April 1st, 2010 Michael A. Jazayeri M.D.
As an Orange County Plastic surgeon, rhinoplasty (nose surgery) is one of the most common procedures I perform.
As with all elective cosmetic surgery, the question arises: should you spend thousands of dollars to have your nose done, look and feel bad for a few weeks, for the hope that you will look and feel better in the future?
The answer, as always is yes if you have realistic expectations, are doing the surgery for you and yourself only, and understand the limitations of what can be achieved given your anatomy.
Often patients bring me photos of celebrities asking if I can make their nose look like the person on the picture. It is important to understand the idea is the same: to make the nose more refined and balanced. However, there is no way to produce a nose exactly like some one else’s.
For example, if a patient has very thick, oily nasal skin, he or she cannot expect to achieve a final result like someone who has delicate cartilage and thinner skin (such as Natalie Portman or Keira Knightley). There is a limitation to how much cartilage I can remove and shape. Furthermore, regardless of how much can be done with the nasal bones and cartilage, once the thick nasal skin drapes over the framework, the result will be different.
The same concept applies to someone who has very thin nasal skin. Although I can perform a very nice rhinoplasty, I have no control over the patient’s healing. Occasionally excess scarring may occur which may be noticeable under a thin nasal skin, but not be visible otherwise.
Having said all of the above, rhinoplasty, if done properly and for the appropriate patient, has a very high satisfaction rate. I am always pleased to see the before and after “personality change” of my patients. It is not just the new hair cut, make-up and clothes, but also the way he/she carries himself/herself!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in central Orange County. If you like to schedule a complimentary consultation, please call 714-834-0101.
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January 8th, 2010 Michael A. Jazayeri M.D.
Nose Surgery Orange County
Many of my Orange County rhinoplasty patients are concerned about post-op recovery.
In majority of my cases, a full rhinoplasty is required. This means the hump is reduced, the tip is refined, the septum and the inside of the nose are addressed, and the bones are narrowed.
For such cases, I have been using the open rhinoplasty technique for over 10 years, since it allows better visualization of the entire nasal anatomy, thus resulting in a more predictable result. The trade-off is slightly more swelling, especially in the tip area, which may take longer to resolve.
Orange County Rhinoplasty Specialist
Dr. Michael Jazayeri Board Certified Plastic Surgeon
After surgery, the patient will have a splint on the nose for protection and nasal packing. Some surgeons prefer to use internal splints rather than packing. This is a personal preference. In my hand, I have had better consistency with packing as I can modify the amount on each side. The patient breathes through his/her mouth until the packing is removed. It is critical for the patient to keep the head elevated to minimize swelling, and to avoid sneezing or blowing the nose.
The patient is seen 24-48 hours after surgery. Most patients are surprised the amount of pain is less than expected. I have had a few patients who have had breast augmentation and rhinoplasty. All agree the pain of breast augmentation was worse than rhinoplasty. At this time, the splint and packing are inspected to make sure every thing is in place, and the patient has no bleeding. The patient should not wear any glasses.
The next follow-up visit is 7-8 days after surgery. At this time, the splint and packing are removed. For open rhinoplasty, I use absorbable sutures at the base of the columella, and no removal is required. I always warn the patient although the nose has improved, there may be significant swelling at this time. The patient should avoid blowing the nose or sneeze forcefully. No glasses are to be worn unless they can be fitted so there is no pressure on the bridge of the nose. If the patient has dry nose, over the counter salt water sprays can be used as often as needed. No exercise or heavy activity is permitted.
The patient returns for their one month visit. The patient is concerned about the swelling, especially in the tip area. Although the swelling has improved, it is still present. I remind patient the swelling usually starts improving at 3 months. However, the final shape of the nose may take 6-12 months. During the first three months, it is common for the nose to go through cycles of less and more swelling. The patient may start exercising and wearing glasses. Obviously, I do not recommend contact sports at this time!
The three month follow-up has arrived. The nose is beginning to take its shape and the patient is happier. I have noticed a metamorphosis in many of my patients at this 3 month follow-up. At the time of consultation, most patients are somewhat shy. At this follow-up, they walk and act more confidently. Many of my female patients have make-up on with nice clothes. It is a joy to see this change!
At the six month follow-up, the swelling in the nose is minimal to none. The patient is pleased with the result. They still walk and act confidently!
One year follow-up has arrived. The nose has achieved its final shape. However, over the coming years, minor changes will occur in the shape of the nose, which are detectable only by comparing photos.
This is a typical recovery for a rhinoplasty patient. Not everyone will have the same experience and, rarely, complications do occur.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 714-834-0101.
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September 10th, 2009 Michael A. Jazayeri M.D.
IGNORE THE INSIDE AND YOU WILL BE SORRY!
Many of my Orange County rhinoplasty patients complain about the shape of their nose.
Although it is important to address the cosmetic concerns of the patient, one must not forget an intra-nasal examination and address any issues inside the nose as well.
Almost all patients have some degree of septal deviation (the cartilage at the center of the nose which provides support to the non-bony portion of the nose). Many, especially in Southern California, also have enlargement of the inferior turbinates. The turbinates (three rows on each side) humidify the air. The enlargement of the lower turbinate may cause or exacerbate post-operative anatomical obstruction leading to airflow restriction. Pre-operatively, although the patient may not subjectively complain about breathing difficulty, many feel better after the turbinate is temporarily reduced by special medication spray.
It is very critical to address these issues, since in majority of cosmetic cases, the nose is not only reduced on the profile, but also reduced in width as well. This cosmetic “narrowing” may cause breathing difficulty if the intra-nasal findings are not addressed.
In almost all patients, a portion of the septal cartilage is removed as part of the straightening process. The removed cartilage is then used to improve the nasal tip and provide additional support to the surrounding structures. The inferior turbinates are reduced, so the airway passage is more open.
If these issues are addressed properly, the patient will have a cosmetically acceptable nasal shape which is functional as well.
Michael A. Jazayeri, M.D. is a board certified plastic surgeon with over 10 years of experience. His office is located in central Orange County. To schedule a complimentary consultation, please call 714-834-0101.
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May 28th, 2009 Michael A. Jazayeri M.D.
-THE NON-OPERATED OPERATED NOSE
I know the title is confusing. However, I chose this title to make a point.
What is the purpose of having one’s nose cosmetically altered if it screams “I had surgery on my nose”?
So what makes a nose look unnatural? In my opinion, the most common alteration is to shave off too much from the dorsum (the hump) of the nose. This will result in a “ski-slope” look, which is most obvious on the profile. The next time you are walking in the street, look at people’s noses. In nature, noses either have a hump on the nose or are flat. A “ski-slope” dorsum does not occur naturally.
This “style” of nose was, in fact, in vogue in the seventies and early eighties. However, our goal today is to make the nose look as natural as possible.
The other common problem is inadequate distinction between the dorsum and the tip of the nose. In females, there should be a slight step-off between the dorsum and the tip. This is called the supra-tip break. In males, this break should be very subtle or not exist at all. One does not want to see the dorsum higher than the tip. This will result in a “parrot-beak” deformity, which is most visible on the profile.
Visible irregularities of the dorsum are an obvious sign of operation. Again, if one looks at noses in nature, visible lumps and bumps do not occur.
There are other subtle signs which may point to a rhinoplasty. However, only a rhinoplasty surgeon can pick those up. My goal, as an Orange County plastic surgeon, is to aim for a natural looking nose. I want people to do a “double-take” and guess if the nose was operated on. It is a challenging goal to meet, but worth the time and effort!
Michael A. Jazayeri, M.D. is a board certified plastic surgeon, with over 10 years of experience. His office is located in Santa Ana, California. To schedule a complimentary consultation, please call 714-834-0101.
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