The 5 Big Worries People Have Before Primary Rhinoplasty

Welcome back to Behind the Double Doors. I'm Dr. Taylor DeBusk. On today's episode, I want to talk about some key things that first time rhinoplasty patients are concerned about the most. Let's talk about those today. We will start with some of the worries people have prior to surgery and then some of those that people have in the post-op setting after rhinoplasty. So some of the worries that most patients or a lot of patients have in regards to rhinoplasty is cost. Cost is always top of mind. It's something that we discuss closely with patients, and there's a lot of key things that go into how much a rhinoplasty costs, whether that's the length of the surgery, the types of augmentations that the patients need, whether or not it's a completely cosmetic or has a large functional component. All those things can make a rhinoplasty a lot more complex.

(01:03)
When we talk about how much a rhinoplasty costs, I always tell them, you know, this is your nose. This is the center of your face. This is something that you can't hide and you don't want to go price shopping or just pick the cheapest rhinoplasty because you think it's cost effective. The most paramount thing in regards to rhinoplasty is getting it done right the first time, and that's what we always emphasize when we talk about price of any sort of facial cosmetic surgery, much less rhinoplasty because it is so technically challenging and complex. So with costs, I always recommend patients talk to our patient care coordinators. They're really good about giving this specific price ranges. They're also really good resources to discuss different financing options if needed. The next worry a lot of patients have is, is this surgeon legitimate? Is this surgeon well-versed in rhinoplasty? And I think that's a legitimate concern when looking at your surgeon.

(02:01)
You need to see what type of training they've had, if they've had extensive rhinoplasty experience and what boards they're certified with, whether it's the American Board of Otolaryngology, E N T, American Board of Facial Plastic Surgery, or the American Board of Plastic Surgery. Those are all very important. I would also look at their surgical volume. Do they do a lot of rhinoplasty? Are they doing this weekly, daily? Do they only do a couple a year? Those are all very important. You need to have a high volume rhinoplasty practice to know that you'll get consistent results because that is very important. Like I said, rhinoplasty is one of if not the most complex cosmetic surgery within plastic surgery. So you want somebody that has pretty extensive rhinoplasty experience. So if you're worried whether or not you're obsessing about your nose or about rhinoplasty surgery specifically, I think you need to really ask yourself, are your expectations realistic?

(03:05)
So going into a rhinoplasty, I always tell everybody that at baseline there's no such thing as a perfect nose. And rhinoplasty surgery, it doesn't create the perfect nose. There's always subtle asymmetries, even though we try to get rid of all imperfections, there's no such thing as a perfect rhinoplasty. There's no such thing as a perfectly symmetric nose. And the last worry a lot of patients have prior to rhinoplasty surgery, or will people judge me for being fake? Or they're always worried about other people's expectations for their rhinoplasty. And I think that number one, you really shouldn't worry about what everybody else is thinking. I know that's easier said than done, but to be honest, you should be doing this rhinoplasty or this surgery for yourself. That being said, what I'm seeing more and more is that people want a natural appearance or a natural nose, not like they did back in the sixties and seventies where they had the ski slope with a very pointy tip, but now people want more appropriate proportions, whether a normal appearing bridge of the nose or a normal appearing, normal appearing tip of the nose.

(04:15)
Now we want something that fits our faces that has the ideal proportions. So some of the things that people are concerned about in the post-operative period or after surgery, number one is will it hurt or how bad is the pain? And that's a question I get in almost every single consultation and surprisingly, or to patients, surprisingly, it's not a painful procedure. I talk about maximizing the use of over-the-counter pain medications, specifically acetaminophen or Tylenol and ibuprofen. I put everybody on a scheduled regimen of both of these medications for the first three to five days after surgery, and the vast majority of my patients do not need narcotic pain medication. Some people take it the first or second night just to kind of help 'em go to sleep, but most patients don't need any of the pain medication at all, which is surprising to a lot of people.

(05:10)
Another concern a lot of patients have is whether or not they're going to get their desired results or if their nose isn't going to look as good as they anticipate. And when I talk to patients, I do bring up the fact that revision rhinoplasty is a real thing. No matter how good of a surgeon you are, everybody heals different. So the quoted rate of revision rhinoplasty is about five to 10%, but the important thing to take into account is that you have to wait until your nose is completely healed. I won't even consider doing any sort of revision work no matter how minor or how great until we're at least 12 months after surgery because it takes that long to heal. And if you intervene prior to that, you're really risking worse complications such as infection or even scar tissue development. If you have had a rhinoplasty and are really concerned with the immediate results after the nasal surgery, I definitely would recommend seeing your rhinoplasty surgeon because there are some subtle, minimally invasive things that can be done to combat some swelling that are in less than ideal positions.

(06:19)
There are a few pretty severe complications that can occur that do need to be intervened on early. One of them is called a saddle nose deformity, and that's where you lose a lot of the structure on the bridge of the nose where the bridge of the nose sinks into the face. That's one of the very few complications after rhinoplasty surgery that I do recommend people seeking further assistance with because as things heal, you do develop scar contracture, and if you lose the support of the bridge of the nose, you need to go ahead and reinforce that with structural grafting like cartilage before you have significant or severe contracture of the soft tissue. If you're concerned after rhinoplasty surgery, if you think something's wrong, I always encourage patients to call the office. Another concern a lot of patients have is whether or not their breathing is going to get worse after surgery.

(07:11)
For me, a lot of my foundational understanding and training with rhinoplasty was all about the function of the nose and the underlying structure framework of the nose. So when I do rhinoplasty surgery, I always build it on a solid sound foundation so that I can ensure that I will always maintain or improve the patient's ability to breathe because it doesn't really matter how good the nose looks, if it doesn't function, it's always going to cause the patient a lot of distress. In your consultation with your rhinoplasty surgeon, I think you should never feel rushed. You should feel like your end goals, whether that be aesthetic, functional, or combination, should always match or align with what the surgeon's expectations are as well as your expectations. And I feel like you should always feel like you're able to ask all of those questions and have all those answered and not feel rushed during your interaction with your surgeon. If you're ready or you're interested in rhinoplasty, I'd definitely encourage you to come check us out at basuplasticsurgery.com and give us a call.

Basu Aesthetics and Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. If you'd like to be a guest or ask a question for Dr. Basu to answer on the podcast, go to basu plastic surgery.com/podcast on Instagram. Follow Dr. Basu and the team at Basu Plastic Surgery. That's B A S U Plastic Surgery. Behind the Double Doors is a production of The Axis, T H E A X I S.I O.