Rhinoplasty and Chin Implant with Dr. Portuese

I’m 38 years old and have hated my nose since the 8th grade. I finally got serious about rhinoplasty and after the last two years of researching and planning, I finally decided to do it. As I went through the process and benefited from so many others sharing their experiences, I decided I’d write an account of my own to pass along the favor, even though it’s a bit nerve-wracking to post pictures of myself out on the internet since I am making all efforts to do this procedure super discretely :) But here goes it.
Before I get into Dr. Portuese and the procedure, I’ll give a little background. First, I have a bony peak on the bridge of my nose, and a ball tip that pulls downward when I smile. As I researched and was looking at all these side views of myself, I discovered that another area that was hard on my profile was my chin. I’ve never really liked my chin but hadn’t thought much of it. As I interviewed surgeons, they all recommended cleaning up the chin area with an implant and liposuction as well as the rhinoplasty to get a stronger profile. After looking at all the profile photos, I agreed. I attached my pre-procedure pics. I look like a bit of a sourpuss in the photo that Dr. Portuese took, and my face is naturally more animated looking, so I’ve also attached another of how I think I commonly look.
I interviewed six surgeons over the past two years, and have looked at literally thousands of pictures. I live in Portland, and I was having difficulty finding doctors who specialize in facial work so I spoke to two doctors in Seattle as well. I didn’t want a general surgeon, I wanted someone who lived and breathed rhinoplasty. This was my face! Most surgeons just didn’t have the volume of rhinoplasties I was expecting. I also ruled out one doctor who basically gave everyone the same nose. Two doctors at OHSU were appealing, but they didn’t have the volume of pictures available to make me feel completely confident. Pictures are very important because as much as doctors will tell you that they can do whatever you want, the truth is that there’s always some judgement calls they have to make to form your features, and they all have different concepts of beauty in their minds and will make their decisions based off those concepts. If they say they are going to refine a feature, by how much? Smaller nostrils - how much smaller? There are vague statements that are made in describing what will be done, so it’s important that you choose a doctor whose aesthetic style is the same as your own. Ultimately, this is why I chose Dr. Portuese. He had an abundance of pictures with trends in work that I thought were beautiful and I wanted a similar result. He also had many reviews on different sites with many happy patients. I always assume that there will be unhappy people, and I did read those reviews very carefully before making my final decision. While I will add feedback about the staff, etc., my rating is primarily about the result, since that’s what is most important. I will gladly take a jerk doctor who would give me a perfect nose - fortunately, Dr. Portuese is certainly not a jerk doctor :)
Okay, so that was a long intro, so here’s a quick review of my all my pre-op happenings. I took the day off to drive up from Portland for my consult. The office is easy to find and there’s parking below (not validated so you have to pay). The waiting room is simple and comfortable, and the front assistant is super super sweet and friendly.
I didn’t have to wait long, which is great because I often times think that doctors don’t know what “scheduled appointment” means. I had my pictures taken. Dr. Portuese was very nice, didn’t come off arrogant, and we had a good conversation about what I was looking for and what he was seeing. I didn’t feel rushed at all. In fact, he seemed to be very attentive to making sure I had all my questions answered.
I was then taken to the office manager, Janet, who worked on editing my photos. I thought this was weird because she hadn’t talked to Dr. Portuese at all before she edited the photos to show me the result. I felt like this would have been better done by Dr. Portuese and I together. Dr. Portuese ended up stepping back into the office and he and I had her make additional adjustments to be more in line with what I was expecting. I will say though, it’s nice to have a photoshopped picture of what your results will be. Not all doctors do this. Janet then went over the pricing, which was about right in the middle of all the prices from other surgeons I had seen for the same work. So I think his pricing is very fair.
When I felt satisfied, I headed back home to make a final decision on what I would do, and I did end up selecting Dr. Portuese for my surgery.
I’ll section out my review in updates to try to keep it organized. Up next - surgery day :)

I had my surgery on Thursday, November 30. I drove up from Portland the night before because I was originally told my appointment time was in the morning. When they called to confirm, it was changed to 11:45, which is kind of a bummer because it was too late to cancel that night of hotel. I wish they’d accommodate out-of-town folks a little better.

For anyone traveling to Seattle, there are of course endless hotels, but we booked an apartment at the Barsala Convention Center Condos for a couple days and it was perfect. It’s only a couple blocks from the hospital and Dr. Portuese’s office. I wanted privacy of course, and it was great that we could just park under the building and then take the elevator up to our apartment - no walking through a main lobby. They also have more space and a kitchen, very nice if you’re going to be cooped up a bit.

My husband took me to the office in the morning and it was easy check in. All the paperwork had been pre-filled out and all I had to do was sign, which was great because I was a nervous wreck. Then we were walked down the hall to the surgery suite. The nurse showed me to a private bathroom with some lockers, gave me a gown, and said something about peeing in a cup. I know it’s old hat to them since they do this all the time, but for someone about to have their face cut open and whose super jittery, it would have been nice for a little more hand holding through it all. I ended up peeing in the cup, but then after saw a paper on the wall with some instructions that said I only needed to provide a pee sample if I thought I was pregnant. Well, I knew I wasn’t pregnant, but that wasn’t clear - so yeah, they got pee anyways.

I got to leave my bra, pants and shoes on under the gown, which actually made me feel a lot better. I had this weird apprehension to thinking they were going to have to help me get my leggings back on after the surgery. Just wear a button up shirt so they can slip it on you after everything is done. The gown has been warmed, which was amazing because I was cold. They also gave me a warmed blanket when I came out of the bathroom, which also helped calm the nerves. Then I was taken to a side examination room where I waited with my husband.

We waited for quite a long time. The nurse brought in some nasal spray and told me to spray it in my nose. Again, instructions were a little too vague. I sprayed it in, but then after 20 minutes she came back and asked if I done it three times, with a few minutes in between. Um, no. She left for a bit longer while I did more sprays. The anesthesiologist finally came in for a minute just to touch base, and then after, Dr. Portuese came in. He just quickly ran through a recap of what we had previously discussed and then left to finish getting ready. My husband felt like it was a bit short, but I felt comfortable since we had already discussed in detail during the consultation. Then finally it was surgery time!

They had me lay on the surgery table and I have to admit, I did contemplate running away. But, I got on the table and was set up with an IV. In all my pre-surgery fretting, I had forgotten to take my contacts out, so I had to awkwardly stop them while they were getting ready to put me to sleep so I could pop them out. A little embarrassing, but I’m glad I remembered because when I woke up, I did have some oily solution in my eyes.

The last thing I remember is taking deep breaths of oxygen, trying not to hyperventilate :) I woke up to someone helping me put my shirt back on, and then being helped into a wheel chair. I kind of remember being wheeled to the car and driven back to the apartment. By the time we got to the apartment, I was a little more together and could walk. We got up to the apartment and I crashed in bed until morning.

Attached are two pics - the first is me when I got back to the apartment right after the surgery, and then me the next day. As you can see, some bruising was developing under my left eye and the sides of my mouth.

So, I’m only eight days post surgery right now and it’s not nearly as bad as I thought it would be. There’s not much pain. In fact, I’ve taken very little of the pain medication. I think the worst thing was that my nose was so plugged up that I couldn’t swallow right. Then I was feeling like I couldn’t swallow phlegm, and then had that feeling that I couldn’t breathe because of it. The next worse thing was the dry mouth and throat, because you are breathing through your mouth constantly. Fortunately, I had read from others to get some Biotene gel - this was a life saver!!! You have to get this to survive! You won’t think it’s a big deal until you wake up with a raw throat and tongue. But Biotene keeps your mouth moisturized and it’s heaven.

For the first couple days, my lips didn’t want to work, due to both the nose and chin surgery. I couldn’t drink from a straw so I just had to dribble from a cup. When I spoke, my lips wouldn’t move, so no one could understand me very well. That got better after about three days. I didn’t want to eat much, and when I did, I wanted soft things because I couldn’t swallow easily. My husband got me a lot of soup, Mac and cheese, jello, and stuff like that.

The bruising and swelling were pretty heavy. I attached photos of me from Monday, four days after surgery. I’m looking a little shabby because I still hadn’t taken a shower yet. There was also some weird oily stuff in my hair from the surgery, probably to keep it out of the way? I should have brought some leave-in deep conditioner for them to use instead :)