Question: I have a small, turned-up, pixie-like nose. Can this be fixed with rhinoplasty and how? What sort of improvement can I expect? Answer: It sounds like you need an augmentative rhinoplasty. While correction of small, aggressively up turned or shortened noses is common after a bad primary nosejob, some patients are simply born with… Read More
RISKS OF RHINOPLASTY
The decision to undergo elective cosmetic surgery is often a decision most people make after lots of research and homework and consultation. While some people make the decision to undergo elective plastic surgery without much research or thought or hesitation, most people do give their decision lots of thought and consideration.
Unlike a trauma or cancer patient, elective cosmetic surgery patients do not “need” the surgery they are seeking. They want and desire the cosmetic surgery instead. So as Cosmetic Surgeons, we take otherwise healthy patients, put them through surgery with its down time and bruising and swelling and risk of complications in order to improve their image and self confidence a few weeks later. While a trauma patient who has broken his jaw in a car accident needs the maxillofacial surgery, regardless of surgical risks, in order to repair the broken jaw, to prevent infection and mastication malfunction, a cosmetic Rhinoplasty patient does not require a cosmetic Rhinoplasty unless there can be fairly certain and significant improvements of the nose afterwards to balance the risks of surgery.
So as a very cautious and conservative surgeon, my rule of thumb is roughly a 20% cut off. What I mean is that if the goals of improvement are not at least a 20% improvement of the face then elective cosmetic surgery should be avoided. If the goals are at least a 20% improvement (or hopefully more), then the benefits of elective cosmetic surgery may outweigh the risks of plastic surgery.
I have patients who come and see me after they have had several nose jobs by other surgeons but they are unhappy with the results. Some have had very poor results and I offer then Revision Rhinoplasty to correct the errors of the previous surgeons. Others have very decent noses and I will take time to educate them and discuss the facts of “tissue dynamics and healing” and will try my hardest to talk them out of another surgery. Of the latter group, some appreciate my honesty and efforts and will walk out of my office with a new appreciation for their noses. Others leave, falsely thinking that I somehow “did not see” their problem or do not want to help them, etc…
The fact is that any surgery carries risk. There is no denying that. We never sugar coat anything. I always have my patients sit down and thoroughly read the multi-page surgical consent forms so that they can have an opportunity to ask questions about every single aspect of the stated risks. I much rather my patients avoid surgery due to fear of risks than to have them blindly dive into a surgery.
For example, the Rhinoplasty Consent form from the American Society of Plastic Surgery is pasted below.
With the popularity of the internet and its accessibility and anonymity, comes great responsibility. For any consumer or client seeking a product or service, “word of mouth” is important. If you want to find a good Chinese restaurant or a good car wash or a good sun screen, it’s nice to hear feedback from others… Read More
This may affect OBAGI, SkinMedica,NeoCutis and IMAGE skin care lines. For many years Plastic Surgeons and Dermatologists in the United States and all over the world have been treating their patients’ skin and helping them look and feel better about their facial appearance, using a combination of products and services. For example, to effectively treat… Read More
Dr. Shervin Naderi is a Board Certified Facial Plastic Surgeon. He has practices outside of Washington DC in Reston-Reston Virginia and Chevy Chase Maryland in the Barlow Building. He is a “Rhinoplasty specialist” as well as a master injector and a clinical instructor for Botox, Dysport and dermal filler injections. He is also an examiner… Read More
Skin Depth Creates Variations in Rhinoplasty Surgery and Healing The thickness of a patient’s skin can affect how the surgery is performed. Thicker skin may camouflage subtle changes, requiring the addition of cartilage to the structure. Thin skin reveals even the most minimal alterations. Typically, thicker skin swells more following the procedure.
I am speaking today to the CEO of Coapt. I am hoping she will decide to voluntarily remove Hydrelle from the U.S. market. I have had doctors and patients contact me from all over the country about serious Hydrelle complications and as I suspected, the number is growing. The only thing that doctors can do… Read More
As of this morning, we have had 2 doctors from Florida, 1 doctor from Ohio, and one Nurse Practitioner from San Diego as well as 1 doctor from Baltimore tell me about their Hydrelle complications. They have all had patients with unexpected to severe complications from Hydrelle. I have even had a patient from Los Angeles tell… Read More
Hydrelle Complications / Risks of Hydrelle Ever since Hydrelle was introduced to the U.S. by Coapt (made by Anika and distributed by Coapt), there have been a significant series of complications that have resulted from the use of Hydrelle: 1) Allergic Reaction 2) Infections 3) Abscess formation 4) Necrotizing Granulomas 5) Scar tissue 6) Delayed… Read More
Warning About Hydrelle The introduction of an FDA approved, safe, Hyaluronic Acid filler, with premixed Lidocaine, for patient comfort, was long awaited and exciting news. Up to that point the Hyaluronic Acid fillers had proved to be the most versatile and safest of all the available fillers. But unlike Cosmoderm Collagen or Artefill which both… Read More