Rhinoplasty to fix high bridge and bump, 3 months post op

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It was probably one day in my preteen years that I...

It was probably one day in my preteen years that I used a mirror to check out how my hair looked in the back, and that’s when I saw it. My profile. I couldn’t believe my eyes. That was what my nose looked like from the side?! How could people bear to look at me? And now, over 20 years later, I am still thinking those same thoughts, just about every single day.

I do not think my nose is too bad from the front, but the profile kills me. Way too big for my face, with a big ugly bump added for good measure. I wasn’t really able to do anything about it during my twenties. I worked full time and couldn’t get enough time off for recovery. But last year I started working part time, and after having a baby, following a long and painful labor topped off by a c-section, I felt like, if I can get through that, I can get through just about anything. And so, here we are. The timing is finally right to carry out my lifelong dream of having a nose that suits my face.

My pre-op consultation is next week, and my surgery is in three weeks. I am gradually getting more nervous and more excited.

Choosing a surgeon

I went to 3 different doctors for consultations. The first 2 were nice enough but I wasn’t satisfied with their level of experience with rhinoplasty. I started feeling like plastic surgeons had to be a "jack of all trades." But if someone is going to mess with my face, I would sure like for them to have a LOT of experience with noses. Finally I went to see Dr. Hubbard in Virginia Beach. He has been doing rhinoplasties at least as long as I have hated my nose (a long time), he has co-authored books on rhinoplasty, and his website is full of before-after pictures. The other doctors I saw couldn’t offer me a single before-after picture of a rhinoplasty they performed. Dr. Hubbard took his time answering my questions. He spent 10 or 15 minutes using a computer program to adjust a picture of my profile so we can start to see the potential "after" results of surgery. The other doctors I saw did not do this. Dr. Hubbard was extremely professional and after the consult I felt extremely confident in his ability to give me a better nose.

I also talked with Dr. Hubbard about a chin augmentation and some minor cheek lipo. I think if I was younger and single, I would have gone for it all. But I consider this decision to be just as important for my husband as it is for me. My husband was concerned that I would really look different if I did all three procedures. So I decided to just go with the rhinoplasty and I’m content with that decision. I’m so incredibly grateful that my husband is supporting me on this. I think I would be very scared if he told me he was going to change something about his face! Deep down he probably is nervous but he knows this is important to me.

I scheduled my surgery with Dr. Hubbard to coincide with our upcoming move to Florida. I’m hoping to be able to hide out between surgery and our departure because one of my biggest concerns is people’s reaction to the change. I am also nervous about my family’s reaction. I have only told my mom, husband and best friend and I am on the fence about telling anyone else. I'm going to get a hair cut before surgery so maybe that will be a distraction.

Today is my pre-op appointment! It's starting to feel like this is really going to happen.

Pre-op Consult

Yesterday (May 21) was my pre-operative consultation. First I had to wait 45 minutes to be seen, which is pretty normal with any doctor visit these days but still frustrating. Then I spent about 30 minutes with a nurse signing forms regarding risks of surgery, pre- and post-operative instructions, etc. She also took more pictures and I paid for the procedure.

I then had to wait another 25 minutes to see Dr. Hubbard. We reviewed the picture he had manipulated during my initial consultation to show the desired outcome for my nose. He examined my nose again while we talked more about my top goals for surgery. As I mentioned before, I do not mind my nose much when I look head on, but I really want a reduction in size from the profile view. Also, the tip of my nose moves when I talk (I will never forget how mortified I was when this was first pointed out to me in 2nd grade). So he is going to try and fix that but he said there is no guarantee it will be completely effective in eliminating the movement.

During my initial consultation, Dr. Hubbard and I discussed the possibility of a chin implant, which I later decided against after talking to my husband. During yesterday’s visit, at one point Dr. Hubbard said my nose is still going to look big after surgery because I’m not getting the chin implant. I’m paying a lot of money to get a smaller nose, so to have your surgeon tell you “you’re still going to have a big nose” is less than desirable. I understand that he is saying my post-operative nose would look even smaller when combined with a chin implant. But the fact is, even without the chin implant, my post-operative nose will be smaller than it currently is, which is my primary goal. I’m not trying to become a beauty queen, I just want a smaller nose. His comment rubbed me the wrong way.

Overall it was a good visit, not a great one. But I am still pleased with my choice of surgeon. Dr. Hubbard is not overly warm but he never made me feel rushed and was happy to answer any questions I had. I trust his experience with rhinoplasty and to me that is more important than his bedside manner.

1 day post-op

I've been home from surgery for about 24 hours and this is the first time I've felt good enough to get on my computer. I'm impressed with all of you that were able to post updates on your day of surgery! My surgery took about 4 hours. I never had problems with breathing and didn't think I had a deviated septum, but apparently it was quite crooked once the doctor got in there. So between fixing that, and my high bridge, the bump on my bridge, and getting the tip to look right, it took quite a while. In addition, he went up under my upper lip to make an incision that should help reduce how much the tip of my nose moves when I talk. That's why my upper lip is so swollen. Honestly that's one of the biggest annoyances right now in terms of discomfort and eating.

I felt very groggy from the anesthesia up until now. I had very minor nausea after getting home and taking my first pain pill, but no other issues with nausea after that. I just took my second pain pill. I wouldn't really say I'm in too much pain, mostly just uncomfortable. The most uncomfortable part of the first night was breathing through my mouth and my tongue getting dried out. Cough drops helped a little. This morning I went back to the doctor and he removed the gauze packing from my nostrils, so I am able to breathe a little though my nose, but I'm still mostly breathing through my mouth.

As you can see I'm quite swollen and bruised. I'm still feeling a little out of it so sorry I'm rambling.

3 days post-op

Swelling and bruising is going down. My upper lip is still quite swollen and sore, and is probably the biggest nuisance of recovery since I can't feel it when I try to eat. My nose just feels like pressure, not really any pain. I'm still very congested. I can breath a little through my nostrils but generally it's easier to breath through my mouth. I took a pain pill last night and may take another tonight. My appetite is pretty much normal and I think if my lip wasn't swollen I could eat almost anything. I'm still very worn out and spend almost all day in bed dozing.

Yesterday afternoon my doctor called me and said he was concerned about some asymmetry he saw during my 1 day post-op visit. Today I went in to see him, and he confirmed that he may want to do a revision on the tip in a few days. I'm trying to stay positive, but of course I thought in a few days I'd be done with the worst part of recovery, and now this feels like I'm almost starting over. This isn't something I ever considered as a possibility so I'm a little dumbfounded by the whole thing. I understand that my nose required a lot of work and it's hard to get it all 'just right.' And I appreciate that Dr. Hubbard is willing to speak up and say he wants to fix what isn't right. I don't doubt his expertise but I'm obviously so disappointed at the prospect of more general anesthesia.

I go back in 2 days to see Dr. Hubbard again, at which point he'll decide if he wants to do the tip revision the following afternoon.

5 days post op, no revision required!

Today I went back to the doctor so he could make a final assessment on whether or not my tip needed a revision. He decided that although my nostrils are not perfectly symmetrical, it was not as bad as it looked a couple of days ago and he wasn't positive a revision would be worthwhile. What a relief. I was prepared for another surgery if necessary but I am so happy that it's not needed.

I started feeling closer to 'normal' yesterday. I got up at a normal time, ate a normal diet, though I was pretty worn out by about 4pm. Today I am feeling even better and actually put on some make up. Although pretty much any amount of physical exertion makes me feel very blah, it's nice to not be stuck in bed anymore. Swelling and bruising is improving gradually.

One advantage of today's appointment was I got a sneak peak of my nose without the splint. I'm expecting the swelling on the bridge to come down but I am already very happy with the results.

Post-op Day 9

I had my splint removed on Day 7. Since then I have been enjoying my new nose, mostly my new profile. I couldn't be happier with it. I think the tip is quite swollen as well and will become more defined over time. But to be honest it doesn't bother me as it is.

-I've been able to breathe very well since about Day 6.
-I love the profile of my new nose.
-Bruising is 90% gone and I can cover what's left with makeup.

-Lots of discomfort from the incision that occurred behind my upper lip. It is still tender and swollen and gets irritated easily if I talk a lot or after eating. It's the kind of constant dull pain that just wears you out. However, the whole point of the incision was to reduce how much the tip of my nose used to move when I talked. And at this point there is absolutely no movement anymore. I realize that could change as things heal and my nose becomes less stiff, but I feel pretty confident that it will never be as pronounced as it was before. So I just have to deal with the recovery and be patient.
-I am still very swollen so I'm having a hard time looking at myself head-on because I just do not look like myself. I especially don't like how swollen I am between my eyes. I'm assuming that this will improve over the next couple of weeks and I'll start to get a better idea of what my nose really looks like.
-My nose is still very tender and very firm. I get a lot of itchy sensations, mostly on the tip, but then if I try to itch where it's bothering me, the area just feels numb. So I get no satisfaction from trying to relieve the itch, if that makes sense. I have a similar problem with my upper lip. It's a minor annoyance but one that happens a lot and I'm tired of it.

Overall my list of cons is much longer than the pros. I think I'm realizing that although I'm starting to feel like myself and I'm no longer bedridden like the first few days after surgery, the second week of recovery has it's own set of irritants that must be dealt with.

Funny side note, on day 7 almost right after splint removal I ran into someone who did not know what I had done. I hadn't yet cleaned all the sticky residue off my nose or covered up my bruises, and I knew it was a bit of a gamble to go shopping, but I was too sick of being house-bound to stay inside any longer. Anyways, I think she saw my bruises and puffy face and thought I was a battered wife. When she asked me what was going on with my face, the only thing that came to mind that I could say was, "I had a little work done." Later on I fessed up to her over Facebook because I was kind of concerned she would call the cops to have them check up on me :)

4 weeks post op

At the one month point, I'm feeling more and more like myself. While the initial recovery period to get over the bruising from surgery is amazingly brief, the fact is that the overall recovery is pretty slow and requires patience.

I still have some stitches up in my nostrils that haven't dissolved which are a bit bothersome. I've also had seasonal allergies that really irritated my sinuses and resulted in a constant runny nose. This is problematic since my nose is still very firm and slightly painful to the touch, particularly the tip. So wiping with a tissue is no fun. In the past week the swelling has come down enough that I feel like I look like myself again. I was very swelled between my eyes before, since my surgeon did some work to lower my high bridge. This swelling really made me self conscious but has improved. I think my smile is not back to normal, and I'm not sure it will ever be the same as before. My surgeon made an incision behind my upper lip to stop the tip of my nose from moving when I talk. So far this appears to have been effective in stopping my nose from moving, but as a result I think my smile will not be as 'toothy' as before. This may actually be the giveaway in pictures that I had something done to my face!

I'm disappointed to see that my nose is definitely crooked at the tip. While I may be the only one who ever notices, I'm still bothered by it. It's especially apparent when looking at my nostrils. Since my tip pulls to one side, my nostrils don't look like they are the same size. If I push the tip to center with my finger, my nostrils look the same. I will see how it goes over the course of the next year, and maybe I will be pleasantly surprised to end up with a perfectly straight nose. But I'm not going to hold my breath.

Overall I think at this point I can say that my rhinoplasty was worth it. In spite of the crookedness, I still prefer my new nose over the old one, particularly when it comes to my profile. I already can't really remember how my old nose looked in the mirror, and I feel like my new nose fits my face very well. It's possible that down the road I will consider a revision to make my tip straight.

3 months post-op

It took 6 weeks for the swelling to go down enough to where I felt like I looked like myself again, except with a smaller nose. Even now, the tip is still very firm and slightly numb, and my upper lip is slightly numb.

My tip is slightly crooked, which leads my nostrils to appear asymmetrical. I'm disappointed by this outcome but overall I would not trade my new nose for my old one. The improvement in the bridge and the overall reduction in size was well worth going through with the procedure. I don't feel anywhere near as self conscious about my nose as I had for the last 20+ years. And recently I was thrilled to see a candid picture of my profile and not hate the picture!
Virginia Beach Plastic Surgeon

Based on my consultation, I have a high level of confidence in his experience and abilities, specifically in regards to rhinoplasty.

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