One of the most popular procedures in cosmetic surgery, rhinoplasty is more commonly known as "the nose job." For those considering the procedure, it's important to know your options and everything the procedure entails. Here are some of the most crucial details, as told by three experts:
Patients can opt to have a filler rhinoplasty that involves injectables instead of surgery.
The initial step for any patient considering a rhinoplasty is to determine its nature. For a drastic shift in the nose’s aesthetics, there’s actual cosmetic surgery, but for less severe changes, there is the filler option. Filler rhinoplasty entails the injection of a hyaluronic acid gel to augment the nose, says Dr. Windie Hayano of The Skin Inc. “It is injected using a needle or cannula, depending on what your doctor is more comfortable using.” In these cases, a stiffer filler is used to provide the nose with more structure.
The procedure, generally safe, lasts only a few minutes. “The topical anesthesia will probably take longer,” Hayano adds. These fillers can balance the overall look of the entire face, and not just the nose. The upside of this is that it can last at least two years and any mistakes can easily be altered. “It cannot, however, fix alar rim deformities,” she advises, referring to the common abnormality observed after rhinoplasty.
Your doctor will need to know everything.
Before the actual procedure, doctors must ask their patients standard queries, such as medical history, current medication, and lifestyle. For fillers, Dr. Windie does a physical examination of the patient “to determine if the patient is a good candidate for the procedure. Not everyone is a good fit for a filler injection and since this is not a surgical procedure, there are limitations as to what can be achieved.”
Dr. Cecilia Ramos-Bernad of Dr. CRB takes her patient’s daily activities into consideration, saying, “I need to know if they drink, smoke, dive, or do other contact sports, among other activities.
Over at the Belo Medical Group, Dr. Vicki Belo and her staff do routine checks on whether there are any functional problems such as obstruction of breathing. “It is in our protocol to ensure that there is complete and full disclosure of the patient including information on previous surgeries because structures may already be altered,” she says. Likewise, she encourages her patients to ask all the questions they need answers to during the consultation so that trust and confidence strengthen the relationship between patient and doctor.
There are different types of materials used in rhinoplasty, and some are more natural than others.
It pays to be familiar with some of the terms associated with rhinoplasty before consulting your doctor. Just as fillers were mentioned, there are other types of rhinoplasty. Goretex, used mainly in cardiovascular surgery, is a synthetic material that comes off as more expensive than silicone and a bit more difficult to carve. Cartilage, or bone, is considered the most natural. Dr. Cecilia identifies cartilage or Goretex as the most effective materials. She says “each case has a different requirement and can require a mix of two or more of these.” Belo advocates a natural-looking nose and, with their nose enhancement program, recommends “that the best materials are still what you call “autologous” or from your own. The rib cartilage gives the best support for nasal framework.” The Belo Medical Group also sources materials from ear cartilage, fascia, dermis, and fat when needed.
Before and after surgical rhinoplasty at Dr. CRB
It’s impossible to replicate your favorite celebrity’s nose.
According to Dr. Vicki, although the surgeon takes note of the patient’s goals, the patient needs to be realistic and to know that he or she cannot have the exact same nose as a favorite celebrity’s. “No two noses are alike. Every patient is unique and factors such as skin texture, thickness, configurationof the anatomy, and facial structure will play a part in making the nose special and specific for every individual.” She adds that those who fear the “surgical look” need not fret because she and her team aim for natural-looking results.
Belo Medical Group presents its proud rhinoplasty patients
Results become evident about two weeks to a month after the procedure.
For the first week, patients usually wear a cast and some swelling is evident. Dr. Cecilia says the swelling takes about two weeks to a month to fully subside, depending on the patient’s individual healing process and the type of surgery.
Meanwhile, Dr. Vicki says that while the look is far from final afterward, her patients may already see an improvement a week after surgery, when swelling has gone down. “In six to eight weeks, the nose looks quite natural already,” she notes, but the healing improvement will continue from six months to a year.
Patients cannot have repeated rhinoplasty procedures.
One of the common misconceptions about rhinoplasty is that its patients can go under the knife for multiple procedures. Since there is already an evident change in the anatomy of the patient, it becomes dangerous to undergo it again, aside from the added scarring from repeated surgeries.
Doctors have a term for patients who are never satisfied with their surgeries. It’s an actual disorder.
There are some cases of addiction to plastic surgery. When does one know when to stop? Dr. Cecilia says the satisfaction with cosmetic surgery is completely subjective, but if a patient is constantly unsatisfied with the results of his or her cosmetic surgeries, it may be a symptom of Body Dysmorphic Disorder, or BDD. According to the Anxiety and Depression Association of America (ADAA), those suffering from this mental health disorder have trouble focusing on anything other than their obsession with their appearance, leading to low self-esteem, social anxiety, and other disorders such as depression or eating disorders. Most doctors will identify these warning signs and alert the patient to seek proper treatment.
There are various risks but if you follow your doctor’s advice, you should be fine.
The outpatient procedure at Dr. CRB takes about two to three hours. The cast must be worn for five to seven days afterward to set the nose and post-procedure care must be followed closely. Patients must keep the area safe, clean, and protected during the healing process. It is at this time that patients may be prone to infections. If the nose is severely impacted during the first few months, it may cause problems for the implant.
For fillers, it’s important you get a trained doctor to do it, says Dr. Windie. “One of the biggest dangers of this type of rhinoplasty is a filler getting into the blood vessels during the injection. This can lead to necrosis of the nose, blindness, and even stroke.”
A good doctor sees to the individual care of his or her patients. Dr. Cecilia checks on her patients after the first few days of surgery. “The important things are sleeping centered and elevated, doing post-surgical care such as cleaning the area, taking and applying the prescribed medication, and doing no strenuous physical activity for a while.” She also advises looking down for the first few days.
Belo doctors do a routine care call on their patients, and their doctors' lines are always open to any questions or concerns about the healing. They give their patients a nasal spray to keep the nasal lining moist and ask their patients to come back in five to seven days for follow-up and suture removal.
You’ll have to give up alcohol and medication.
Before the procedure, patients are advised to stop medication to prevent bruising, as well as to give up alcohol and blood thinners, as these will affect the success of the surgery. For those taking the filler route, Dr. Windie says it’s important the doctor knows of any aspirin, Vitamin E, or medication intake that might cause bleeding. The patient must also not have any existing infection or inflammatory condition.
Anesthesia is involved.
Anesthesia is necessary in this procedure. Topical anesthesia usually used in filler procedures, while a local anesthesia is essential in rhinoplastic surgery. Doctors suggest that sedation will aid in both the patient’s comfort and the doctor’s performance. Dr. Vicki shares that supplemental IV sedation makes the patient more comfortable.
The surgery comes with downtime, some swelling, and possible scarring, so plan accordingly.
Swelling is common in this type of surgery. Belo says the maximum swelling occurs on the second or third day. “It may also extend near the eyes and start to subside from there.” For those who worry about scarring, Belo advises patients that each body is different and reacts differently to the healing. “Scarring can vary from patient to patient,” she adds, and it is more common for those who’ve had several surgeries. However, Belo assures patients that the doctors she works with always see to it that the scars are well hidden, placing them along skin lines and shadows.
*This story originally appeared on TownandCountry.ph. Minor edits have been made by the Preview.ph editors.