Nose Surgery

Many people dislike their noses, and some of those -- at some point in their lives -- choose to seek help from a plastic surgeon. Step one is deciding to make a change. You want a nose that breathes efficiently and looks good. That doesn't mean it should be non-ethnic; it doesn't have to mean cookie-cutter-small; and it doesn't necessarily mean tiny and turned-up.

WHAT HAPPENS DURING MY CONSULTATION?
Dr. Aguilar will do a thorough examination of the inside and outside of your nose. He'll use computer imaging to assist him in showing you what he thinks are realistic goals. Dr. Aguilar states, "Some patients think that a doctor can mold a nose as if it were clay, and that's just not the case. For that reason, I have to find out if their idea is realistic. I tell them what I think I can deliver, and my goal is always a natural-looking nose that doesn't look like it has undergone a 'nose job.'" Skin thickness is a huge consideration because a patient who is looking for a defined tip may not get that because his particular nose could be impossible to thin. For definition, sometimes grafts are required.

WHY IS IT IMPORTANT TO CHOOSE AN EXPERT IN THE NOSE SURGERY?
For patients seeking nose surgery, Dr. Aguilar has the advantage of being an expert in the nasal airway. "Being able to breathe well has to be as high a priority as looking good," he explains. "I want the nose to blend unobtrusively with the other facial features. It's important to understand that every nose is unique in its shape, bone, skin, and cartilage."

WHAT SHOULD I LOOK FOR IN BEFORE/AFTER PHOTOS?
Sometimes, cosmetic nasal surgery is overdone, and what you get is a very unnatural appearance. If you see that kind of look among a doctor's before/after photos, you probably need to shop around some more. Another bad sign is a book full of nose "afters" that all look the same. Some plastic surgeons are known for delivering one kind of nose rather than an individualized version for each patient.

HOW OLD DO I HAVE TO BE TO HAVE A NOSE JOB?
Ages for nose surgery range from4 up to 65. It's not unusual for young people to have nose surgery, but it's also common for older folks to choose this surgery.

CAN DR. AGUILAR GUARANTEE THAT MY NOSE WILL LOOK LIKE IT DOES ON THE IMAGER?
No. But a surgeon like Dr. Aguilar who has done many nose surgeries has more predictable results. It is impossible for any doctor to guarantee results because he cannot foresee your individual healing patterns.

WHAT CAN I EXPECT AFTER SURGERY?
For ten days, you will have something on your nose. The splint is removed on day five and replaced with a bandage. You will use nose spray for stuffiness and apply ointment. In the past, noses were "packed" for days following surgery, which was very uncomfortable and gave nose surgery a reputation for being painful. Fortunately, with new techniques, that is no longer the case.

WHAT SHOULD I DO TO SPEED RECOVERY?
Stay upright as much as possible. Sit and stand and walk around. For a week, don't lift heavy objects or bend over. Avoid hitting or bumping your nose. Sleep with the head of the bed elevated for a week; put an extra pillow under your head. Avoid sniffing, which will not relieve the sensation of stuffiness. As the swelling of tissues decreases, your breathing will improve. Don't rub your nostrils or the base of your nose, which could cause infection or bleeding. If you have excess discharge, use the moustache gauze dressing, which may have to be changed every 30 minutes. This isn't abnormal and will lessen greatly in the next 12 hours after surgery. For the first 24 hours, your nose will be lightly packed to decrease oozing; this is removed the first post-op day. After that, use the saline solution and ointment to clean the nose and keep crusting to a minimum. Use the prescribed medication for any discomfort. Don't take aspirin or aspirin-containing medicine.

WHAT'S A DANGER SIGN?
During the post-op period, expect some minimal bleeding, as in bloodstained mucous. But, if you're profusely bleeding from either nostril, call Dr. Aguilar's office as soon as possible. He will need to see you.

WHEN CAN I RETURN TO WORK OR SCHOOL?
Usually, patients return to activity (work or school) three to five days after surgery. Physical activity is curtailed until Dr. Aguilar gives the go-ahead.

WHAT CAN I EXPECT IN THE FALLOWING WEEKS?
It may take a full six weeks for the turbinates to heal. Often, there will be crusting at the healing sites that Dr. Aguilar will remove for you. This may require frequent visits. It is, however, normal, and you shouldn't be concerned. Crusts can interfere with proper breathing, so keep your visits on a weekly basis. Continued use of saline irrigations will help as well.