Surgery for broken/bulbous nose -my journey

Like many others as I grew older, I became very...

Like many others as I grew older, I became very aware of my ethnic nose. Mainly because the older I got (I am 49), the wider and more bulbous it seemed to become. It was way too prominent a feature on my face. I would joke about having my nose made tiny with my husband. Well, two weeks ago, I had fainted and face-planted onto the floor leaving me with a broken sinus/nose - septum. I went to my ENT who told me that he could not do anything for me, too much of the nose was damaged and I would need a reconstruction through a plastic surgeon.

I didn't know how I felt when I was told that I needed a reconstruction. Surgery is never pleasant but at this point, I just want to breathe right and sleep through the night peacefully. So I am scheduled to see Dr. Michael McNeel in 5 days. Of course, in anticipation and researching doctors, I have been reading this site, looking for noses like mine (which seem to be impossible to find) and many do not have reviews for people who have had a reconstruction from injury. My septum is pushed to the side (along with the rest of my nose). If I run my finger lightly along the nose, I feel various breaks in the bone and dips. I have posted a before picture which was taken a month ago, one up nose shot (the nostrils were swollen then and actually look more tilted now) and one I took today (11 days after my injury). As you can see my nose is broken at the bottom of the eye level and pushed to one side, my brow bone is still swollen (I had a nice knot on my head above the eye) and my black eyes have faded just leaving a purple/black mark below the side of my face that took the most impact.

Basically, what I want out of this surgery is: (1) to improve my breathing (make it like it was before the fall); (2) straighten the nose; (3) reduce the general wideness of the nose; and (4) reduce the bulbous tip and pronounced nostrils. I look forward to consulting with Dr. McNeel as he uses the Vectra 3D imagining system. I am curious if all four wishes I listed can be fulfilled.

Today was my consult

Today was my consult and I was very excited. Dr. McNeel and his nurse were very nice. The doctor did not do any "hands on" examination of my nose as he said you can plainly see it. He was concerned about the fracture and discussed with me the different approaches to surgery after a break and the different schools of thought with regard to timing of surgery after a break. He wanted to have some time to review the scans from the hospital, so I returned to his office later with a flashdrive with the scans taken at the emergency room that was provided by the hospital for my primary doctor. He said that I might need a surgeon who does more facial reconstruction depending on the damage shown on the scans but he would let me know Needless to say, I was disappointed that I did not leave with a plan for a working, centered and improved nose but better safe than sorry.

Now it is just wait and see.

Dr. reviewed the scans says he can do it - Yea! I am more than excited.

I got a call from Dr. McNeel today. He said that after reviewing the hospital record, he thinks we can address the issues from the fall and tip of my nose. So basically, they are putting together a plan to re-break my nose, straighten it, fix the broken septum and brace it with some inner splints and shave down the bulbous tip and I am extremely happy. I am just waiting for the nurses to get back to me with scheduling.

If you have had this procedure, I appreciate any tips you might have. I don't smoke and take a daily multivitamin.

The night before and full of excitement and anxiousness.

I have the supplies, meds and real self user's suggested supplies. I am reviewing my pre-op sheets, have spoken with the hospital people - when to arrive, where to park, what to wear, etc. To keep myself occupied, I was playing online with a plastic surgery simulator. Dr. McNeel does have imaging but not at his Woodstock office, only his Marietta office. So I was unable to get a visual of what my new working nose will look but I have been playing around and made a wish nose so I will post that and we will see if it looks close or better. I have confidence in Dr. McNeel.

My surgery is in the afternoon and no food or drink after midnight tonight but I will probably have nothing to eat even before then. I have had surgery before and I know that I don't even want to swallow my own spit as I will be throwing up. I know, TMI. That is never fun so I am not even going to chance it. My husband will be accompanying me and I will be recovering at home. The drive home is always unpleasant for me but thank goodness the hospital is only 25 minutes away depending on traffic.

I really must say that I appreciate all of you who have shared your experiences. Recovery is never the same between two people but I feel better knowing what could happen, what works, what doesn't, how to survive sleeping in the living room recliner, etc. And hopefully, those coming up on their own surgery might find something helpful in my experience.

I will keep you updated. Goodbye to my broken, Sicilian nose. I know my daddy would forgive me.

Surgery day - I made it to the other side

Today was surgery day. I was excited and everyone was so very kind and helpful. Dr. McNeel is just such a nice doctor and my anesthesiologist was very kind as well. I got there and the prepped me. The most painful thing in the prep is the IV. Everyone picks my one hand and they cannot get it in so they poke around and it hurts. Another nurse tried the other and it was in.

My husband and I chatted and joked. Humor calms me and it did. Dr. McNeel came in next and marked my face. The nurses joked and called it my butterfly face painting. I was wheeled into the surgery room and put on a table. The table is narrow, so I don't know how they get a larger man or woman on it. The doctor told me that he would put on a breathing mask and that I was to take three normal breaths, slowly then breath normally thereafter. That is the last thing I remembered.

I woke up and, to my surprises, was not freezing. Every time I have been in recovery, I have been freezing. My pain was in the tip of my nose at about a 4-5 pain index, my eyes were watering, my two front teeth hurt a little (but that also happened when I fell and broke my nose - so the nose bone must be connected to the tooth bone - lol) and my throat was starting to hurt. I had to drink ginger ale and eat two saltines before I could get a pain pill. I will tell you that I took me forever to eat those saltines. I was just so afraid of vomiting. I did not feel nauseous but I did feel lightheaded. So it was more caution on my part then anything. I got 11/2 cans of ginger ale down and the saltines. Next was to try to use the ladies room. I didn't feel like I had to go but I thought I would try and it was good because I did not have a sensation of needing to go but I obviously did. I suppose all the hydration from the drips. The nurse gave me something for vomiting for the drive home and that worked.

My husband said Dr. McNeel came out right away to let him know that I was out of surgery and that everything had gone very well and that I have a nice, straight nose. My husband says you can tell that it is straighter and ore defined and that I will be very happy with it. I cannot see on his angle so I will take his word for it.

My nose was dripping at a good rate in the car. I was released at 5 and I have changed the pad twice but now it now 9 and is slowing down a lot. Surprisingly with all this dripping, I can breathe! Yea. The best thing. I did not use the strap. The strap was making the gauze rub against my stitches so I just felt better to tape it comfortably.

I had chicken soup and took my steroids, antibiotics and arnica. I another pain pill by itself later. I have used the ladies room again and feel less foggy walking with assistance than I did before.

My pain is a two in the tip of my nose and my throat is a 4 now.

1 day post op

It is almost 24 hours since my surgery. My nose is still dripping (very slowly). I am not in pain, have had no nausea. My eyes are black but I expected that. I feel generally good. No watery eyes.

Last night's recliner sleep was o.k. I programmed my phone to remind me when to take the different medications through the night. I could breathe a bit through my nose now and then and I slept in basically three hour increments. I keep my drink and saltines by me as every dose of my meds need food. I had applesauce and oatmeal so far to eat today and I made ice ginger tea to drink. My throat is still bothered by the intubation but I found that a tablespoon of honey every three hours helps so much with the soreness. I try to walk around frequently as advised by the hospital. The hospital called to check in on me just now.

When I was cleaning my drip, I took a pic. It looks like it is going to come out really nice. I will update you tomorrow as I am going to try to catnap some more.

Day 2

The theme for today is washing my hair and taking a bath was just a wonderful experience. My pain is still manageable, at worst a 2 when I need to take my meds. Swelling has increased around my eyes and cheeks. More black on the eyes. I can taste, smell, move my upper lip and feel the tip of my nose. Last night, I slept like a rock. Yawning is bothersome as it stretches the nose. I haven't noticed any swelling of the nose. Everything looks good. I find myself having to cough hard every once in a while. You get a build up of mucus (like having a cold).

The annoying dripping has stopped but I slept with a drip pad on last night as the warmth it creates around the nose seems to help me breathe better. I am able to breathe through my nose more when it has the warmth from the drip pad so that I am not mouth breathing all night long making my throat hurt. My appetite is not there. I eat because my meds require it. I made a large pitcher of cucumber water. I wish I could have a cup of coffee.

Day 3 - Colorful bruising, tired and cutting back on pain meds

Well it is Day 3 and I made it well so far. Today, I am tired. Still no appetite. Tried to eat food to make me "go" but nothing worked and I wound up having to use a suppository. That worked so I feel better. The doctor wants you to try to go within two days of the surgery. It just was not happening for me so I had to bring out the "big guns."

I am extending the time between pain pills and it is working for me. I space them about 10 hours and tomorrow I will try to go on Tylenol. I continue to take my antibiotics, arnica and steroids. Yesterday in the evening, my one very bruised eye got so swollen that it was semi-closed. I have one of those eye gel masks that I use when my eyes are sore and I had that in the freezer and was able to use that. My eyes have not tolerated icing well. That has cleared up today. I am taping my glasses to my forehead to watch tv. I am not comfortable putting in my contacts until all the swelling goes away. My nose occasionally drips a drip or two of a pink-yellow fluid but that is not bothersome.

Today, I have a lovely rainbow of bruising by my eyes. Lovely purplish-black, red, yellow and green. On my bad eye it extends a bit down the cheek as I think it is just draining down. Face is still puffy. All the swelling in making my eyes wrinkly. I am trying to put some moisture there so that I don't get after effects of the swollen skin.

Last night I gently bumped my nose. As I was sleeping, a little hair blew on it and in my sleep, I went to wipe it off the tip. Well, that woke me up for sure. OW! Otherwise, I am doing well and will update you tomorrow as to my journey to healing.

Day 4 - Every day gets a little better but recovery is certainly not glamourous. LOL

Today I stopped my pain meds. I am just taking extra strength Tylenols. My face feels tight and it loosens up after I take the Tylenol. I still am taking the steroid although today's dose is just in the morning and in the evening, the antibiotic and the arnica still.

Last night I had a bad sleep in the recliner so when my husband went to work, I went to bed propped myself up with pillows. Mistake. I feel asleep and sunk down. The angle of my head went down and my head is stuffy now. Also I had a lot of build up in the nostrils (dried blood) - I went through around 15 Q-tips with peroxide trying to loosen it so that I can get some air in there. I only wipe the front. I don't go digging. I had a closed rhino so there are stitches that will catch on the Q-tip if you enter the nostril. I don't feel the drip anymore but the evidence is there at the entrance of the nostril.

Appetite is a little more today which is good. I have gotten more adept at bathing myself and cleaning around the cast. So I feel normal. I guess today I would equate the feeling to having a severe cold. Your face is tight, you are congested and you are tired. So I am relaxing and just going with it.

Swelling and bruising are better today. Recovery is not glamourous. I am just glad that I am comfortable in my own skin (that unfortunately did not happen until I was in my 30's) that I can share the good, bad and the ugly. I try to smile in my pics because healing is not fun but in the end it will be worth these days of discomfort.

Day 5 - Things are much better

Today things are much better. The congestion is minimal, I have not needed to take a pain pill and I am hungry. All things improving. My face swelling has gone down a little. The bruising has minimized slightly becoming more greenish, yellow in some spots. I am not wearing my contacts, still taping my glasses to my head. There is a bunch of swelling around the eyes and sometimes if my eyes are swollen and contacts are in they get sticky and it causes more irrigation.

I am in good spirits. Tomorrow my internal splints come out and my cast comes off. It will be nice to get the cast off. The glue kind of melts and goes down your nose and little hairs/fibers in the air get stuck on it. That is how I banged my nose that night from the sensation of the hair on my nose.

Day 6- Doctor Visit

Today was my post op appointment. I was hopeful that I would get my cast off and splints out today. I took 1/2 percoset before I went and I was glad that I did. Peeling off the cast was a little painful. My doctor peels it. He does not do a gradual removal like you see some do with Q-tip to loosen it. He cleaned it off, felt the bones and then told me that my nose is still mushy and the splints need to stay in and the cast go back on for another week. [SAD FACE]

I did get to snap a picture of it and although it is just day 6, very swollen and not "set" yet, it looks fantastic. I was only alone with my uncovered, new nose for a minute. From what I can see, it is right on target to look like my wish nose but even better!!! I made my "wishnose" with a program on the web. Even swollen like it is, the appearance is much better than it was. I don't know about my breathing until these splints come out but I am hopeful that will be amazing as well. I will get to see where it is on Day 13. I made a progressive photo - before/wishnose/day6.

I understand my healing might take a little bit longer than others because I had injured my nose and this is a reconstruction septoplasty/rhinolplasty. I appreciate that Dr. McNeel is thorough and cautious as to its healing.

Day 7 - Some swelling today - no reduction in bruising

I have a bit more swelling today that I believe was caused by yesterday's cast removal, examination and re-casting. My nose did not want to be bothered and it is showing today. The inner splints are uncomfortable. I am trying to keep my nostrils moist with a spray here and there with nasal saline solution. That gives some relief from the splint discomfort. No change in my bruising and swelling around my eyes has not gone down any from the day before. Still black, purple and yellow. I don't even try to put on concealer like I did yesterday to go to the doctor because it actually looks worse when I do.

Days 8 and 9 - bruising almost totally gone on one eye - Swelling down 70 percent

I am healing and on the mend. One eye is significantly down on swelling and bruising. The other eye still needs time. Facial swelling is down 70 percent. I wish my cast was off and splints were out but I know that it is best that they are still on/in. it is a good day. I am feeling more myself.

Day 10 and11- One eye continues to be bruised - Swelling down about 80 percent in my face

Two more days until my cast off (hopefully). The tip of my nose is not as sensitive today. Hopefully, that is an indication that the bones are knitting together. I can move my upper lip but it moves weird, I think because of the inner stints. I can't wait for those to come out. I just keep on drinking my water, sleeping in my recliner (although it is not the most comfortable), spraying a spray or two of saline solution in the nostril to keep things moist, cleaning my nostrils with the Q-tip and peroxide solution at the very opening (I still get dried blood out). Some people on videos stick the whole cottony part of the Q-tip in - I don't. Just being overly cautious. The doctor can clean it more if it needs to be when he takes the splints out. I will update you on Wednesday with my big reveal. Thank you to all those who have offered words of support and advice during this long duration.

Day 13- Cast Off/Splints out! Horray!

MY VISIT: Today was my follow up after last week when the Dr. decided to leave the cast on for an additional time to help my healing. Since last time the glue on the cast was still super strong and hurt when he pulled it off, I took a shower and let the water drip down my fact so that it would be looser (and it was so that helped very much). I also took a Percoset that I had put on the side since I heard that removal of the inner stints can be painful (that helped as well). The removal of the stitches was not so bad but I developed a bump in my left nostrial. Most likely a reaction to a dissolving stitch which the dr. said should resolve itself. The pulling of the stitch in the nostril with the bump was annoying. Right now the bump feels like an annoying boogie, I want to put my finger in my nose but I know that is a No No. The glue was cleaned off (and keeps coming off) but having the cast on, has made my nose a little dry and I can see some red bumps so I will need to make sure I get on point with my facial care. As far as nose care, Saline spray to keep it most in the nostrils when it feels dry.

I will continue to sleep in my recliner for another week for my nose to get a little more settled.

THE RESULTS - I am very pleased with my reconstructed nose. Dr. McNeel says it is still very swollen and the results will refine themselves as time goes on. I can really breathe nicely (and I have super-smell now which is not always favorable LOL), it is straight and the bulbous tip is no longer bulbous. It is not a foreign shape to my face and it looks very similar to how my nose looked 20 years ago before I noticed my nose seeming more bulbous at the tip. My husband is very pleased as he was upset that my face would look different but he agrees that it looks very similar to when I was younger. I made a side by side comparison picture of the before surgery and today. I still have my black under the one eye, I put some concealer on that worked well for an hour before it faded. I do not need to post profile pics because my profile has remained exactly the same surprisingly.

I have a follow up in 4 weeks and will post my progress again at that point.

Its the 20 day mark for me!

I am 20 days from my surgery. Breathing is really good now. I still have the little bumps in my nostrils but they seem to be going down. Black eyes are but a distant memory. My swelling is going down very slowly. I posted a pic of me today and a comparison before/cast off/20 day pic so you can see that my nose is refining but very, very slowly but hey, it is much better than it was before fat and broken. LOL

My nose is still is experiencing dryness and peeling and I put moisturizer on it every night but I suppose it just needs to shed the skin from being in the cast for so long. I have read that I should not give my self any facial scrubs to try to exfoliate it so I have controlled myself. I continue giving myself a spray or two of the saline nasal spray. It helps my breathing. I will update you again at my next doctor visit (before if there is anything new or of note).

It has been 30 days! Progressing in small changes.

I can't believe that it has been 30 days since my surgery. My nose continues to be sore and I can feel the soreness and swelling down the outer sides of bridge of my nose and a little bit above it and down to the top of my nostrils. It has it's moments of swelling and moments of looking more refined (I have posted my 20 day/30 day comparison pic so you can see the small refinements that have occurred within the last 10 days).

Congestion is not a problem. I continue to give 5 sprays each nostril of saline to keep it moist in there (plus it is still a little sore and irritated so that helps) and I do ice my nose before I go to bed because it feels good. Sometimes at the end of the day, where I said my nose is sore along either side of the bridge, it feels sore and the ice helps to lessen it for my sleeping. I still have those bumps on the inside. They are getting smaller as well. I still try to sleep on my back, a tiny bit propped up but it is so hard for me the side sleeper!

I could not help myself and I broke down and used a biore nose strip. The clogging of the pores was getting too much for me. Although pulling it off hurt a little, there was so many clogged pores there that it was worth it but I do not recommend you do this until the 30th day or beyond (just because it was a little painful and made my nose swell fora little bit after).

Do people notice this new nose? Surprisingly no. I posted a before and 30 day pic as well. Some people know about my fall and that I broke my nose and surgery to fix it and they will tell me that it looks straight and natural (not different style from the original) for my face. The other people who did not know about my fall, just don't notice it at all. My family is the one that sees most of the

I have my first check up in two weeks and will let you know what is happening then. I look forward to all this swelling to go down or at least for the swelling not to come and go like it does.

6 weeks post op

I had my 6 weeks post op exam yesterday. The exam basically consists of the doctor checking on the healing of your bones and cartilage, checking on the healing of the inner nostrils and looking and feeling for the amount of swelling that still remains. Everything looks straight and nostrils are good.

My bones and cartilage are where they should be in the healing process (remember it is a little bit different for me since I broke my nose a month before I had surgery). The bones and cartilage will be hardened to my doctor's satisfaction in another 6 weeks so I have to be very careful still and, at that time, I will have another check up. Swelling is still there (more prevalent on the side that had more damage) but we all know it takes a while to go down so I am not concerned. The bumps inside the nostrils are resolving.

I still use my nasal saline spray and if I feel that congestion is coming on (its the season) he said I could use Afrin to help. I do still use frozen gel pack at night for five minutes before I go to bed and in the morning. I feel less tenderness when I do that (maybe it is psychological but I will continue to do it because it comforts me). My skin is still uber oily but the flaking of the nose has stopped.

Overall, my feelings at six weeks are that I am happy with how I am able to breathe (I still have super smell but it doesn't bother me anymore) and I am pleased with how it looks so far.

It is my two month mark

It has been two months and my breathing is very good. I do not have any bouts of stuffiness and I keep my nose moisturized with the nasal saline in the evening before I go to bed. My nose is still sore at times and I do not have the hardness at the tip that some people complain about. Any refinement is slight and not really noticeable from the look of 1 month post pic to the two month mark.

3 month post mark

It has been three months since my operation. Patience is key with healing. My nose is looking really good (even when it has its swelling going on). I have posted two pictures from different times of the day so that you can get an idea. I continue to use nasal saline to clean my nose but I stopped using ice every once in a while. I am just going to let it do its thing.

Sometimes my nose looks a little crooked to me and then the swelling changes and it doesn't. It still has a bunch of healing to do. You still cannot press on it without it being a little painful. The bones and cartilage are still knitting I suppose.

As a whole, I am happy. I breath well. The bumps inside the nose have not gone totally away but they do not obstruct my breathing.

I have reached the 4 month mark!

I am feeling really good. Breathing is incredible and, knock wood, I haven't had a cold in these 4 months. I still saline my nose everyday. I had my last Drs. appt last week. He said all the bones are starting to harden and that all is looking good. He pretty much believes that where I am at is what my nose will look like from this point forward. He asked if I was happy. I said generally I was but I would have liked the tip just a bit more narrow and he said that could work out because the tip is the last to reverse from the swelling process. I like the contour of my nose. I think it fits my face much better. Believe it or not, my nose did look like this 20 years ago. As I said I noticed in my 30's, my nose getting more bulbous at the end. So I am happy with my outcome. I have posted a healing progression picture noting the subtle changes for those who are interested in what might happen while your nose is still developing. I plan to keep posting progression for 1 year.

Today makes 5 months since the surgery (more refinement)

All and all things have been good this month. My breathing is excellent. It is almost like having an extra nostril to breath out of. That is the difference in airflow. I continue every other day to irrigate my nose. So far I haven't had a cold but my nose will randomly drip now and again. This only happens occasionally and is not bothersome but it happens. There are no sore spots anymore. I believe this month I have had a little more refinement in the tip (although day to day, I still experience slight changes). I posted a side by side of my 4 month and one taken yesterday (my 50th Birthday) and 5 month mark. I am happy with my nose. Yesterday, I was going through old photos and just looking at the difference was amazing.

I am now at 6 months post op

There have been no noticeable refinement or change for this month only the fact that the swelling times are getting less and less. As I said before, if you go for a drink after work, the alcohol will give you a little swelling so be prepared. I have posted a picture. I still love my results. I love that my nose is not too different for my face. People only notice how really good I look not that something is different about me.

7 Month Mark

I have posted an updated collage for those who wonder what the healing process looks like from month to month - so I have updated it to this point. Still swelling on the cartilage close to the tip comes and goes but it isn't as often. My breathing is still very good. I have kept up with nasal irrigation. I have become accustomed to having my sinuses feel "clean" and moisturized after using the nasal saline. I still like my result but I am also picky on some days and wish my surgeon had went a bit more drastic and some days not. My love/like/picky relationship with my nose is not enough to consider any revision. All I can say is that I do not hate my nose in photos anymore.

I am 10 months post op

You know, it feels like forever ago that I had my surgery. I removed most of my pics (sorry) but I bumped into 2 of them on other surgery sites so I just thought it best to streamline with one pic. Showing day before surgery, 10 months and cast off so you get an idea of the before and after and the bit of refining that takes place between the time the cast is off and a few months later.

I believe my nose is pretty much where she is going to be. I still have occasional swelling (from heat, alcohol) but a little ice on the nose for 3 minutes in the am takes care of that. I still have the occasional mystery nose drip but that goes away as soon as it came.

Is my nose super perfect? No. I would have liked it a bit more pinched at the end with a slight swoop for the profile. I realize that my doctor was working with a recently broken nose that had a bunch of damage to it and wasn't optimal to work on. All things said, I really like the improvement and I feel very confident with it.

Would I do a revision to tweek it? No. But if I notice over time the tip starts to widen as I age, then the answer will be yes.

Am I glad that I did it? Yes.

Would I pick the same surgeon? Yes.

It's been a year

It will be a year since my surgery in two days but I thought I would update now while I have the chance.

While I think we all hope for mounds of further refinement once we get our casts off, although there is further improvements, they slow down after a certain period.

After a year my nose still swells and unswells. It has its good days and its puffy looking days. I don't know why that is. There are known things that make it swell like wine or heat but sometimes I don't know why it is swollen. It is mostly swollen in the morning. The swelling can sometimes make it look off center and slightly crooked.

On important days when I want to look my best and I wake up and find my nose swollen, I ice it which seems to help. Since I want to keep my reviews as real as possible, I did not ice it and left it. It is about average today and not swollen in this comparison pic.

Overall, I feel better with my nose. I don't loathe pictures of myself anymore and I don't wear as much makeup anymore. Feeling that my nose was fat and tremendous, I would wear a bunch of eye makeup to try to draw your eye from my nose. Now I don't. I don't even feel self-conscious walking around with no makeup.
Atlanta Plastic Surgeon

Dr. McNeel is a top rate doctor. He listens, understands, makes suggestions and doesn't rush things. These are all the qualities I appreciate. It is a hard decision to pick a surgeon to work on any part of your face especially your nose as it takes a certain amount of artistry. I am glad that I did my research and I am glad to have found Dr. McNeel and would recommend him.

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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