California Rhinoplasty Questions

If you have further questions about rhinoplasty, check the list below to find answers. While some information presented here is also contained in the above text, these short responses should complete your introduction to rhinoplasty. We also encourage you to consult with Dr. Kabaker for individualized answers to all of your questions.

Am I a good candidate for rhinoplasty?
The best rhinoplasty patients are in good health, over the age of 16, non-smokers, and are able to avoid blood thinning medications for two weeks before surgery. They have complaints with nasal appearance and/or breathing, and have realistic expectations of the result. They are able to understand the basic aspects of rhinoplasty so they can easily participate in their own care.

How do I choose a rhinoplasty surgeon?
There are many good rhinoplasty surgeons available, so choosing the best one for you is a challenge. Your surgeon should listen well to your requests and not tell you what you need. He or she should educate you enough to help you understand what you are going through, but not overload you with information. He or she should only promise realistic results. He or she should work toward creating a natural and improved look for your nose, and not necessarily a “perfect” nose as suggested by magazine advertisements or celebrities.

How many doctors should I consult with?
As many as you need to feel completely comfortable with the doctor you choose. Some patients are able to settle on their surgeon after only one consultation, while others require several to best compare their rapport with each doctor.

Is a surgeon’s experience important?
It certainly is. We think your surgeon should be someone who only operates on the face, and has done enough rhinoplasties to master all available techniques. We think the age of a surgeon is not important; only his or her ability to translate your requests into results matters.

Are “before and after” pictures helpful?
They are, and our doctors will show you many. But, remember that you are the only person with your exact nose. Every patient is different, so try not to base your decision on before and after photos. You should focus more on what the surgeon will do for you as an individual.

Do you use computers to change my pre-operative photos?
Yes, we do, and we use the latest software available to provide realistic projections. Keep in mind that these “morphed” images are not guarantees of an actual result, but will help you as you plan your procedure.

Is rhinoplasty expensive?
Having a rhinoplasty is like investing in your self-image and confidence, so while the financial cost is not low, the rewards can be great. The actual cost of your procedure will depend on exactly what is done, and a written quote will be given to you. We promise, though, that the overall value of your procedure will be competitive and fair. Costs for dedicated facial plastic surgeon like Dr. Kabaker reflect their dedication to this specific field, and we feel that you should not emphasize cost savings when dealing with your face.

Do I need to see my own doctor before a rhinoplasty?
All patients require basic lab tests, and typically patients over the age of 45 require a written clearance from their personal physicians. All specific requirements are described in the attached Rhinoplasty Instructions.

What do I need to do the day before surgery?
The day before a rhinoplasty, you should eat normally but avoid excessively heavy meals, or foods that can lead to acid reflux. Prepare your affairs so that you completely relax and rest after surgery. Most importantly, do not eat or drink anything after midnight before your procedure. See the attached Rhinoplasty Instructions for all suggestions.

Where does the surgery take place?
Procedures are done at the Aesthetic Facial Plastic Surgery Our Clinic, our fully accredited surgery center.

What kind of anesthetic will be used?
For almost all cases, a deep sedation will be used, which means you will be completely asleep and pain-free during the entire case. No breathing tube will be needed in these cases. Some other patients, having shorter procedures, can have lighter sedation. However, everyone will be completely comfortable during the procedure.

Can I wake up in the middle of surgery?
No. If you are having a deep sedation, an anesthetic professional (anesthesiologist or nurse anesthetist) will be dedicated to providing anesthesia during the entire case.

How long does the procedure take?
Primary rhinoplasties are usually done with a closed approach, and take 1 ½ to 2 hours. Revision procedures may take up to 4 hours and often require an open approach.

How much pain will I have after surgery?
Not as much as you probably think! We have found that most patients are very worried about pain, and pleasantly surprised to find that discomfort is mild. The biggest complaint most patients express is nasal obstruction from gauze wicks in each nostril, but these are removed the day after surgery and the obstruction is thus resolved. Pain is usually well controlled with medications, which we will prescribe.

What kind of nasal packing is used after the procedure?
None. There will be a small gauze wick in each nostril, and these are removed the morning after surgery. This removal is not painful, so patients should not over treat themselves with pain medications before this office visit.

What are the risks of surgery?
Adverse events are rare and mild. One possible risk is bleeding. All patients have nasal drainage for a few days after surgery, and early on this may be “blood tinged” – pink in color, but not a true nose bleed. Approximately 2% of patients will actually have blood slowly oozing from a nostril, and this is easily controlled at home. We will show you how during your evaluations. A severe nosebleed, requiring our intervention, is extremely unlikely. Another risk of surgery is excessive scar formation. This is also very rare, and usually seen as a hard bump in the nasal bone, or a softer bump at the nasal tip. For the approximately 2% of patients who experience this, the problem is easily correctible. Such scar tissue does not reflect poor surgical technique – it is true that some patients are just prone to a robust healing response.

Will I be swollen?
Swelling is impossible to avoid. Your cheeks will be swollen for approximately one to two weeks after surgery, but this is often only noticeable to the patient. Your nasal skin, though, will be swollen for longer, and this is extremely important for patients to remember. It may take months for the swelling at the tip of your nose to resolve, and the “final result” will not be seen until the swelling is gone. This waiting period can be frustrating for some patients. We will give you many suggestions about minimizing swelling, and helping it to resolve as quickly as possible.

When will the results of my rhinoplasty be visible?
Though it will be swollen, your nose will look more aesthetically pleasing and natural immediately after surgery. You will first see this as soon as your plastic splint is removed (after one week). And, once all bruising is resolved, there will be no adverse signs of surgery – only a better nasal structure that continues to improve as healing progresses.

Will I have scars?
If your procedure is done with the “closed” technique, then all incisions are inside the nose and no scars are created in your skin. If you have the “open” technique, then there will be a very small, unnoticeable scar in the skin between your nostrils.

How much time off should I take from school/work?
At least one week is recommended. The plastic splint on your nose will be removed after seven days, leaving you free of this obvious stigmata of surgery. You may still be mildly bruised under your eyes, so if this will interfere with your work or school, then it may be safer to take two weeks off.

What precautions should I take after surgery?
You should avoid contact to your nose for about two months after surgery. Also, any strenuous activities or exercise during the two or three weeks after surgery will increase your swelling, so should be avoided. We understand it is often difficult to abstain from exercising during this time, but you should consider this an important investment in your outcome. Wearing heavy glasses should be avoided for several weeks. Lastly, avoid excessive heat or sun exposure for the month after surgery.

Do patients ever need another rhinoplasty?