Revision rhinoplasty - a well-structured nose can be life-changing

When I was researching a rhinoplasty surgeon for my first surgery, I did not know how important the words “structure,” “projection,” and “rotation” would be. I was focused on a vague sort of aesthetic improvement, but I did not understand how to achieve those results. I blindly thought that working with a surgeon of good repute would be enough. “Let the expert guide the experience” was my approach. It did not pan out for me. Instead of anything close to the morphed image I thought my first surgeon and I had agreed upon, I received a saddle nose.

The deviated septum that needed correction became half of a septum, with the bridge scooped out and no support offered to the bottom half of my nose. What had once been a strong top line collapsed at the halfway point. The tip, still bulbous, began to droop. Over the years, the collapsed bridge and the drooping tip became more pronounced. Breathing became increasingly difficult. I first approached Dr. Z because he was local (the first surgeon had been based in Dallas and required travel and a hotel stay) and because he performed complicated revision rhinoplasties. Two other local surgeons had declined my case, stating that I could not achieve the results that I desired. (Note: neither surgeon admitted that he did not have the necessary skills; each one instead put the onus on me, saying that I desired unattainable results, but the true translation was that they did not have the requisite skills and I needed to keep looking for someone who did. Bottom line: never give up.)

Dr. Z, his office, and his staff surprised me repeatedly, in ways that I’ve discovered matter. First, I was running a few minutes late for my consultation. When I called to inform the office, they warmly told me to drive safely, and not to worry. The time was mine and they were happy to see me soon. That response affirmed that the practice was customer-centric and not ego-driven.

Second, the office is stunning, in a thoughtful and well-designed way. Other surgeons’ offices often contain cheap reproductions of what is meant to look like expensive furniture: fake Chippendale pieces with glass tops and heavily-turned legs proliferated in the Dallas surgeon’s office. Fake Mies van der Rohe Barcelona chairs with busted leather stitching, cheap aluminum frames, and the most uncomfortable cushions were in the waiting room of one of the surgeons who declined my revision rhinoplasty. I can understand not investing four or five figures in a waiting room chair, but a little authenticity would be nice. In Dr. Z’s office, the furniture choices are eclectic, comfortable, and harmonious.

They complement the wall art and the color scheme in an intentional, artistic, and welcoming way. The mural of faces behind the reception desk is a brilliant reminder that beauty comes in many forms and that diversity is the best part of life. That kind of design aesthetic pervades the practice: whoever you are, however you come to them, your uniqueness will be celebrated and enhanced. You will become an even better version of your already amazing self.

This last sentiment was reinforced when I met Dr. Z, with whom I spent an hour in consultation. His gracious exuberance is immediately apparent and it is accompanied by technical experience that comes through during the morphing session. Never once did he infer I needed his help. (Two other surgeons, with whom I met after Dr. Z, both agreed to take my case, but also acted as though they were not sure how I dared to show my face in public with my then-nose.) He and his wife/office manager, Barbie, spent time talking about what was possible and ensuring I made a choice out of enthusiasm, not dread or despair or defeat, since bringing those emotions into the surgery would affect the result.

The morphed image surprised me, in part because it still looked like me and in part because the improvements were in areas I did not expect and added up to a whole that was more and different than I anticipated. Here is where Dr. Z’s aesthetic combines with the concepts of rotation and projection. Rebuilding the bridge would help the lower part of my nose project outward. Rotating and structurally supporting the tip would lift my nose and give it a more youthful and feminine appearance.

Reducing the bone at the top of my nose would retain some of the shadow of the saddle nose that I had become familiar with, and further shrink the overall size of my nose. Instead of a fairytale nose that a renowned surgeon waved his magic wand over, I had prospects for a refined nose that was achieved with real, technical skills.

Two other selling points concerned the possibility of using local anesthesia and cadaver rib cartilage. I was short on PTO and needed a fast recovery. One of the other surgeons with whom I consulted walked me through the process of harvesting my own rib cartilage and when I considered the downtime for and potential complications from an additional incision site, I knew that local anesthesia and cadaver rib cartilage were the right choices for me.

On the day of the surgery, most things were calm and orderly. A minor hiccup concerned a prescription that my pharmacy elected not to fill, without telling me. But other preparations were smooth. The injections for the local anesthetic were super painful; I’m not going to lie. I have hyper-sensitive skin and thought those injections would do me in. But we took a break and then soldiered through it. Once the anesthesia kicked in, the situation improved and became one of the most remarkable ones of my life. To be an active and aware participant in the recreation of your own body part is amazing.

Rebuilding my septum took the bulk of the almost-five-hour surgery; I could feel when it was complete and that my body was happy to have the new cartilage in place. Recovery included some nausea from the sedatives, and required a lot of ice, but, with help from others at home, it was doable.

Four days after the surgery, I returned to work. Dr. Z did not recommend such an early return - he said a week of downtime would be better - but I was worried about my PTO allowance. In retrospect, I would take the week off. While I could physically work online, my body was exhausted and just wanted to shut down for more healing time. A week after the surgery, the splint was removed and I fell in love with the results. I could not get over how much they youthened my appearance. One trend I had seen in Dr. Z’s work, and which was another deciding factor for me, was the facelift effect of his rhinoplasties.

No matter what kind of a nose he gave someone - and his work showed a great range of nose types - the ultimate effect was a lifting of the appearance of the mid face. The face seemed to open up and attention shifted up to the eyes. I could see that same result in my own face, along with the restored bridge and refined tip I had wanted (and that others said was not possible, ahem). Ten weeks later, I am still delighted and the swelling is not fully down yet. (I declined steroid injections to speed the reduction in swelling, opting to let it go down naturally, over time.)

All in all, Dr. Z is an ideal choice, when you want to have an educated hand in your beauty path. He understands that pleasing aesthetic results take many forms and the best ones are rooted in your unique physiognomy and personality. By staying awake for his surgery and being an active participant in the moment of transformation, you have a special opportunity to rewrite your approach to beauty, in real time. I cannot recommend this conscious experience enough.

As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway.