Tuesday, October 19, 2010

Doctor Says: "Go Ahead and Pick Your Nose"!

Of all the surgeries that are performed at the Gallery of Cosmetic Surgery, nose reshaping/rhinoplasty is Dr. Sadati’s absolute favorite. Dr. Sadati, a board certified facial plastic surgeon, has spent a large majority of his career in pursuit of training, education, and experience with the masters of nasal surgery in order to provide the best care to his patients. He has successfully performed hundreds of rhinoplasty (nose reshaping) procedures in which the care and precision in which he does nasal surgery is paramount.
Dr. Sadati likes to think that there is no surgery more important than nasal surgery. The nose has two important roles: the first role is that the nose enters the room first and sits right in the center of your face during conversation. It is the focal point of your whole face and represents your image. The second role of the nose is a functional role. Your nose is what allows you to breathe clearly and to smell. One role cannot be exchanged for the other and great care must be taken to maintain the functional role while improving the cosmetic role.
A large portion of the Gallery of Cosmetic Surgery practice is doing revisions or corrective surgery of other physician’s work. Dr. Sadati takes great pride in making note that he has repaired many major rhinoplasties from other physicians where the patients have had up to 3 nasal surgeries without cosmetic or functional success. These corrections are the most difficult cases but they often result in the happiest patients which gives Dr. Sadati a great deal of professional fulfillment and he believes these challenges are what make life worth living. There is no problem Dr. Sadati considers too challenging for his review and consultation.
The range of surgical techniques in rhinoplasty is very wide. A basic cosmetic rhinoplasty to reduce the hump might take 1 hour to perform. A nose that requires a correction of the septum, narrowing the base, and changing the tip might take up to 3 hours. As a result, the fees for nose reshaping procedures vary accordingly.
Our goal at the Gallery of Cosmetic Surgery is to safely and consistently provide an improvement in self-confidence and self-esteem by enhancing your appearance in area(s) of your body more towards your ideal. The ideal candidate is both psychologically and medically healthy, who is motivated by personal goals, not by external motivation from friends, relationship partners or personal obsessions. Realistic expectations and clear understandings of the risks, benefits and alternatives, as well as acceptance that there are never any written or implied guarantees of outcomes. Verification of optimal medical health and psychological stability is often obtained at the discretion of the physician prior to consideration of patients for cosmetic surgery from primary physicians or specialists.
What to Expect in Recovery:
The average recovery for nose reshaping is 4-8 days but it is important to note that this will vary patient to patient depending on the significance of the procedure. Approximately 50% of patients do experience minor black eyes as a result of the surgery and this can linger for up to 7 days.  You have to wear a hard nasal splint on the outside of your nose for 6 days.  The nose DOES NOT NEED TO BE PACKED EVER!!!  This is an antiquated technique that should have been discarded years ago.  The nose does not need to be packed and I have not packed a nasal surgery in over 14 years.  Your nose will swell inside and outside and this will restrict your nasal breathing for up to 3 weeks.  Slowly, the airway will clear and breathing will return to normal or improve from breathing prior to surgery.
As you heal:
Healing:  How quickly and easily you will heal depends on a number of factors such as your genetic background, your overall state of health and lifestyle (exercise, diet, smoking, drinking, etc…).  Many people believe your doctor is solely responsible for the healing process, but no one person can make another heal.  Dr. Sadati can facilitate (but not accelerate) your healing but you must also take an active role in that process.  Your cooperation and close attention is extremely important when it comes to your post-operative healing.
Another MAJOR factor in the course of healing is how well you follow the instructions that are given to you by Dr. Sadati.  You will receive verbal instructions as well as written instructions after surgery and it is imperative that you follow those instructions. We set those guidelines for you to promote your healing process and to prevent the occurrence of any complications that can interfere with your recovery.  It is crucial that you recognize that you are a partner in this process and have a responsibility to follow instructions carefully.  The instructions we give you are designed to give you the best opportunity for healing without delay or surprise.
Your first 48 hours:
If you are going home, a family member or friend must drive you because you have been sedated.  Someone must stay overnight with you.  If you choose to stay overnight in our guest suite you must have an adult caregiver to stay with you or a caregiver can be provided for an additional fee.
Activity:  Take it easy and pamper yourself.  Try to avoid any straining.  You may go to the bathroom, try to get up and move a little every hour, but take it easy.  No matter how good you feel please do not clean house, rearrange your attic, etc….We do not want you to bleed and cause any more swelling and bruising that is unavoidable.  Use common sense as your guide.
Ice packs:  We recommend using cold or ice packs for the first 48 hours to help reduce swelling, bruising, and pain.  Use frozen peas in the package or crush ice cubes and the ice into a zip-lock bag.  Using ice after your procedure should help, not hurt so if the ice feels too uncomfortable don’t use it as often.  Leave the ice in place no longer than 20 minutes per area.
Diet:  If you have any post-operative nausea, carbonated sodas and dry crackers may settle the stomach.  If nausea is severe, use the sublingual Zofran you were prescribed.  If you feel normal, start with liquids and bland foods, and if those are well tolerated, progress slowly back to your regular diet.
Alcohol:  Alcohol dilates the blood vessels and could increase post-operative bleeding.  Please do not drink until you have stopped taking the prescription pain pills, as the combination of pain pills and alcohol can be dangerous.
Smoking:  Smoking may adversely affect wound healing and cause loss of skin and tissue death.  Smoking reduces arterial (blood) oxygen supply which is necessary for normal wound healing.  Exposure to second hand smoke has also been implicated in delayed or abnormal wound healing.  It is best to avoid smoking &/or exposure to second hand smoke in the post-operative period while your incisions are healing.  Nicotine causes blood vessels to constrict and may interfere with normal wound healing.  When blood vessels constrict there is less blood supply that can get to the wound which means less oxygen for normal healing to take place.  You should avoid cigarette replacements such as nicotine gum, patches or the inhaler during your post-operative period as these have similar effects as smoking and second hand smoke.
Driving:  Please do not drive while taking prescription pain pills.  Please be advised that all medications may impair judgment and the ability to drive or operate heavy machinery.
Family and Friends:  Support from your family and friends are very helpful during your recovery.  But because they may not understand what is normal in your post-operative care, their comments may unintentionally create emotional turmoil for you.  You can trust that we will tell you honestly how your progress is and what we expect your results to be.  Please trust in our knowledge and experience when we evaluate your progress.  We know it is difficult not to compare your recovery with other people you may know who also had cosmetic surgery, but it’s imperative to remember progress varies greatly patient to patient and everyone has a different recovery.
Cosmetic surgery has certainly become less taboo in the past decade,  but your friends may still be reluctant to bring it up and discuss it because they think it may be a private matter to you.  Patients occasionally feel upset that “no one noticed” or “said anything.”  If you are comfortable discussing your cosmetic procedure then you should do so openly.  When people ask how you are, respond saying “I feel wonderful. I just had cosmetic surgery and I’m recovering.”  This lets people know that they may talk freely with you.  Often if you will open up about your procedure you will find that your friends and acquaintances are very interested in discussing it with you.
One potential drawback after surgery that can take places is that quite frequently patients experience a very brief period of “let down” or depression after cosmetic surgery.  Some may subconsciously have expected to instantly look and feel better, even though they rationally understand that this will not be the case. You will be told what to expect during your recovery but the incisions can still come as a shock sometimes to see the initial results. Patients commonly question their decision to have surgery during the first few days after surgery because it’s hard to imagine the incisions once they are healed and everything has settled into place.  As the healing occurs, these thoughts usually disappear quickly.  If you feel depressed, understanding that this is a “natural” phase of the healing process may help you to cope with this emotional state. Just try to remember it’s a process and there are stages for each process we go through, healing from a surgery is no different.  Your incisions may come as a shock in the beginning but try to remember that over time those incisions will heal and the scars will decrease and the final outcome will be much different than what it looks like right after your procedure.

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