One of the most challenging procedures in plastic surgery is cosmetic nasal surgery (Rhinoplasty). While the operations are quite straightforward, patient healing plays a large role in the end result. Dr. Yager’s experience allows him to recognize what is possible for each patient, based on the thickness of the skin, skeletal stability, and anatomical ideals.
Every nose is different, and the decision to alter the appearance of the center of your face is a major one. The most important factors in achieving patient satisfaction are accurate diagnosis, flawless communication, and a realistic prediction of the end result. Computer imaging is a necessity in this procedure more than any other. It enables you to see the changes on your own face, not just to look at other nice results. Dr. Yager always spends time looking inside as well as outside of the nose, and to also consider the harmony with the lips and chin. A nose can be perfectly beautiful, but if it does not balance with the rest of the face, it looks bizarre.
Not everyone can have the perfect, tiny nose they desire. We can change the bridge of the nose fairly easily, narrow the nostrils, and somewhat alter the tip. Definition of the nose depends on the thickness and quantity of skin that is present, and this should not be changed. Dr. Yager will show you what is possible, harmonious, and safe. If you desire something outside of these parameters, he would suggest you really think it over and seek other experienced opinions.
The length of the procedure depends on the changes we agree to make. It can be 30 minutes or 2 hours. The procedure is done with an anesthesiologist under monitored sedation or sometimes general anesthesia, depending on the work. Sometimes the stitches are all inside the nose, and dissolve on their own. On occasion, a few small stitches are placed under the nasal tip, or along the junction between the nose and cheek to narrow the nostrils. If structure is deficient in the nose, prefer to use your own cartilage if available but we occasionally use Porex implants to add support. They are the best tolerated by the body, and we will discuss them if they might be needed to enhance your result. A small gauze pad is placed beneath the nose for 24 hours, and some tape lines the bridge for 5 days. Any removable sutures come out within 1 week. Dr. Yager does not use nasal packing or splints, as they are uncomfortable and unnecessary.
In recovery, you are observed for 1-2 hours. Head elevation is important. Swelling is expected with bruising often underneath the eyes if the bones are reshaped. While you may return to work in 1-2 weeks, your nose will slowly change over one year. The last of the swelling is usually in the tip. This does not mean that you look very swollen for a year, as usually a great improvement is seen in 2 weeks. Patience is very important. Pain is usually mild, and easily controlled with Tylenol or a mild analgesic. You may not wear glasses for 6 weeks if the bridge of your nose is reshaped.
Dr. Yager’s satisfaction rate with nasal surgery is very high because he spends the time beforehand to plan and discuss the case and your expectations. Your idea of a “nice nose” and your surgeons might be very different, so it is crucial to communicate as clearly as possible and define your expectations prior to deciding on surgery. Dr. Yager will do everything in his power to assure that your chances for success are maximized, and that both you and he enter the operating room confident and relaxed.