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Considering a Nose Job? Ask yourself these 5 key questions

Rhinoplasty, better known as a “nose job”, is performed to alter the size and/or shape of the nose and is one of the most commonly performed types of plastic surgery. An estimated 77,000 people got rhinoplasty in 2010; while some simply didn’t like the noses they were born with, others needed corrections to previous surgeries or accidents that damaged their noses.

Before opting for any kind of cosmetic surgery, there are some key questions you should ask yourself before going under the knife.

Am I healthy enough to get plastic surgery?

Cosmetic surgery has its risks just like any other type of surgical procedure. The risks are even greater in people who have preexisting health conditions. That is why it is wise to take your health into consideration before getting any type of cosmetic procedure. Your plastic surgeon may require that you receive clearance from your physician.

Have I considered the alternatives?

There are a number of ways you can improve their appearance without getting rhinoplasty. Trying a new hairstyle or wearing makeup are two of the many ways to improve your looks without going under the knife. Makeup tricks can also change how your nose appears, and some cosmetic injectable fillers can alter the appearance of your nose temporarily without invasive surgery.

Am I doing this for myself or to please others?

Far too many women get cosmetic surgery to conform to society’s standard of beauty or to impress someone else. While a nose job, or any cosmetic surgery, can improve your appearance and life, it’s important to do it for the right reasons. Do it for yourself, not someone else.

Can I afford this procedure?

Nose jobs can cost thousands of dollars, depending on the surgeon and the complexity of the procedure. Because most nose jobs are elective, they aren’t covered by insurance. While you may be able to setup a payment plan with your surgeon’s office, you may be expected to pay a significant amount up front. Note that many med spas and clinics accept credit cards, so that’s always an option as well.

Can I afford to take time out of work and school?

In the end, it’s worth it, but in the meantime, you will be sore after your nose job. Patients are expected to stay home for at least a week after surgery and are advised to avoid strenuous activity. Make sure you can afford to miss work or school during this time period and that you have help with daily tasks, such as child care and household chores.

Once all the above answers are “yes” make sure you choose a doctor who specializes in rhinoplasty. Ask your doctor of choice, how many they perform per year, look at their before and after photos and consider computer imaging to make sure you are both on the same page.


Copyright 2012. As licensed to Pearlman Aesthetic Surgery. All rights reserved

3-D Imaging for Rhinoplasty and Facial Rejuvenation

I’m thrilled to announce that we now have the latest in imaging: a Vectra-3-D

The difference between men and boys is the price of their toys. I have a fabulous new “toy” for my office. It’s called Vectra 3-D imaging. This system uses 6 cameras that take simultaneous photos of your face to construct a 3-dimensional virtual model. This model then can be morphed, like the now old fashioned computer imaging, but with fewer yet more sophisticated steps. What makes this even cooler are the 3-D glasses that give a stereoscopic 3-D view of these images. Here are the main advantages of 3-D imaging;

  • Faces can be rotated and viewed from any angle imaginable
  • Morphing is performed on a 3-D image so it doesn’t need to be repeated for each view as is necessary with 2-D imaging
  • Actual volume changes, such as how much to remove from a nose or add to a cheek or chin are instantaneously available
  • Far superior for facial surgery such as facelifts, facial implants and facial fillers than 2-D imaging, which I felt was great for noses and chins, but not much else

Another advantage of the Vectra 3-D system is the many analysis tools available. Facial contour changes can be evaluated by color changes and actually measured, similar to a geographical contour map. Since I have an academically active practice and like to analyze everything we do to assess improvement and maximize patient results, we can actually measure volume changes following facial fillers. To see a consultation with 3-D imaging please check out this link:

 Our Facial Plastic Surgery fellow is currently conducting a study on facial fillers and assessing volumes placed with aesthetic improvement. We want to see how much it takes to get the “Wow” in Wow cheeksTM.

3-D Facial Imaging adds an exciting new tool to facial assessment and is a wonderful device for evaluating facial changes that may and do result from surgery and facial fillers.

Nasal Fracture, Broken Noses in New York

What should you do when you break your nose?

This sounds simple but even some doctors don’t know how a specialist in facial plastic surgery treats broken noses. First, there are only two true emergencies when you break your nose. First and most obvious is a non-stop nosebleed. Obviously, get to the nearest ER or specialist and have them treat your nose, which likely requires topical decongestants and/or nasal packing for a few days.

The other emergency that rarely occurs when you break your nose is called a septal hematoma. The same very delicate blood vessels in the septum that may bleed can also bleed under the “skin” or mucosa of the nasal septum. This causes the septum to blow up like a balloon on both sides of the nose with blood that can’t get out. If this blood isn’t drained (by a specialist), it can cause the septal cartilage to get weak and collapse over a few months time causing a saddle deformity (severely scooped nose). So, if you have trouble breathing after breaking your nose, the inside needs to be checked for a hematoma, preferably within 24 hours.

Now to address the nasal bones: If you do break your nose use ice right away and keep in place, 20 minutes on and 10 minutes off for the first two days. If the only problem is shifting of the nasal bones to the side, they can be repositioned by a minor surgical procedure called a “closed reduction.” Unless you are seen right after trauma, the nose is usually too swollen to do this right away. However, after about two weeks, the bones start to heal so the ideal time is somewhere between three days and two weeks. Beyond two weeks, we may need to wait two months for the bones to fully heal before re-breaking.

If there is a simultaneous deviated septum, cartilage heals differently. I prefer to wait at least six to eight weeks before treating the crooked septum. So, if both a nasal bone fracture and deviated septum are present, I delay fixing the broken nose for the stated minimum of six to eight weeks then re-break it when I fix the septum so the patient only has one operation instead of two (closed reduction then septoplasty).

As for a rhinoplasty after sustaining a broken nose, I prefer waiting at least two to three months to let everything heal and settle if I we are to do more than straighten the nasal bones and a deviated septum.

Treatment for a broken nose can be a simple surgical procedure. But if not treated properly, the consequences can be more severe.

Teen Rhinoplasty as a graduation gift in New York

Crain’s New York June 7-13: Pomp and Rhinoplasty honor grads

New York, NY. This week I was quoted in an article on plastic surgery as graduation gifts in Crain’s New York. I won’t hassle you with the link since it will prompt you to sign up and create a password etc (even though it’s free). To summarize, it talks about high school students getting cosmetic surgery, mainly rhinoplasties as graduation gifts. These aren’t really the surprise type of gifts that we usually associate with graduations. These are usually more like parents who are giving in to their teenagers who likely have wanted this surgery for a number of years; and now the parents have finally given in. High school graduation is a very good time for this surgery. As long as there is 3 weeks between surgery and going off to college, they are meeting people with their new nose, and often new confidence. Of course it takes a full year to see the final nose, but even at 3 weeks the nose is looking better than prior to surgery.

Graduation is a transition for educational, emotional and even physical maturity. Why not start out on the right foot? It has been proven in numerous psychological studies that improvement of facial appearance goes a long way in instilling and building confidence. What better time than when a teenager is moving on to a new environment about to make new friends and wants to put their “best face” forward. For more information on teenage rhinoplasty, please see my prior blogsSteven J. Pearlman, MD, FACS

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