Marianne's Rhinoplasty Journey!

Well, my doctor told me if I had just had the tip nipped and tucked and narrowed that the bone structure towards the top would look wide. Well, I never even thought I had a thick nose until he pointed it out. Alas! $3,000USD more than just having the tip 'done'. But, then of course after he pointed it out I obsessed about it. He was right, I had to have it done!

Surgery Day Well, surgery day rolls up and I am excited...I have a tendency to "freak out" when going under anesthesia so, of course, I did. I started asking everyone if I was dying and cursing and asking where I was. Well, a few minutes later I was totally down for the count. Marc said that there was a lot of tugging and twisting and pulling. For the actual infracture (breaking of the bones to narrow them) the doctor held a chisel thing called an osteotome and he would instruct the nurse to tap with this mallet. He would say, "tap tap...tap tap...tap tap" I think it took quite a few times.My boyfriend, Marc, has witnessed each surgery I have had and he said this one (rhinoplasty) was pretty gruesome.

Then my tip was 'nipped and tucked' by skewering some cartilage and twisting it around and around and then cutting it off. Now, at this point I woke up and said "Owwww it hurts" (creative, huh?) Last words I heard were "give her some more..." Now, they inject quite a bit of a solution of Lidocaine (pain reliever) and epinephrine (a vasoconstrictor which lessens bleeding) into your nose to impede swelling and bleeding during the procedure so I was told that that is mostly where the bruises come from. Although I don't know how this can be since I have watched a few rhinoplasty surgeries on tape (both open and closed procedures) and only saw the injections placed within the nose and not around the eyes. But I guess there are minute vessel rupture during the procedure.

A friend pointed out to me that this surgery has the highest rate of revisions. It seems that some people, especially mature people, may not readily accept the new look. Being accustomed to their "old" nose they just can't seem to comfortably make the transition. Although there are a few rhinoplasties that just don't heal right, due to something as serious as human error (the doctor's) or as simple as not having your head elevated enough or sleeping on one side a lot without a proper cast, tugging on it, etc. The nose can "pull" to one side if the cast does not support it properly in the first week. Or quite simply, your body may just heal that way.

After my nose was "set" the way he thought it should be he put a cast on my new nose - this one was the kind that you place in hot water and then can mold it over your adhesive-laden, taped up nose. Well they all picked out a neon yellow cast as a joke which you can see in the photos! Marc said that they then proceeded all to make fun of me and take photos with "rabbit ears" behind my head and well, I AM KIDDING! Hello!

Anyway, my surgeon then put a pressure dressing on my eyes and I was brought to the recovery room. I was very disoriented, I think emotional from my anesthesia as well - I remember shivering too from the epinephrine which is like a quadruple espresso on crack or something. But the worst part was not being able to see! I had to keep that pressure dressing on for a few hours!! I think I remember Marc trying to give me a sip of water in the recovery room and then he spilled an itty bitty drop of water on me and in my anesthesia-induced haze I thought he did it on purpose. I started crying and couldn't believe he did that on purpose! What kind of person pours water all over a post-surgical rhinoplasty patient who can't even stand up by herself??? I think I made a mental note to pack my bags and move out as soon as I was able. I look back and laugh so hard when I remember my crazed thoughts!

After I felt better and my vitals were all in check they sent me home. I was wheeled out of the office in a wheelchair and could not see a thing! I wondered, people must thing I was in an accident as the cars drove by us. I say that now, but I don't think I was wondering anything at the moment. Thank goodness the ride home was only about 20 minutes.

about 2 hours post with pressure dressing	4 hours post
6 hours post	7 hours post - drugged up again
3 days post - I'm sad	5 days post
5 days post	8 days post-op

The Road To Recovery
We're home!! Uh oh. I am nauseated... You ingest a bit of blood during the procedure and it can make you sick. Which it did. In my flower bed. In front of my neighbors. Marc said our neighbor was walking with her baby stroller and accompanying rug rat and I threw up this black-red substance into my Lobelias and Violets!!! For shame!! Marc said the neighbor just kind of started walking faster and was trying not to stare - I wonder if she thought I had been kidnapped or something?

The swelling and pressure is relieved by "icing" and I strongly recommend it. I was instructed to keep it iced for 24 hours and then thereafter for comfort. The best thing to ice it down with is, get this, a bag of frozen peas. Knowing from experience now, I recommend using frozen raspberries or blueberries, because frozen peas tend to stink after a while and my friend busted her bag 'o' peas all over herself and her bed linen! Alternatively, I suggest that you buy both the veggies and the fruits and see which you like better. I mean it's not like they are expensive, right?

AWESOME Tip!< This was sent to me by a visitor.I wish I would have known about it. "Make a mixture of 1/3 isopropyl alcohol and 2/3 water (mix a pitcher) and pour this solution into Ziploc sandwich bags with about 1/2 a cup in each bag (you may want to double-bag).It stays colder longer, stays slushy because of the alcohol and is still very lightweight."

Breathing & Sutures
The only thing I disliked was breathing through my mouth and feeling 'stuffed up'. I do not like breathing through my mouth whatsoever (unless I am scuba diving or snorkeling, of course). So, it was probably more psychological than anything. My lips got really chapped and someone told they used Aquaphor® by Eucerin (which by the way works WONDERS) for their chapped lips. I wish I would have known this after the fact. *duh* on my part, I didn't even think to use chapstick.

This is because of the constant breathing through the mouth plus scrubbing and cleaning of your skin with the harsh chemicals. It is a necessary evil so just slather your Aquaphor® or favorite lip balm on and deal with it.

The stitches were the dissolvable kind but they felt like they took forever to dissolve. I had great big spidery black hair-like things sticking out my nose for a week or two, YUCK!

Cast Removal
My cast was removed on the 7th day.WOO HOO!! Look out...the swelling "moved down" and I could actually feel it throb and move south until the area between my top lip and nose was swollen and felt stiff. It did this for a few hours and I had to be VERY careful not to accidentally hit my nose. I was very protective for many weeks about my nose. Even though it wouldn't break or anything, it sure felt tender and well - you will feel as though you can mess up your nose. And you can! Sometimes your skin hasn't completely adhered or something. You just never know so be careful with it. No contact sports!!

Well I am in for the long haul as it takes about a year for the swelling to completely subside but it will start looking good in a few weeks. Just when I thought it was looking great - it defined and looked even better!

By the way, my doctor prescribed a Pharmaceutical grade Arnica montana derivative in pill form called SinEcch and an Arnica montana topical ointment called Boiron. I swear by this stuff. I had one bruise about the size of a quarter on my left side from my bra when I was sleeping on it and that is it! You can order SinEcch from Alpine Pharmaceuticals for about $29.US. It significantly reduces swelling, bruising and speeds the healing process. Well it has with all of my surgeries and other patients I have spoken to. If your doctor does not offer nb it, perhaps you can speak to him and suggest its use. I strongly recommend it and so do many other patients. Would you like to know more about the benefits of Arnica montana? Or perhaps Bromelain? Although if your surgeon says no to it - don't you dare!

Getting Back to Normal & Other Concerns
Some patients will lose their sense of smell, temporarily. I did for a short time, but only regained half of my sense of smell after several months. It took about 9 months to get my full sense of smell back (I have an EXTREMELY keen sense of smell, I have an uncanny ability of being able to differentiate hundreds of smells one after the other. I guess that is my little "gift". Your nose may be swollen and for up to a year. Don't laugh at this next one, but the scar tissue may heal in a way that may cause a "whistling" sound to be heard when you breathe in and out. Either that or if your tip or nasal structure was made too thin it can cause this as well as difficulty breathing form the nose.

Post-operative Chronological Photos

Note!Never mind the eyebrows, please. I had NO clue what I was doing, but it got better. Obviously I learned eventually - somewhat.Check out that swelling and how it dissipates over time. It WILL subside, have faith!

*These photos each will load in a separate window for ease of comparison*

1.5 months post (immediately after collagen injections)	4 months post (2 wks after Gore-Tex lip implants)

18 months post

A friend pointed out to me that this surgery has the highest rate of revisions. It seems that some people, especially mature people, may not readily accept the new look. Being accustomed to their "old" nose they just can't seem to comfortably make the transition. Although there are a few rhinoplasties that just don't heal right, due to something as serious as human error (the doctor's) or as simple as not having your head elevated enough or sleeping on one side a lot without a proper cast, tugging on it, etc. The nose can "pull" to one side if the cast does not support it properly in the first week. Or quite simply, your body may just heal that way.

This is when the swelling was still apparent on the tip and there was no dent due to the swelling & no "pinched" look. I loved it back then. This is how it looks in the morning if I have edema

In this pic you can see the facet of my soft triangle forming even more so. It resembles a dent above my right nostril. Now at over 2 yrs. post it is even more so.(this is not a very flattering pic)

The tip of my nose goes a little to the left. Not that you could notice because you wouldn't sit there and look at my nose in a thousand different angles repeatedly. But, you would your own. Also, I had to have cartilage taken out on the right side and added to the left.BUT I noticed since my new pics were up in comparison to my befores that my nose went to the side before my rhinoplasty

Two and a half years post-op:

check out the scar tissue ridges inside - oh so attractive. Think I'll start a trend. My skin was VERY irritated from Obagi and Retin A

I look like a a typical cartoon witch.Where's my broom??

I look utterly horrible in this pic though. I'm tired from caring for my friend all night who was recovering from her cheek/chin revision

3 Years Post-op - Before & After Comparison

gladly not much of a change of the profile

Before & After, front

gladly not much of a change of the profile

Four Years Post-op
These pics were actually taken before I had some temporary lip injections, hence the nose is a little cut off at the top in the laterals.  Sorry :(

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Almost 5 Years Post-op

tip leans to the left and a lil too much projection

Columella leans to the right, tip to the left

weird angle sorry - this pic makes my nose look HUGE.

little too much columella show, but profile is not too shabby, lol!

little too much columella show, but it pulls down more when I smile big

okay I am NOT smiling, I am trying to have a completely relaxed face.I look funny but the nose looks good to me here :)

Five years post-op These pics were taken a day after having more temporary lip injections a year after the above, lol. Nose looks good here But the view from above shows what I dislike.