Nose fillers or Asian rhinoplasty?

Q: I have a very petite nose. Little to no bridge. This is something I desperately want fixed I was considering permanent nose fillers cause after I get it fixed I never want to look back. Plus I can’t afford to keep coming back for corrections but I don’t know if it will get the job done. I was also considering Asian rhinoplasty but that might be well over my budget. What would you recommend I do?

A: I would caution you against using anything permanent in the nose that did not come from your own body.  The best way to create permanent refinement and reshaping of your nose is with surgical rhinoplasty using tissue from your own body (autologous grafts).  It’s much wiser to wait until you have the means to do it right the first time.

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Will alar wedge excision adversely lengthen my upper lip (area between nose and mouth)?

Q: I am contemplating minor revision rhinoplasty but want to avoid further lengthening of my long upper lip. Will alar wedge excisions affect this area?

A: Alar base modification (alar wedge excisions) will have no effect on the length of the upper lip. Computer imaging may be helpful in your case to demonstrate the effect alar base modification will have on your appearance.

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Will a wider nose make my eyes look closer together?

Q: Hello. My nose is very very narrow and pinches a bit in the center of my bridge. I have had a consultation, and I have been told that my nose would be more compatible with the rest of my facial features if it was made straighter and a bit wider. I actually agree with this, but I’m worried because my eyes already look a bit too close together in my opinion, and I am concerned that making my nose a bit wider will make my eyes look even closer together. Do you know if this will be the case?

A: Actually by lowering the bridge of your nose between your eyes (radix) you will observe the opposite effect: your eyes will appear further apart.  Raising the height of the bridge and making it more narrow would cause them to look closer together.

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How can I achieve slightly wider nostrils?

Q: Hi I was just wondering if my nostrils can be stretched open ever so slightly…or would I need a whole nose reconstruction for this to be possible…also would there be scarring?

A: There are a few ways your nostrils could be widened during rhinoplasty (alar batten grafts, lateral crural strut grafts) and the incisions could be designed to be hidden from view – so the scars would not be visible.

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What happens if I wear glasses after septorhinoplasty?

Q: Can this affect my breathing? It’s been a week and a half since my surgery and I thought wearing glasses would be okay after the first week. I’ve noticed these dents on the bridge of my nose though, my breathing isn’t as good as when I got my nose splint inserts taken out, is this normal? Is your breathing supposed to deteriorate after your nose splints get taken out? Once the swelling goes away, will my breathing get better? or do you think my glasses are a cause of my breathing problems?

A: Touch base with your surgeon regarding his/her protocol of wearing glasses.  Most surgeons, myself included, prefer to have patients avoid glasses for at least a few weeks after surgery (if the dorsum was reshaped).  It’s unlikely though that your glasses are responsible for your breathing issues.  You may have some intranasal swelling once the splints were removed, causing your breathing to be temporarily worse.  Follow up with your surgeon to best address your concerns.

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Obtuse naso-frontal angle and bulbous, upturned tip post-rhinoplasty

Q: At 19 days post-rhinoplasty, my bridge appears low & scooped, not high and straight, as in surgeon’s pre-op computerized projection. Nasofrontal angle is extremely obtuse, though the surgeon said he’d use a ‘notching’ tool to retain the angle between my forehead and bridge. The tip is pointy, which I wanted, but appears over-projected and a little bulbous/upturned. Is all this just the result of post-op swelling? Might the shapes and angles of my nose still change for the better?

A: The appearance of your nose will certainly change from what it looks like 19 days after surgery.  Your nose will continue to undergo changes for the entire year after surgery, while 60-80% of the changes will be evident in 3-6 months.  Follow up closely with your surgeon to ensure the best result, and try not to fixate on the day to day variations of your nose while it heals.

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Fix my deviated septum and make my nose look prettier – can one doctor do both?

Q: I’m a 17 years old girl and want to get a nose surgery to fix my deviated septum, the small bump on my bridge and maybe make the tip of my nose smaller. I was wondering if a doctor can fix all of these problems at once or if it takes more than one surgery. Also, can a cosmetic doctor fix my medical problem (deviated septum) or do I need a certain type of a doctor to fix the medical problems and another to make my nose prettier? My nose isn’t really big or ugly but I just feel insecure about it.

A: Addressing both the functional issues of septal deviation and nasal obstruction, while also reshaping and improving the appearance of the nose, is commonly done during septorhinoplasty.  Seeking out a rhinoplasty specialist will ensure the best cosmetic and functional result.

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What is the likelihood that I will vomit after rhinoplasty?

Q: My surgery is scheduled for Friday May 30th, and my biggest fear is vomiting post op. My Dr. is loading me up with anti-nausea meds including the patch to wear on my neck. Will this reduce the chance that I will vomit after surgery?

A: A number of factors will affect your level of nausea after surgery.  One of the keys is having an excellent anesthesiologist who is familiar with rhinoplasty.  The type and amount of anesthetics you are administered during surgery plays a big role in how you wake up from surgery.  Nausea in these cases is rare.  For your case, your recovery nurses and your surgeon will be the best people to ask regarding how much nausea to expect.

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Which has more swelling? Primary surgery or removal of implant and grafts?

Q: 2.5 months post op after open rhino. Goretex on dorsum and nasal septum was harvested for tip height and added ear cartilage for projection. I am planning to have all these removed since I don’t want anymore unnatural implant on my nose but scared of what it will look like after. Its ok if it will just go back to pre op structure or better but I hope not worst than my original nose. Will there be more swelling after removal compared to what I experience during primary? Hope its swells less.

A: The synthetic implant on the bridge of your nose can be removed with minimal swelling, but removing the septal and ear cartilage grafts from the tip of your nose will create significant swelling.  After revision surgery, the nose will take longer to heal and for the swelling to fully resolve.

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I have a bump and line in the middle of my nose after rhinoplasty. How did this happen and can it be fixed?

Q: I had rhinoplasty about 4 months ago but I started noticing a bump and a horizontal line developing in the middle of my nose. This wasn’t much initially because of the swelling I guess, but it became more obvious with time, especially when I look at the mirror… My doctor said he never saw something like this over his 25 years of experience and suggested that I massage my nose and bone and wait for a while… He mentioned filler too but I want to know what happened and what my options are.

A: Although it’s difficult to provide a definitive, there may be an irregularity in the bone and cartilage of your dorsum.  At 4 months you are still fairly early in your recovery so your nose will change in appearance, so your bridge may or may not improve.  Revision rhinoplasty may be necessary to smooth the contour, but shouldn’t be considered until the nose is fully healed.

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