| Dr. Robert Kotler is a plastic surgeon certified by the American Board of Otolaryngology/Head and Neck Surgery. Here the Doctor has answered some of the common questions Bizymoms visitors have about Rhinoplasty.
Q. What is rhinoplasty?
A. Rhinoplasty is an operation that changes the appearance of a nose. Typically, ours are performed from entirely within the nose; no external incisions. All incisions are made within the nose and these incisions are closed with absorbable stitches.
Q. What are the benefits of rhinoplasty?
A. The benefits of rhinoplasty are strictly to improve the appearance. Because the nose is the most prominent facial feature, it is important that the nose be in harmony with other facial features. A nose that is too large or has a bump or is too wide or it droops too far down or has a bulbous tip or is crooked, is generally unsatisfactory and is amenable to improvement. The art of rhinoplasty has been perfected over the years. While the original rhinoplasty operations often looked a bit unnatural and artificial, today’s well-trained surgeons are capable of delivering natural looking noses that give no advertisement to having been operated on. I am pleased to say that I am one such patient. I had my nose surgery done by the legendary Howard Diamond, MD of New York. Dr. Diamond was one of my principal teachers and mentors.
Q. What are the risks associated with rhinoplasty?
A. There are very few risks associated with rhinoplasty. First, all patients - regardless of age - must be cleared by their internist or family physician with respect to having a normal physical exam and laboratory and x-ray tests. Because the operations are done under local anesthesia and very light general anesthesia, there is very prompt recovery; after most of our operations, patients leave the surgery center one hour after the end of the operation. Rhinoplasty is performed on bone and cartilage with no entrance into major body cavities and, therefore, it is not in the same category of risk such as heart surgery, lung surgery or abdominal surgery.
Q. What does a rhinoplasty procedure involve?
A. The operation is done through hidden incisions inside the nose whereby the surgeon tunnels under the skin and shaves or files down the bony bump, refines the tip of the nose using miniaturized sculpture tools and narrows the nose by controlled fracture or a break of the bones such that they are repositioned to create a narrower nose. Other nuances include releasing the depressor septi muscle which is responsible for the nose "cranking down" with smile. In some people, the base of the nostrils can be narrowed when they are unduly large.
Those patients who cannot breathe can be helped at the same surgical session by having correction of the deviated septum and reduction of enlarged turbinates all of which can contribute to blocked noses which, in some people, leads to sinusitis and other major complications and problems. Likewise, correcting the deviated septum and enlarged turbinates will even help patients with allergic problems.
Q. How long does it take to recover from rhinoplasty?
A. Typically, most people return to work and normal activities within seven to ten days. A full exercise program can be resumed at ten days. I returned to my practice one week to the day after I had the procedure done looking quite good although still with some swelling, but not any sense of disfigurement. The nasal bones are healed within six weeks and typically patients look very good by ten days to two weeks, such that it is very difficult to tell they had surgery and further refinements take place as minor swelling continues to diminish such that by three to four months, the typical postoperative photographs are taken.
Q. How long can one expect the results to last?
A. Rhinoplasty results are eternal. The nose changes very little with aging. In fact, the rhinoplasty is somewhat of an anti-aging procedure in that noses that have not been operated on tend to droop and widen with age where those that have had rhinoplasty do not suffer that fate because internal scar tissues stabilizes and "holds" the tissues in place.
Q. How does one locate an experienced surgeon in my area?
A. Depending on how large the city is, one would seek out a superspecialist in nasal surgery. That surgeon would be board certified in either plastic surgery or head and neck surgery and should have served a fellowship in facial cosmetic surgery such that he would be considered an expert holding a higher degree of sophistication than the practitioner who did not obtain a fellowship after board certification. It is very important to ascertain if rhinoplasty is the most common procedure done in that practice. If it is, one can assume they would be in good hands. The least attractive practitioner would be one who does rhinoplasty only occasionally and whose practice emphasizes body contouring such as tummy tuck, liposuction, breast augmentation or breast reduction. It is unusual to find surgeons who are superstars in both in facial surgery and body surgery. You want a facial surgery superstar whose practice is built around nasal cosmetic and functional surgery.
Q. How to contact Dr. Kotler if we have further questions?
A. Our practice is glad to answer questions. They can be submitted via our website, www.RobertKotlerMD.com or by telephone (310)278-8721, 9-5 PST, M-F. Ask for Auria who is our patient advisor and consultant. Our office makes Skype consultations available to patients as well as online computer imaging: our office computer can show one the predicted results of their cosmetic procedures. Our website is rich with its library of 320 before and after photographs, including 80 rhinoplasty case histories including, of course, the before and after photos. |
