical Arnica packet and began taking it a day before surgery. I found this particular brand helpful because the directions are very clear and specific; the capsules are taken three times a day for four days, starting the day of surgery. Arnica is a homeopathic supplement that is known to reduce bruising and swelling post-procedure.
I had an adult coloring book (who thought of this? – such a great idea), a number of new books and magazines, and a bunch of my favorite movies on hand to provide some distraction and to keep my mind occupied. All of my medications and supplies were set up and ready at the house for my arrival home from the hospital.
Surgery Day
A bit of nerves on the morning of surgery. I went to the wrong hospital! After all of my pre-planning and preparation you would think I could have gotten the address and location correct lol. Everything worked out just fine and after the check-in process I met my anesthesiologist, surgeon and nurse and was ready to rock. 7.5 hours later and I was in recovery chatting it up with my mom and the nursing staff. With the effects of the anesthesia and pain meds still on board I felt surprisingly good for the first 24-48 hours.
Day 3
Ugh. Chatty Amy has left the building. Day 3 was my toughest day. I looked like a chipmunk and felt like I had been in the boxing ring for a couple of rounds. The icing and pain medication helped with the discomfort. I had a pretty constant headache and overall feeling of heaviness on days 3 and 4 especially. Sore throat was another one of my complaints post-surgery. I found that cold pudding and popsicles were helpful in alleviating the dryness. Lozenges helped with throat pain. Tracking my meds, nose cleaning, and water intake was a good way for me to stay consistent and feel organized (OCD much?). I strayed from my low sodium diet to eat a small McDonalds french fries (don’t tell the doc) because it sounded good and I needed a little comfort by way of the golden arches. Lots and lots of water and tea.
Photo on the left taken in the OR before surgery and the photo on the right taken on the couch 2 days after surgery
Day 6
The big reveal day was 7 days after my procedure. Time to get all the gear off! Detachol was poured onto the cast to loosen the adhesive. I felt a bit of pressure as the external plastic cast was removed but no pain. The tape easily peeled off. The suture removal was not bad – a slight feeling of pulling every now and again. The internal stent removal was the most uncomfortable - feels a bit like having the inside of your nose waxed. The stinging went away shortly after the removal. It is a bit shocking to see your face and nose so swollen. I could see that the shape was going to be a big improvement but I definitely had to use my imagination a bit due to the swelling and slight bruising. Took the rest of the day off to rest and headed back to work the next day.
6 months Post-op
WOW! What a difference a couple of months can make. I am thrilled with my surgical outcome and continue to see small changes from month to month. I knew with a revision I could expect to see swelling persist for 12-18 months but seeing truly is believing. I notice more swelling in the morning after not having my head elevated and also in warmer weather. I am sure it is not noticeable to anyone other than me….perhaps I am spending too much time in front of the mirror.
HELPFUL TIPS:
I was very attached to my travel pillow post procedure. It made me feel safe and secure (from bumping my nose or falling asleep on my side).
I put frozen peas in individual zip lock bags and threw them in thin socks in the freezer. It was easy to pull a pair out and mold them around the nasal area (not on the cast).
Warm prune juice a couple of times a day to promote a bm (sorry TMI). That combined in the later days with Colace was necessary.
Got up several times a day to do a little walk around the house and to stretch my muscles. Nothing major but a bit of a break from sleeping and binge watching Netflix.
The power of positive thinking! Without sounding hokey or like I drank the Kool-Aid I will say that positive thoughts and affirmations before and after surgery promote a much more positive outcome. I’m not saying that I was all smiles and rainbows during my recovery but I was consistently reminding myself that I was lucky to have had surgery with such a brilliant and compassionate surgeon and that the outcome wouldn’t be immediate but it would be impactful and pivotal in my life.
Choosing my surgeon
As I mentioned earlier in the blog, I had a primary rhinoplasty many years ago. The entire experience left me feeling sad, mad, and with an outcome that negatively impacted my breathing and appearance. It wasn’t that I went into the process blind; it was more that I didn’t spend enough time doing the research and ignored some red flags. I based the majority of my decision to proceed with my original surgeon on the projected images – red flag #1. I am now very aware that the ability to make changes on a photograph(s) is like using an advanced version of photo shop. A surgeon can very easily over promise and under deliver when presenting projections. I looked like Angelina Jolie in my morphed photos – needless to say, I did not end up with that outcome and am not dating the newly single Brad Pitt. Red flag number 2 was the fact that the surgeon was very dismissive of my list of questions and desired areas of improvement. He said I would look like the image presented and that was that.
After having gone through my primary rhinoplasty experience I was unsure I would ever address a revision. That was until a number of colleagues and friends talked to me about Dr. David Kim. He was consistently referred to as a rhinoplasty specialist and surgeon that was kind and approachable. I heard from quite a few nurses that he was really great to work with and that he was a perfectionist in the OR. Working in the industry allowed me to meet Dr. Kim and that eventually led to the opportunity to work with him in his clinical practice as his patient care coordinator. After observing Dr. Kim in surgery, working with his patients before and after their procedures, and seeing him teach and present to other surgeons around the world, I became extremely confident that he was the only person I would allow to perform my revision. So glad I made the decision to have my revision with Dr. Kim!
Important Factors when choosing a surgeon
1. Board certified (preferably double board certified as an ENT and Facial Plastic surgeon for rhinoplasty procedures)
2. Extensive experience and training with rhinoplasty
3. Feeling comfortable with the surgeon’s bedside manner and surgical plan
4. Understanding exactly what is going to occur during your procedure and why (basically an explanation of the techniques employed based on your anatomy and desired outcome)
5. Imaging
Provider Review
Board Certified Facial Plastic Surgeon
55 Francisco St., San Francisco, California