Rhinoplasty basically is a procedure performed on the nose as a cosmetic procedure. It could also be added or additional to a rhinoplasty, septoplasty and other procedures that are done or performed to help the function of the nose, but per se, when we do a cosmetic nose surgery, its function or its use is only to enhance the appearance of the nose, so if there are any specific concerns that you may have regarding your breathing or function of your nose because it is the function of the organ, obviously you need to discuss that with the surgeon who would be coming to speak with you, one our associates surgeons or myself. Make sure you address that issue, make sure you bring it up and make sure it is documented, that it is a concern to you specifically, sometimes we need to have one or two surgeons work together to address those issues at the time of surgery and if that may be the case, then we need to know about it ahead of time.
Nasal cosmetic surgery or rhinoplasty can be performed in two different ways. There is an open technique and there is a closed technique. Most surgeons may be about, 80 to 85% of the surgeons only perform the closed technique. The closed technique is a simpler procedure, is a faster procedure with no scarring on the outside, but downside that it is a procedure that depends only on sense of tactile sensation or feeling of, you know, the sensation between your two fingers, rather than any visual help from, you know seeing exactly where you are operating, so it limited, and because of that, because it sort of is by "guessing" to trying to create a semester between one side to the other, there is a basically a chance that there may be a slight imperfection. Of course, in an experienced surgeon's hands the chance of imperfection is very minimal and of course you know in case of surgeons at the New Me Surgical Institute because we do a high volume of cosmetic surgical procedures on the nose, it is quite a safe procedure to be performed. However, certain patients really are not good candidates for a closed rhinoplasty technique and certain patients who have had closed rhinoplasty surgery technique by other surgeons outside of New Me Institute that may not be happy with the results are really candidates to have an open technique.
The open technique differs from the closed technique in that instead of just having scars on the inside or incision or cuts on the inside of the nose, also has a very small incision on the columella which is a portion of the nose right here in the center and this scar is usually invisible after it heals. It is very, very, very hard to ever see it even if you are looking for it. It heals incredibly well. So, for that little incision, you get a tremendous benefit and the benefit is that the surgeon can actually lift the skin flap completely off and be able to exactly examine the cartilage that creates the tip to know exactly what needs to be done and then as he is doing these techniques, he can measure using a caliper by the tenth of the millimeter as to exactly how much is being removed from one side versus the other, so that there is a complete 100% symmetry. In certain cases, patients actually need cartilage added to their nose and so with a closed technique it is very hard to really see exactly where the cartilage needs to be placed and then fix it in place, so with the open technique it is much more precise.
This technique, the open technique was a common technique to be performed in the, you know in the past, may be about 50 to 60 years ago, and then over time, it lost its glamor because people where trying to minimize scar, but recently, in the last 15 to 20 years in the post specialty trainings and fellowship trainings has become very mainstream again and it is actually a sort of a deviation from the previous old technique. It is a much more conservative and safe technique now and it is something that you know, it requires extensive training and again our surgeons at the New Me Surgical Institute are highly trained in this technique and it is now main stream in most practices. It requires a very tiny scar, but then the opening, the exposure that it gives the surgeon is excellent. It gives you an opportunity as surgery to perform an excellent procedure very precise and then give the patient really the results that they are looking for and under direct control rather than just guessing by sensation, so the bottom line is the technique of the closed or open depends on the your particular needs. There are no cookie-cutter techniques when it comes to nose and this is true more than any other procedure. The result of a nose job is unbelievable. The effects of the nose job is unbelievable, both from the standpoint of just pure cosmetic, also the rejuvenation. It is a central organ in the middle of your face. It is an organ that really people are seeing all day long, everyday, everybody in contact with you is looking at it. It has a tremendous effect on how you appear and the idea with the nose is generally not to be noticed after we do a nose job. In other words a good nose job is a nose job that nobody even ever notices. So, if we do a nose job that is really perfect, then your nose would not be noticed organ in the middle of your face, you know, it would be something that blends in with the rest of your face and gives you basically a very nice natural appearance and fits in very well with the rest of your facial, you know, structures. And that is what we are really shooting for. What I don't recommend is giving you a nose job that really looks like a nose job, meaning you know, it looks perfect on its own, but then it does not fit with the rest of your face and that is really the difference between what the New Me Institute offers you and what may be other places that you have visited may actually be addressing. The bottom line is what we want you to understand is, you are the boss, you tell us what it is you want, we will very try hard and very much to really give you the results that you are looking for. We do encourage you to bring us pictures of noses that you like. We will tell you specifically if those noses will be possible or their appearances will be possible with the structures that you have. The bottom line is, nobody's nose is the same anatomy of the nose in different individuals differs. There are different noses, different anatomies and you know it is not possible for, you know, people to have any type of nose that they like obviously, you know, if you don't have enough cartilage, if you have too much cartilage, if you have too much bony tissue, if you have too much skin, if you have too much, you know, fatty tissue in the area, you may not be able to have the nose that you personally want, and the surgeon would actually need to explain that to you, so that you understand. The bottom line is we want you to be as they say on the same page with us, you know, we want to make sure that you comprehend what is possible for you and what isn't possible for you and then decide if really what is possible for you is what you would like to have and then our goal is to give you that result. Sometimes, you know, what we try to do is, we try to be more conservative and the reason for that is, you know, it is easier to remove tissue but it harder to put the tissue back, so we tried to be very conservative and we give you the most conservative outcome for your procedure that we possibly can and we try to be right on them as we say you know just bottom line is we want you to have an excellent outcome. Our goal is to surpass your expectations, so please make sure that you feel comfortable with us. Again, the key word here is comfortable. Ask any questions you have and make sure you address any issues you want. Tell us what your real goal is, what it is that you really want to see as far as your nose is concerned. This is the one specific procedure that is so unique, everybody wants a different thing, you know, I have consulted hundreds and hundreds and hundreds and hundreds and hundreds of patients and I if could tell you two patients who wanted the exact same thing, I couldn't. Because the bottom line is you know everybody's idea of beauty is different, idea of a nice nose or a perfect nose is different. Everybody's facial structure is different. Everybody's anatomy is different. So, what you want u can have and what the next patient wants and can have are completely different and what really makes the difference is communication. Make sure you feel free to communicate with us, bring us the pictures you want and then we will sit down together and discuss again and again until such time that we are completely clear as to what is possible and then our job is to go into the operating room and give you as close to a perfect result as we can.
The basic preoperative course of rhinoplasty is similar to any other procedure. The goal is to minimize any risk for you. Depending on your age, there are certain issues that may apply to you and not to next person, but the bottom line is three to four weeks before the procedure the patient needs to stop smoking or any type of nicotine use, alcohol, drugs, and aspirin, Motrin, herbs of any kind, vitamins of any kind. Basically, nothing except food and prescribed medication.
The other is that if you are taking any regular prescribed medications you need to discuss that with your internist and also our family doctor and also with the surgeon, myself, or myself associates who have been trained by me specifically about those and make sure that those are safe to be taken prior to surgery. The night before the surgery obviously you are going to stop eating and drinking anything from 12 midnight on. You need to have someone to come with you to the operating room or the surgical center, the day of surgery, in order to take you home and they would monitor you that night and bring you back the next day.
Postoperative course will include taking of antibiotics and pain medications basically and that you need to discuss with the nurse and/or doctor on the day of surgery but the bottom line is you will be taking the antibiotics until such time that you have taken all of them and if necessary the doctor will ask you to continue or get a refill on the antibiotics. The pain medications, basically take the absolute bare minimum number of pain pills that you are absolutely required to take to control your pain level.
Packing is one of those issues that most patients really fear in rhinoplasty, most patients don't require packing, it is somewhat uncomfortable to have the packing in place. Some patients may generally at the most is 24 hours postoperatively we remove the packing. The other is splints; the splint is placed in almost all the cases, just because it ends up helping healing and most patients will have it at the most for 10 days to two weeks. It is a small cast material or a metallic splint. It looks okay and bottom line is it does help the outcome and really is the necessary part of the procedure. The bottom line is again, just along with anything else we have discussed in this whole series of tapes that you may have been listening or watching, the bottom line is we want to make sure you understand that New Me Institute is about making you comfortable. Feel free to call us any time. Don't hesitate. Ask as many questions as you need to. I want you personally to feel comfortable with us. If you have to ask again the same question you asked before, you are welcome to do so, as many times as you need to. Tell your friends, the people that are going to be watch and helping you that they can call any time 24x7 if they need to ask a question in order to give you a better care. We want you to have the best possible outcome. Our goal is to serve you, to give you the best result, to give you the most natural outcome we stand with you here, all through any procedure you have with us and our goal is to give you the best possible result throughout your care at the New Me Surgical Institute.
Thank you so much. |
