Posts Tagged ‘Nose surgery’

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Anesthesia Options for Rhinoplasty

Friday, July 16th, 2010

Rhinoplasty may be performed under various depths of anesthesia including local anesthesia, intravenous sedation (also called IV sedation, twilight anesthesia or MAC anesthesia) and general anesthesia. Each option has its advantages and disadvantages depending on cost, safety, awareness and side effects.

IV Sedation

Although many surgeons prefer IV sedation for rhinoplasty, this is not the best anesthetic approach. It mostly relies upon the skillful dosing of powerful anesthetics through an intravenous catheter. The main point is that the anesthesiologist must be very skilled to achieve the right dose of anesthetic, since in many instances the patient may stay conscious to some extent.  On the other hand, if too much anesthetic is administered, the patient stops breathing.

In case of IV sedation the airways are not protected by a breathing tube and blood can be inhaled into the lung, leading to serious complications.

Although IV sedation is less expensive than general anesthesia, the risks, discomfort and effectiveness of it make it less preferable than general anesthesia.

General Anesthesia

Because nose surgery is comparatively non-invasive, the patient only requires enough anesthetic to render them entirely unconscious. Longer surgical cases are far better tolerated and the airway is protected from aspiration by the presence of a breathing tube.

The after-effects of general anesthesia are generally mild and short-term. And because respiration is maintained by a ventilator, the depth of anesthesia can be adjusted to keep blood pressure low and thus minimize bruising, swelling, and bleeding.

Perhaps the biggest reason against the use of general anesthesia is the fear of post-operative nausea and vomiting which may dramatically elevate blood pressure levels leading to much heavier facial bruising, swelling, and discomfort.

In addition, the technical benefits of general anesthesia translate into better cosmetic outcome for the patient with fewer anesthesia-related risks or side effects.

Schedule a free consultation with Los Angeles rhinoplasty surgeon Dr. Armen Vartany to address any questions concerning rhinoplasty.

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Modern Advances in Rhinoplasty

Thursday, July 8th, 2010

Modern advances in rhinoplasty allow surgeons the opportunity to select from a wide range of techniques to give each patient a really unique result, going as far as correcting even the smallest features the patient is not happy  with. The patient and the doctor are free to design a nose that adds an aesthetic beauty to the face not possible without cosmetic enhancement.


Rhinoplasty surgeries are more concerned with aesthetics and artistry more than ever. The nose surgeon will take all the elements of your face into consideration when planning your nose job, as “facial harmony” is the first priority. To architect your ideal nose, your surgeon can use technology such as computer imaging, nasal endoscopy to explore your nasal anatomy, and other methods of internal evaluation.

You can have a look through magazines in order to decide on the “perfect nose”, view before and after photos, and discuss specific sizes, shapes, and relative proportions with your surgeon. Take every detail into consideration; think about your profile, and how you’d like to look from the front and sides. Figure out specific features of your nose that you are not satisfied with, and features on others that you find particularly attractive. Your cosmetic surgeon should be able to interpret and balance all of this information to create a nose that is uniquely you.

As a perfect model is designed, your rhinoplasty surgeon will decide on the right nose surgery procedure:

• Open Method – An incision is made on the columella between the nostrils

• Closed Method – An incision is made inside the nostrils

During the nose surgery, skin is separated from the underlying bone and cartilage, the bone and cartilage is then artfully shaped with a combination of surgical skill and advanced tools, and finally the skin is then draped over the new nose.

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What If Your Nose Job Went Wrong?

Tuesday, June 29th, 2010

People undergo rhinoplasty/nose surgery for purely cosmetic reasons (i.e. to improve the appearance of the nose), for functional reasons (i.e. to clear any blockages) or for both reasons at the same time. Regardless of the reasons for nose job, a patient may claim compensation whenever the surgery goes wrong.

There are different reasons why rhinoplasty surgery may go wrong, leading to a compensation claim. Here are some of the most common ones:

* Further disfigurement which is caused by the nose surgery;
* Temporary or non-temporary loss of sense of smell;
* Failure to achieve the main agreed expectations (i.e. the desired shape or solving the functionality problems);
* Infections;
* Making the appearance even worse than before the surgery.

What compensation can the patient claim in case of negligent nose surgery?

In many of the cases described above, the patient may be left with problems that require further surgery. Naturally, if the primary rhinoplasty went wrong, it is unlikely that the patient will be willing to get a revision nose job from the same Los Angeles rhinoplasty surgeon.

This is obvious and if a patient happens to appear in such a situation, he/she should seek legal advice to learn their options. The cost of the further treatment can be claimed as part of a successful medical negligence claim. Furthermore, the patient may also claim compensation for the pain and sufferings they have gone through, along with the other material expenses.

If you believe that you are the victim of medical negligence following rhinoplasty surgery, you should seek expert legal advice from a medical negligence no win no fee solicitor. Most solicitors will speak with you to find out the details and will provide you with an initial assessment of the strengths or weaknesses of your claim, thus helping you to make an informed decision.

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Asian Rhinoplasty Trends

Thursday, June 17th, 2010

The number of Asian-Americans patients who turn to Los Angeles rhinoplasty surgeons to improve their looks is growing continuously. Since Asian noses tend to have a wide bridge and a flat nasal tip curve, the current Asian rhinoplasty trends involve the changing and reshaping of these characteristic features.

The Bridge

Asian-Americans who come to the decision to undergo nose surgery generally want to make their nasal bridge higher. To accomplish this, a piece of silicone is inserted above the natural bridge to create a nose bridge that projects farther from the face. However, most of the patients complain that this technique results in an obviously artificial nose. Sometimes, the sharp edges of the implant are even noticeable through the nose skin. However, recently plastic surgeons have begun using cartilage grafts to build up the nasal bridge during Asian rhinoplasty. The cartilage is taken from the patient’s own body and helps to achieve a more natural look. A synthetic material called Gore-Tex is also becoming very popular because it is safe and is not visible under the nose skin.

The Tip

Asian-Americans generally have wide nose tips with wide, flared nostrils. This is why one of their primary requests is for a smaller, more defined tip and more proportional nostrils. If more than simple reshaping is required, implants can be used to get the desired definition.

The key to a successful Asian-American nose job is to keep the nose balanced with the rest of the face. The nose surgery should not make the tip too small or the bridge height too high for the rest of the face. It is of utmost importance for the surgeon to preserve the ethnicity to make the nose after the rhinoplasty as appealing and natural looking as possible.

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Male Rhinoplasty

Thursday, June 10th, 2010

Over the last decade, the popularity of male rhinoplasty procedures for aesthetic reasons has increased among men. They seem to be more and more concerned about their looks and even opt for plastic surgeries to become more handsome.

Male rhinoplasty is much the same as female rhinoplasty except for the fact that the nose is shaped to look masculine rather than feminine. Even ethnic male rhinoplasty does not involve any special procedure. The main difference between male and female rhinoplasty procedures is that while women expect to have smaller noses after such an operation, most men are more interested in shape than in size.

Male facial features are firmer and require a similar nose to balance them, and that is why a man with a button-like nose on his face will hardly look handsome. This is the reason why men usually expect an improvement in the contour of the nose without losing the characteristic feature of it. They want to achieve a more aesthetically pleasing nose, usually by reshaping the nose to make it appear less prominent.

Reshaping might mean a reduction in width but rarely in length; the Los Angeles rhinoplasty surgeon may be asked to smooth the bridge of the nose and reshape the cartilage but he will rarely change the profile, unless it is crooked. This is the reason why male rhinoplasty is considered to be easier from the surgeon’s aspect. On the other hand, when bones are involved, things become a bit different. Men’s bones are tougher and thus the nose surgery can become more traumatic for a man – there will be more serious swelling afterwards and probably more broken blood vessels.

For more information on male rhinoplasty, please contact us to schedule a free consultation with a reputable and board-certified rhinoplasty surgeon.

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Is a Nose Job Permanent and Does It Result in Permanent Scars?

Wednesday, June 9th, 2010

Unlike breast augmentation, face lift and many other cosmetic surgeries, rhinoplasty lasts forever, since once removed, bone or cartridge will never regrow.

If a nose job is carried out properly, the results should not deteriorate over time. However, in case of a poor rhinoplasty procedure, nostrils may begin to pinch or scar tissue can form.

Though nose surgery results are permanent, the aging process will have an effect on the appearance of your nose as your face changes, but the overall reshaping and new nasal structure should remain the same. Though nose reshaping surgery is permanent, many people prefer revisiting their surgeon to keep track of the progress of their nose. In such cases if they feel any changes do need to be made, they are able to consult their Los Angeles rhinoplasty surgeon and discuss their options.

Despite the permanence of rhinoplasty results, you may want to reshape your nose again as your face matures and is reshaped with age or you may simply want to touch up your surgery after the initial rhinoplasty. If you wish to do this, then you should undergo revision rhinoplasty. This procedure can be ideal for enhancing or revising the poor aspects of your initial rhinoplasty.

Scaring after rhinoplasty

Some slight and almost unnoticeable scarring is inevitable after rhinoplasty. The extant of scaring depends on the type of nose surgery: a closed rhinoplasty surgery creates scars only on the inside of the nose, whereas an open rhinoplasty which may be necessary for more extensive reshaping, creates only one external scar at the base of the columella. This scar fades over time, becoming nearly impossible for others to detect.

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The First Week after Rhinoplasty

Tuesday, May 25th, 2010

During the first post-operative week you should limit your activities as much as possible. Though you are encouraged to walk about the house, you should avoid bending at the waist or lifting heavy objects. Remember that overexertion may result in bleeding. When sleeping try to keep your head elevated on 2-3 pillows and avoid turning on your side.

Do not lose control over your emotions. Post-rhinoplasty depression is usual, but do not let it take over you. Crying will only add to the swelling and initiate bleeding. This state will quickly pass as you will begin to feel and look better.

Use plenty of fluids and easily chewable foods for at least the first week after your nose surgery. Clean around your nostrils with hydrogen peroxide three times a day. After cleaning, place a little amount of Vaseline or antibiotic ointment around the nostrils to keep them from drying out.

During the first post-rhinoplasty week, swelling will obstruct your nasal passages making it harder to breathe. You may use a humidifier which will make breathing through the mouth more comfortable. Blowing or sniffing should be avoided as it will only irritate the healing tissues and slow down the rhinoplasty recovery. Sneeze with your mouth open to decrease the pressure on your nose and reduce the risk of bleeding.

You may take a bath in the tub on the first day after the nose job, while showering is allowed on the second post-operative day only. Try to keep the cast dry while taking a bath or shower (in case the cast becomes wet, dry it with the help of a blow dryer). Washing your face with a mild soap is also allowed. Avoid being in smoke-filled areas as excessive smoke may irritate the nasal tissue. The use of alcoholic beverages is also not encouraged as it may increase your chances of bleeding.

For further questions concerning your activities during the first post-surgical week, contact your Los Angeles rhinoplasty surgeon.

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Rhinoplasty: The Benefits of Computer Imaging

Friday, April 23rd, 2010

Computer imaging is an exciting innovation in rhinoplasty that allows patients to visualize their possible surgical outcomes. Visualization has traditionally been achieved by the manual manipulation of photographs; nowadays the technological developments in the areas of optical sensing and computer-aided design, make it possible to construct a computer-based imaging system which can simulate the effects of nose surgery on patients.

This technology allows the plastic surgeon and the patient to reach a mutual understanding of goals and expectations. However, it is important to realize that imaging, no matter how realistic and reasonable it is, is for simulation only and the final results may vary from the simulation.  No reputable Los Angeles rhinoplasty surgeon will ever guarantee a specific result. Computer imaging simply ensures that you and your surgeon share a common surgical goal and helps to establish the ideal aesthetic outcome. For example, a patient who has a moderately enlarged nose but a small chin, with the help of imaging, may find that what he/she actually desires is a conservative rhinoplasty and chin augmentation for facial balance rather than an intensive reduction rhinoplasty.

To visualize the post-rhinoplasty results the surgeon will take photos of your nose from different angles, download those images into the imaging software and with the help of a morphing program, manipulate the images to show the potential plastic surgery results. With this technology patients and surgeons can review different surgical options. After the imaging is complete, the surgeon will print a copy of the imaging for the patient and keep another copy to review on the operating day.

Computer imaging is also helpful for those patients who are considering nose surgery but are not totally sure whether rhinoplasty is for them or not, since it allows them to see the potential surgical results before making their final decision.

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Tips to Reduce Swelling after Rhinoplasty

Thursday, April 15th, 2010

Rhinoplasty is a surgical procedure which involves temporary side effects. One of them is swelling around the nose and eye area which starts immediately after the nose job and reaches its peak within two or three days. Swelling after a nose job is normal and mostly disappears within two weeks.

Though swelling after rhinoplasty cannot be avoided, it may be reduced to some extent. Here are a few tips on how you can minimize swelling and alleviate the discomfort associated with the rhinoplasty recovery process.

1.    Abstain from alcohol for at least five days before your operation.

2.    Do not take aspirin or ibuprofen for at least ten days before your nose surgery.

3.    Avoid taking non-steroidal anti-inflammatory drugs for at least seven days before the nose job.

4.    Get up and start walking as soon as you can after your rhinoplasty. This promotes better circulation throughout your body and helps reduce swelling in your facial area.

5.    Keep your head elevated at all times, even while you are sleeping.

6.    Do not bend over with the head below your heart.

7.    Apply a cold compress around your nose area. Do not apply the compress directly to your nose or on your skin. Use a thin cloth or paper towel to protect the swollen area. Apply a cold compress for 20 minutes on the swollen area three times a day. You may use packs of frozen peas or mixed vegetables instead of an ice compress.

8.    Avoid hot showers as hot water can worsen swelling.

9.    Avoid salty food as salt can increase swelling. Eat yogurt, lettuce and eggs which contain Vitamin K which reduces swelling.

10.    Your doctor may prescribe a pain reliever or an anti-inflammatory medication that can help decrease your swelling.

11.     Apply arnica gel to the swollen areas of your face. Arnica is a homeopathic herb used to quicken recovery by reducing post-operative swelling and bruising. You can also take arnica pills a few days before surgery. However, you should consult with your rhinoplasty surgeon before resorting to this remedy.

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The Cost of Nose Surgery

Tuesday, April 13th, 2010

The cost of nose surgery is dependent on the following factors:

•          the surgeon’s skill level/experience

•          the extent and complication of the rhinoplasty procedure

•          the geographic location of where the surgery is performed

Only after examining your nose and discussing with you your needs and expectations, can your surgeon tell you the exact cost of rhinoplasty.

Primary nose job costs range from $3,000 to $8,000. The cost comprises of 3 fees: anesthesia fee (ranging from $600 to $1,000), facility fee (ranging from $700 to $1,100) and surgical fee (this fee is difficult to determine since it depends on such factors as the surgeon’s experience, training, skills).

Revision rhinoplasty costs are much higher than primary rhinoplasty costs since revision rhinoplasty requires much more knowledge and experience and is more complex than primary nose jobs. The costs range from $10,000 to $15,000.

Choosing a board-certified rhinoplasty surgeon from the American Board of Plastic Surgery is an essential factor for a successful nose surgery and achieving satisfying results.  Since board certification requires specific and thorough surgical education and training, certified surgeons may require higher fees. However, opting for such a surgeon will increase your odds of success and reduce the risk of complications as you will receive the most appropriate treatment.

The type of certification is also important. There are more than 150 self-designated boards, but few of them (e.g. the American Board of Plastic Surgery) are designated by the American Board of Medical Specialties.

As mentioned above, the extent of the nose surgery also influences the cost of rhinoplasty, e.g. a slight modification or reduction to the point of the nose requires less surgical time and fee than narrowing the bridge or a complete change of the nose shape.

The cost of rhinoplasty may be partially covered by insurance if the procedure is a medical necessity. However, if rhinoplasty is done for purely cosmetic reasons, then it is not covered by insurance.

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