What To Expect From My Rhinoplasty Consultation?
Before having a nose job done, you should have a one-on-one discussion with the plastic surgeon you chose about all your concerns and expectations. Prior to consultation you can contact the doctor’s office by phone or email, and ask to get more information about the fee range for rhinoplasty and cost of an initial consultation. Make a list of questions you have for the surgeon - anything that is related to your future surgery, for example – the doctor’s experience, training, board certifications, techniques or other issues that concern you. Gathering some pictures of the nose that you would like to have (and would not like to have) from magazines, the surgeon’s website or other sources, keeping your goals realistic, would also help to move forward your discussion.
During consultation, details of your past and present medical history will be thoroughly taken. The surgeon will also explain to you all details about the procedure and available options - the technique he will use, the facility (should be accredited), the costs, the recovery process, side effects of the anesthesia, preventing infections, the risks and potential complications of a nose surgery. Surgeons may suggest that patients can enhance their overall look by adding another procedure, for example a chin implant if the nose sticks out of the face and makes it look imbalanced. Computer simulation technology can be used to give you an idea of how your nose and your face will look like, based on your goals you determined earlier. The surgeon will explain instructions you’ll need to follow both before and after surgery to maximize the chance of quick and full recovery.
If you are healthy, if you don't like the shape of your nose, and you aren't motivated by whim, you're probably a good candidate- provided that a qualified nasal surgeon sees the same problem that you do and feels that he can improve it surgically. If you became obsessed with a minor flaw in your nose, don't be surprised if the nasal surgeon refuses to operate. You may be seeing something that just isn't visible to anyone else, including a potential surgeon. You may be envious of a nose you've seen in a film or magazine and want it for yourself. Creating an exact duplicate of a nose from a magazine picture is almost always impossible, but this doesn't mean the surgeon won't be willing to operate. However, most surgeons are not eager to operate on a patient with unrealistic expectations.
Various physical issues can prompt you to consider cosmetic nasal surgery or rhinoplasty. If you're like most people who desire a nose job, you probably inherited your problem from your family and the shape of the nose for the most part is congenitally determined from birth. If you broke your nose in the past, you may have developed a post-traumatic deformity or nasal bump. If you fractured your nasal bones and your nasal septum, your nose may now be crooked and you may have difficulty breathing. Insurance coverage may pay for a portion of the procedure that is medically necessary based on x-rays or a CT scan. Insurance never pays for cosmetic procedures. Ethnic rhinoplasty has also surged in our society. In the United States, Dr Rizk sees a multitude of noses from around the world from different ethnicities including asians, middle eastern patients, Europeans, Africans, and Hispanic noses.
Other reasons patients request rhinoplasty may be that the nasal tip looks a little different from one side to the other. One side may be lower or higher or slightly twisted or have a protrusion not present on the other side. Because the external shape of the nasal tip follows the shape of the underlying cartilages, your nasal tip shape can be improved if the cartilages can be straightened or made more symmetrical. This problem is probably congenital, but may also be the result of an injury. Crooked nasal tips can be improved significantly, but may not be 100% perfect because cartilage has a multitude of curvatures which may not be completely corrected. Cartilage grafts, tip grafts, or even very small implants may be required in order to obtain maximum correction.
Crooked noses occur when your nasal bones or your nasal septum (or both) do not sit symmetrically in the midline of your face. This condition can occur if you inherited it from your family, suffered a small birth injury, or broke your nose or septum in a later injury. You usually need to straighten your crooked septum as well as your nasal bones to obtain permanent correction. Doing only a rhinoplasty-without correcting the deviated septum- almost always results in some persistent crookedness.
Another reason a patient may request a rhinoplasty is due to excessive nasal tip projection. The nasal tip projection is the distance that your nasal tip protrudes out from your face. If your tip projection is abnormally large, your entire nose will look too big. If you have this problem, you inherited it. This problem doesn't develop after injury. Fixing this problem involves reducing tip cartilages or rotating a drooping nasal tip.
Some patients request rhinoplasty for excessive nasal width. If you think your nose looks good in profile, but don't like the thickness or width of your nose, you may wish to have it thinned. If the skin on your nose is thicker than average, your surgeon may not be able to thin it as much as you want. If the extra width is due to wide nasal bones, your surgeon can probably make a significant improvement. Wide nasal bones can usually be surgically fractured inward. They can also be narrowed by rasping (filing) your bone. Remember, that very wide nasal bones can never be made very thin; only thinner. Having thick nasal skin requires other maneuvers to thin the skin and place grafts to obtain good definition. You have to ask your surgeon how much experience he/ she have with ethnic or thick-skinned noses.
Some patients seek rhinoplasty because they are unhappy with the overall size of their nose. If your nose is too big or too small to fit your face, you may find a surgical solution that gives you the proportions you have in mind. Some noses are just too large in all dimensions and are out of proportion to the face. Very large noses can be reduced significantly, but not to a very small size. There are real limitations to the changes that can be made. The surgeon can narrow the tip, reduce overall nasal width, lower the nasal profile, narrow the nostril base width, reduce the size of the nostrils, reduce the projection of the nasal tip, and shorten the overall length of the nose by rotating the nasal tip higher so the tip doesn't hang too low toward the upper lip. Not all patients need to have all these surgical steps performed to correct a large nose, but all are available if needed.
If a nose is too small, you may want a larger nose to be in better harmony with your face. A small nose may be congenital or may be due to an overly aggressive previous rhinoplasty or it may be due to an accident/trauma. For example, you may want a larger nose if an accident has crushed the bridge of your nose or if you're Asian with a very low nasal profile. Whether you're looking to correct an injury or improve on what nature gave you, your surgeon has various techniques and materials that can be used to make these corrections. Your own cartilage can be harvested from your nasal septum, or your ear and is called an autologous graft. Bone can also be an autologous graft. Various types of implants made of artificial materials may also be used to make your nose larger. Dr. Rizk will discuss the advantages and disadvantages of the various implants versus your own cartilage.
If you have an excessively long nose or an overhanging nasal tip (where the tip of your nose hangs over your upper lip), you probably inherited it. Rhinoplasty surgeons measure the angle between the upper lip and columella; this measurement is called the nasolabial angle. The ideal angle for women is 100 degrees and in men is about 90 degrees. In general, long noses are totally correctable. Surgeons can shorten noses by reducing the length of support cartilages within the nose, by shortening the nasal septum, by occasionally anchoring (suturing) the columella to the end of the septum, and by excising skin within the nasal vestibule (the area inside the nostrils). Except under unusual circumstances, noses are almost never made smaller or shorter by removing external nasal skin.
If you are unhappy with a bump you were born with or developed after an injury that is a very correctable condition A nasal bump or hump is caused by enlargement of your nasal bones You may be born with a nasal bump or develop one after an injury. You may have a hump in combination with any of the other nasal problems discussed as well. If a nasal bump is your only problem, the success rate of surgery is excellent with the endoscopic 3d technique Dr. Rizk will recommend which has a very rapid recuperation rate.
If your tip is too rounded, too bulbous, or too broad, you can blame your parents and grandparents because these problems are usually congenital. Surgeons can achieve dramatic improvements in the external tip shape by modifying the tip cartilages. Making your round nose as thin as you want depends on skin thickness and the skill of your surgeon. Sometimes, the culprit in thick nasal tips is thick skin, and if that's the case, improvement requires specialized grafts and thinning the skin as well in selected areas.
Lastly, you may seek a rhinoplasty consultation if you are unhappy with nostril width. You may find that the base of your nose is wider than you would like. This occurs more commonly among some ethnic groups such as Latinos, African Americans, Middle Eastern patients and Asian patients. Some Greeks and Italian patients also have thick skin. Your surgeon can remove a wedge of tissue at your nostril bases in a procedure combined with your rhinoplasty or as a separate procedure. The technique can narrow your nostril bases, reduce the length of your nostril sidewalls, and make your nostrils smaller, depending on the design of the wedge excisions.
FINALLY, WHEN DOING YOUR RESEARCH ON WHICH SURGEON TO CHOOSE, MAKE SURE YOUR SURGEON IS A DOUBLE BOARD CERTIFIED FACIAL PLASTIC SURGEON WHO DOES A LOT OF RHINOPLASTIES AND CAN CORRECT BOTH INTERNAL AND EXTERNAL NASAL DEFORMITIES AS THEY, QUITE OFTEN, ARE INTERRELATED.
At the end of your consultation, you want to have a clear understanding of what the surgeon has recommended for you.
Dr. Rizk will sometimes do computer imaging as part of his consultation, especially from the profile or side view. However, sometimes he will not do computer imaging for revision rhinoplasty or from front view as it is too inaccurate. Dr. Rizk will usually discuss his surgical plan on sheets with diagrams of nasal anatomy only if he feels you are a good candidate for surgery. If Dr. Rizk does not feel you are a good candidate for rhinoplasty or revision rhinoplasty, he will obviously not discuss specifics of a surgical plan.
For more information about Rhinoplasty Candidates, click here.