Melissa's Rhinoplasty Journal

My name is Melissa. I'm 22 and have always hated my nose. When I was a little girl I would cover my face when I laughed because I hated that my nose grew wider with a smile. Whenever I catch a glimpse of my profile in a reflection of a car window, or a mirror I just cringe. It's funny because I never imagine myself to look how I do. My nose is extremely bulbous, too long, has a large bump on the bridge and looks to wide. I've always wanted rhinoplasty but was scared of the surgery itself. The idea of a knife cutting into my skin, hammering my the bump off my nose scares me like you wouldn't believe. I finally got the courage and set my mind that I was going to do this when I saw a girl I worked with come in. She looked fantastic! I couldn't pinpoint what it was that was so different about her. I thought maybe she got a new haircut, maybe it's her new low cut shirt, and just then she pulled out her before and after rhinoplasty pictures. The difference was amazing! When you look at her you couldn't see that she had some kind of artificial nose, it still looked like her except the rest of her features lit up. Her eyes looked so much bigger and sparkled, she was constantly smiling and I never noticed what beautiful lips she had. Having a rhinoplasty puts off the focus on your nose and lets people see your other features, she was a prime example of that. I knew that I wanted to have my nose fixed by the same doctor, so she gave me the referral.

I went to my consultation with Dr. X. I walked into the French style double doors that read "Plastic Surgery Dr. X" 20 minutes early but had to wait 40 minutes after that. My hands were sweating, for some reason I felt incredibly vain for wanting my rhinoplasty. There were others in the waiting room, not tall blonde bombshells like I envisioned but just regular people. I imagined that these other people had some sort of valid excuse for plastic surgery like a birth deformity or maybe deformed because of an accident and I felt incredibly ashamed.

When I finally got called to go into the small consultation room, the nurse who was leading me back told me she had her nose done my this doctor in 1987. Her nose was way too small for my liking and very pig-nosed, I told myself that is what she wanted because she seemed very proud of the results. I waited another 10 minutes and he came in with a clip board and said "so you want a nose job, huh?" I was shocked that he didn't use the medical term for it. I said "yeah" and he sat beside me and started prodding, pinching, and lightly tugging on my nose. He said, "okay here's what I think we should do.." and he proceeded to draw on a clipboard the hump he wanted removed, the length shortened, the tip refined. I sat there and listened, still feeling ashamed to be there. His cell phone rang twice during this consultation interrupting my list of questions. He then told me it was his wife, and he had done many procedures on his past wives, and gave me a couple other intimate details about his personal life. When he spoke of his past wives there was a little hostility or maybe disgust in his voice. He finished what he was telling me about how his wife left him after he gave her a new face and stood up and asked me "so..sound okay?" I just nodded my head, maybe I was in shock because this is not what I had envisioned my 130.00 consultation fee to go like. Where were the before and after photos? Wasn't he going to show me a computerized image of my new nose? I left after my five minute consultation confused and disappointed, and I haven't even asked him all the questions I had prepared, and I never got a chance to show him the nose pictures I spent hours looking for in magazines. I told my friend who had the nose surgery and she said he is a weird guy, but that's just his personality. I decided that I really wanted to click with the surgeon who was going to alter my nose, and kept looking.

One year later I got the nerve to continue looking into consultations. My sister had just got her breast augmentation and the idea of having a larger chest had always appealed to me but I was really concerned about losing sensation in my nipples. It turns out hers are more sensitive after the augmentation and she is in love with her new boobs. I have decided to get a breast augmentation and a rhinoplasty. After all those are the two things that I don't like about my body. I always wondered how I would feel with a larger chest. I imagined that I would no longer feel inferior or less feminine to all of the bustier girls in bikinis at the beach. I also feel a little less ashamed about getting these surgeries, after reading every word on implantinfo.com I don't feel so alone. It turns out there are a lot of other women who have felt ashamed of getting plastic surgery! I looked up Dr. 2 in Madison, Wisconsin. His picture on his website was so inviting he was smiling and looked so!
  pleasant to be around. I felt at ease with his breast augmentations, the girls on his website looked natural and amazing! He only had one rhinoplasty on his website which worried me, especially because I didn't love the work he had done with her nose (I would have wanted less projection). When I call to make the consultation date he couldn't take me for a couple months and the secretary suggested I go with Dr. Z because "he is just as good". I asked, is he also board certified? I heard that this is the most important question to ask to avoid complications. "Yes, he is" she tells me with an irritated tone in her voice. I look into the internet for any information on this doctor and find that he was into hand surgery before he was a plastic surgeon. That relaxes me a little.

I go into the Dean Health Clinic the day of my consultation. I didn't have to wait long at all before I was called into the small consultation room. One thing I did notice that I didn't like was the staff was talking about another patient while I was in the waiting room. "Can you believe her" one nurse or receptionist would say to the other. I wondered if that patient was upset about a surgery, and this made me feel very uncomfortable. Dr. Z came in soon and I only waited about five minutes. He had a smile on his face and seemed very pleasant. He asked what I would like to have done to my nose, and I told him exactly what I wanted. I was pleased that he asked me, Dr. X never did. He told me what he would have to do as far as sedation goes, he told me a little in detail how he would perform the surgery, he was very informative. I asked him if he had any before and after photos to show me. He had none, and said he would see if he could find some for me. He was very young, and I wondered that how he became board certified at such a young age. He told me he wasn't board certified. I was "very" upset about this. I definitely did not like that he didn't have any photos to show me or wasn't board certified. He told me that he could refund my 30.00 for the consultation fee, after I left the clinic I decided that I would rather go to someone who is board certified. I felt bad that I was being such a nuisance (especially since I really liked what I saw of his personality), but then again, this is my FACE we're talking about. I called the Dean office after the consultation and said I'd like to schedule an appointment with Dr. 2. They seemed irritated that I wanted my fee waved because he wasn't board certified. I imagined the nurses talking afterwards about another difficult customer, me.

My second trip to the Dean Clinic, and my third consultation with a plastic surgeon. The wait was minimum and Dr. 2 came in smiling. He mentioned the mishap between me and Dr. Z and I said, "I think I may have upset some of the nurses." And he said, "well, that's life." I liked how he shrugged it off like it wasn't a big deal at all. I asked him if he had any other before and after photos and he said that was the only one but he might be able to find some others (I've heard this before.) I asked him when he would be able to find the other photos and he was very vague, and always said "we'll see what we can do." He told me he was a perfectionist that he loves a challenge and he will work until he gets it right. I liked that a lot. Some of the things I didn't like about him was that he crossed his arms (in a defensive way) when he was talking with me, and he wheeled his chair to the opposite side of the waiting room when I was interviewing him my list of questions. He also seem!
 ed to be offended by some of my questions about him as a surgeon and answered them in a cocky way.  One of the questions he seemed to not like is when I asked him, "are you board certified?"  He answered, "of course I am."  I felt like HE didn't feel comfortable around ME. Again, I felt very uncomfortable after my third consultation and wondered if I was ever going to get my surgery done. I found a website called rhinoplasty4you and they had a message board and a lady referred me to a doctor there in Omaha, Nebraska. I checked out his intricate website, for the second time (I had found it once before on a search engine) and was sure that he was the doctor for me. I knew I didn't even need a consultation.

Here is the letter I wrote to Dr. Denenburg:

Dear Doctor Denenburg,

I am living in Madison Wisconsin right now and have had three consultations. They all have had none to very few (one or two) before and after picture results to show. I am 22 years old and have started up a business without anyone's financial help and have always had to make hard decisions but after I've made them I always feel relieved. After my prior consultations, when it came to decide my surgery date, I am left feeling anxious, worried, and uncomfortable. When I came across your website and saw your before and after pictures I knew that I didn't even need to have a consultation. I am certain that you are the one to help me fix my nose.

There is one problem. I own a small lingerie store in Madison, Wisconsin and only have two employees with hectic schedules. The first week of January is my slowest time of year and I plan on closing my store for the first week. This would be the perfect time to schedule my surgery date, but your secretary has told me you are booked up until the middle of January. If there is no way that you can squeeze me in the first week of January, I will have to wait until next year in January to have my rhinoplasty. It's taken me four years to build the courage to finally go through with the surgery and I would appreciate it "so much" if there was anything we could work out.

There are things about my nose that I definitely don't like. I don't like my bulbous tip, I wish it was a little more refined. I don't like the bump on the bridge of my nose. I think that my nose projects too far. To be honest with you, I don't think I like anything about my nose. I understand that you cannot change my nose, but you can improve it. When I was looking at your rhinoplasty before and after pictures, it was difficult for me to point out what was wrong with their nose, but the after results were amazing. I would like to speak to you over the phone to talk about my nose.

Thank you,

Melissa Files Cell Phone# (815)xxx-xxxx

Business # (608)xxx-xxxx

Here is the letter he wrote me:

Hi Melissa,

Thanks for sending your email and photos. I believe I notice the same features of your nose that you point out in your letter. There is the bump along the bridge of your nose, that is visible from the frontal view as well as the profile views. It's probably visible from the frontal view because it's wide as well as projecting out away from the bridge of your nose. The tip of your nose does appear wider than I would like to see it ideally, and I agree with you that it projects too far away from your face as well.

Another factor to consider, I believe, is your chin. You have a little bit of a weak chin, which makes your nose look a little stronger. There is an operation where we add strength to the chin, and it can help draw attention away from the nose. Of course, it's not mandatory, but it can help a lot in certain situations, and yours is one of those situations.

I made a modification of one of your profile views, and it's attaching it to this email. In the attached picture, the image on the left is your original; the image in the middle shows changes to your nose, where I brought the tip back toward your face, took down the hump, and elevated the tip a small amount; and the picture on the right shows the same exact changes to the nose, with the addition of a stronger chin, so you can see what that looks like as well.

I also made an animation out of the modification, because some people find the animation easier to evaluate. You can see the animation in your Web browser by going to the following link: http://www.FacialSurgery.com/anim/FilesMelissaAnim.gif

I do think that your photographs so your areas of main concern on your nose well enough that if you did decide to go ahead with surgery, we would be able to schedule a date for your operation with your consultation the day before the operation itself, saving you from having to come to Omaha just for a preliminary consultation. Please feel free to let me know what you think after you've had a chance to digest my response, and thanks again for sending your photos.

--Steve

This is Bonnie writing to you now. I'd like to step in and answer your question about costs, as well as some other things we need to do to schedule surgery. I should tell you that I'm holding Tuesday, January 4th for you for a surgery date. I'll hold this date until tomorrow morning to give you a chance to go over all this information. That is the only day available the first week of January for surgery. You would need to be here on Monday for an in-person consultation with Dr. Denenberg.

The cost for your primary rhinoplasty would be $x, and a chin augmentation would be an additional $x. To that, you would have to add another $x for the operating facility and anesthesia fees. There would be additional expenses in the range of $250.00 to $350.00 for such things as pre-operative blood tests, and some prescriptions and miscellaneous items. And, of course, you would have to get yourself to Omaha and back.

As far as payment is concerned, our policy is to receive a $x nonrefundable deposit at the time surgery is scheduled, with the balance of the payment due in full, six weeks prior to a scheduled surgery date. We do not have an in-office payment plan, but we find that many of our patients like charging their surgery to Visa or MasterCard, thus allowing them to handle monthly payments on their own. You could also contact your bank, savings and loan, or credit union to inquire about a loan. Several of our patients have done this to pay for surgery.

Another thing I should mention is that you may not be alone that first night after your surgery. If you come to Omaha alone, we would need to make arrangements for a sitter to stay with you the night of your surgery. She would be responsible for putting cold cloths on your eyes all night and assist you as needed. Her charge is $x, and you would need to pay her before she leaves you the morning after surgery.

Most of our patients stay at the DoubleTree Guest Suites, which is located near our office. They provide a room for a discounted price, in the range of $90.00 per night, when you call the local sales office and tell them you are a patient of Dr. Denenberg's and that you are requesting his preferred rate. The DoubleTree has a courtesy van that offers free transportation from the airport.

Since Dr. Denenberg has reviewed your photos and has determined that you would be a good candidate for surgery, you could call me any time to schedule a date for the operation, and arrange to be here the day before surgery, so that you and Dr. Denenberg could have a thorough in-person consultation and make sure that you are both happy with the plan.

Dr. Denenberg would want to see you a week after surgery, too, to see how you are doing and remove any stitches. Some people prefer to stay in Omaha for the week. Others go home a day or two after surgery and then return for the follow up visit.

After you have called me and scheduled a date for the operation, I would then send you a large packet of information. The packet would include our patient handbook, surgery paperwork, pre-operative instructions, laboratory information, prescriptions, hotel brochure, etc. As I mentioned earlier, the paperwork and your payment would need to be returned six weeks before the scheduled surgery date.

You may call me anytime, at the number on the bottom of this email, if you would like to discuss the possibility of coming to Omaha. We look forward to hearing from you.

--Bonnie

After looking at his alterations of my profile photos that he made for me I was even more at ease with him. This is exactly how I envisioned my consultation to go, and I wasn't even there yet I had another consultation right before surgery! I was shocked that he wanted to implant my chin, especially since I have never been self conscious about it. I studied the photos for hours and asked my sister and my fiance and they both like the rhinoplasty but don't like the chin. I'm almost 100% positive that I don't want a chin implant, I'd rather save the money for bigger boobs anyway! The cost is another thing that shocked me, I thought I'd pay 5,000-6,500 for my rhinoplasty. Usually higher cost means higher quality and I would pay 2 times the price that he asks if that means I'd be happy with my face. I've been dreaming of being able to take a picture without worrying about the results, looking in the mirror and liking what I see and I can't wait until January 4th! My fiance is sic!
 k of hearing me talk about plastic surgery and wants me to stop looking up information on it all day, but I can't help it. I want to learn as much as I can about it.

I drove the 6 hour drive to Omaha, Nebraska for Surgery, it was the longest drive ever since I let my fiance listen to the football games on the radio (not exciting for me) and all there was to look at was Iowa corn fields. The Doubletree Suite was the nicest hotel I've ever stayed at. I can't believe when you walk in they have palm trees inside the buildings, they give you warm cookies, and the bed was so comfortable! The consultation before surgery was so thorough. Unlike any of the surgeons I saw in the past, he make sure all of my questions were answered 100% and I never felt rushed. One very interesting thing that set him apart from any of the other surgeons I've been to is the way he pinched my nose. I noticed that he was the most gentle out of the three I've been to before. I walked out of there with my fiance feeling totally confident, my only worry was the numbing shot and IV.

Dr. Denenberg gives you sleeping pills to take the night before surgery, and I'm one of those people who don't like to take medication if it's not necessary. Since I was so confident about the surgery I opted on trying to sleep without them. That was a mistake. I think it was just anticipation of finally having my rhinoplasty that woke me up three times that night, even though the bed was so much more comfortable than my own at home. When it was time to wake up I took my Hibiclens shower (Hibiclens is a very stinky anti-bacterial soap that he instructs his patients to use), dried my hair without any products and left.

We only had to wait a few minutes until they took me into a room to clean my face again and put on the lovely hospital gown. They let me keep my panties and socks on which made me feel a lot more comfortable, and gave me a robe to wear walking into the surgery room. I thought the robe was a nice touch since those hospital gowns are backless. The nurse was very pleasant and gave me the numbing shot before for the I.V. very gently. I told her about my fear of needles and she said after I took the shot that I'm a lot stronger than I think I am. I thought that was very sweet. I didn't even feel the I.V. being put in after the numbing shot. She asked me if I would like to ask the Dr. any questions before going off and I said, "no," because I honestly couldn't think of a single one.

Here's where it got very uncomfortable for me. Prior to my surgery I had this horrible dream where the Dr. let a student nurse oprerate on one side of my nose while he did the other. Then when the cast came off one side was gorgeous, and the other side was a disaster! While I was drifting off I saw a brunette nurse poke her head around the door to look at me, and I had it set in my mind that my nightmare was going to come true and she was going to ruin my nose! I tried to ask that sweet blonde nurse if I could ask the doctor a question but it wasn't coming out and then I drifted off. The next thing I remember was the next morning after surgery in the Doubletree bed asking Tim if he could give me my raisonettes. I have a horrible addiction to chocolate.  I ate one chocolate raisin and went back to sleep, definitely a happy camper with some chocolate in my system.

Tim, my fiance, told me what happened that I couldn't remember. I work up from surgery, out of it, and he dressed me with the help of the blonde nurse. He said that she was trying to make sure I wasn't exposed when they put on my zip front sweater, but I just had no shame and flung that gown off of me. They wheelchair me to the car and when I got to the hotel I got in bed right away. He was very diligent about making sure that there was an iced washcloth on my eyes and bridge every 15 minutes (another instruction the Dr. gave me) but as soon as he would change it I would wake up and tell him "no" or throw it on the floor. Thank god Tim knows me well enough to not argue with me or I would have never had that cloth on my nose. He said he would wait until I drifted off again and then place it on my nose. I can't believe that I didn't remember how incredibly important it was for me to follow every instruction to the tee, but I guess that's what happens. I am so grateful that he was there for me and the whole experience made me feel even closer to him.

The next day when I got out of bed I went right to the mirror. I heard so much about bruising and I bruise so easily that I was certain I would look like a mess. I had almost no bruising, just one tiny little faint yellow bruise on the bridge of my cast. I could breathe through my nose fine, not as good as normal, but what can you expect? That's another thing I never would have expected because I heard so many people upset about breathing through their mouth. Another thing is that I had almost no pain! Throughout the week when I had my cast on I only took a couple pain pills when I pain reached a 2 or 3 on the 1-10 scale. I have had colds or a flu that hurt way worse than having my rhinoplasty. I can't believe how easy it was for me, it really shows you what a wonderful experience you can have if you pick the right surgeon. To be 100% honest with you the worst part of the healing process was not being able to work, and not being able to clean those nasty crusties out of my nose. They really were starting to smell putrid, oh yeah I almost forgot to mention that I could smell!

I drove back up to Omaha, this time with my mom, to get the cast taken off. I heard so many horror stories about how much pain it was to get it taken off. I was expecting to see blood and expecting to bite my tongue so I wouldn't cry or scream. Now that I'm writing this I feel embarrassed to have thought that since my experience so far as been a piece of cake. The nurse took us into a familiar room because I had been in there for part of my consultation. She set up some instruments behind me. The shiny tweezers, and some instruments that looked like they could have been used for cutting or prodding. I was SO scared, my heart was racing. Dr. Denenberg came in and greeted us, as warmly as he has been in the past. My mom was talking to him as he was preparing the cast to be taken off. I was thinking in my head that I wish she would shut up so he could talk to me about my nose. What he was doing and what I could expect, I just wanted him to say anything so I wouldn't be so scared. I must have been acting like a baby, mom said I was gripping the arm rests of the chair and I know I was squeezing to curl my toes in. I hope I didn't make him feel too uncomfortable, I told him that I was expecting major pain but didn't have any. It was uncomfortable when he took the cast off, probably because of my worry, and the stitches didn't hurt at all. Well.. except for one. It was right by a nerve and I DEFINITELY felt it when he was taking that one out.

After the cast came off he put me in front of the three-way mirror. I was expecting to feel embarrassed like I did last time. I read on a message board not to look forward to this moment because your nose will probably still be ugly because the swelling is so intense, In the past, whenever I was in a position where people were looking at my face I always felt embarrassed and even ashamed to own an ugly face. I've always lived my life believing that there will be people who will think I'm pretty because I am a nice person. That looks didn't matter just they way you treated people. This time, for the first time in my life I felt that my face was actually pretty. I even noticed other features of my face that I thought were just plain-Jane okay, but now I thought they too were pretty. I was trying my hardest not to cry, I didn't want to be inappropriate, but I can't describe how it feels to actually like the way your face looks. Dr. Denenberg gave me a tissue and he showed me that there was still swelling that would go down. He taught me an exercise that I could do to help some of the swelling by the bridge between my eyes. It was very hard to learn that simple exercise because I was so excited about my nose. I hope I didn't weird him out because as I was leaving I went to shake his hand to tell him thank you and ended up asking if I could give him a hug! I am so ridiculous!

I went back to work the following day. I had planned not to tell anyone who didn't notice that I had a rhinoplasty. I talked to lots of people that I talk to on an everyday basis that day and no one said a word. I wore pretty dangle earrings and pulled my hair in an up-do and had some people compliment me on my earrings but no one said a word about my nose. I can't smile like I used to since there is some swelling in my upper lip (Dr. Denenberg said that is normal), and I think people have been noticing that there is something wrong with my smile more than my nose since I usually smile a lot.

Anyone who is researching rhinoplasty should make sure that they feel comfortable with their surgeon before they sit in that operating chair. I can't imagine not feeling confident that I will have an improved nose after the whole surgery and healing process is over with. I hope that my story will help someone with their decision, or maybe make them feel more comfortable. Thinking back on all the times I felt ashamed to want a rhinoplasty makes me feel stupid for even having those feelings. The most important thing I wish I would have learned that it's okay to want to do something to feel better about how you look. The way I felt about how I looked shaped my personality. I will come across to people a more confident, happier, and because I will be more confident and happy I think I will look smarter. I truly believe that since my confidence has been boosted it will change the way I interact with people. I am so grateful to Dr. Denenberg and his staff and websites like this one that helped me find him.

Melissa