Improve your beauty profile
As one of your most prominent features, your nose has a significant ability to alter the appearance of your face. Its shape, length, width and proportions all combine to give your face its unique beauty and character. That’s why when you are considering rhinoplasty, it’s important to select a surgeon with extensive experience and recognized skill in nasal surgery.
Dr. David Hayes is considered a leading expert in rhinoplasty; he performs more than any other plastic surgeon in the area. And because he’s board-certified in both Facial Plastic Surgery and Otolaryngology (ear, nose and throat specialty), you can feel confident you will receive the best possible care.
Dr. Hayes recognizes that the diversity in nasal anatomy requires that the surgeon be versatile in multiple techniques. Rhinoplasty is complex because the esthetic goals must also be in sync with the functionality of the nose itself. Noting that soft-tissue variances and the complexities of cartilage make each nose comparable to a unique work of art, Dr. Hayes uses his trained eye to create symmetry and balance to not just the nose but the entire face.
If you're considering rhinoplasty...
Rhinoplasty can reduce or increase the size of your nose, change the shape of the tip or the bridge, narrow the span of the nostrils, or change the angle between your nose and your upper lip. It may be performed in conjunction with other procedures to improve breathing. The goal is to improve the nose making it harmonize better with other facial features.
Candidates for Rhinoplasty
The best candidates for rhinoplasty are people who are looking for improvement, not perfection, in the way they look. If you're physically healthy, psychologically stable, and realistic in your expectations, you may be a good candidate.
Age may also be a consideration. Many surgeons prefer not to operate on teenagers until after they've completed their growth spurt-around 14 or 15 for girls, a bit later for boys. It's important to consider teenagers' social and emotional adjustment, too, and to make sure it's what they, and not their parents, really want.
Planning Your Surgery
Good communication between you and your physician is essential. In your initial consultation, Dr. Hayes will ask what you'd like your nose to look like, evaluate the structure of your nose and face, and discuss the possibilities with you. He will also explain the factors that can influence the procedure and the results. These factors include the structure of your nasal bones and cartilage, the shape of your face, the thickness of your skin, your age, and your expectations.
Dr. Hayes will also explain the techniques and anesthesia he will use, the type of facility where the surgery will be performed, the risks and costs involved, and any options you may have. Most health insurance policies don't cover purely cosmetic surgery; however, if the procedure is performed for reconstructive purposes, to correct a breathing problem or a marked deformity, the procedure may be covered. Check with your insurer, and obtain pre-authorization for your surgery.
Be sure to tell us if you've had any previous nose surgery or an injury to your nose, even if it was many years ago. You should also inform us if you have any allergies or breathing difficulties; if you're taking any medications, vitamins, or recreational drugs; or if you smoke.
Don't hesitate to ask Dr. Hayes any questions you may have, especially those regarding your expectations and concerns about the results.
Revision Rhinoplasty
Dr Hayes is well known throughout Montana and surrounding states for his expertise in revising rhinoplasty surgeries where the outcome from the original surgery by another surgeon was not ideal.
Revision rhinoplasty is a more complicated procedure and requires expertise to achieve the desired results. Make sure to bring any records of previous rhinoplasty work with you to your consultation.
Preparing for Your Surgery
We will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications, and washing your face. Carefully following these instructions will help your surgery go more smoothly.
While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.
Where Your Surgery Will Be Performed
Rhinoplasty may be performed in our state of the art office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, for cost containment and convenience.
Anesthesia used For The Procedure
Rhinoplasty can be performed under local or general anesthesia, depending on the extent of the procedure and on what you and Dr. Hayes prefer.
With local anesthesia, you'll usually be lightly sedated, and your nose and the surrounding area will be numbed; you'll be awake during the surgery, but relaxed and insensitive to pain. With general anesthesia, you'll sleep through the operation.
The Surgery
Rhinoplasty usually takes an hour or two, though complicated procedures may take longer. During surgery the skin of the nose is separated from its supporting framework of bone and cartilage, which is then sculpted to the desired shape. The nature of the sculpting will depend on your problem and your surgeon's preferred technique. Finally, the skin is redraped over the new framework.
Your surgery may be a "closed" procedure where all the incisions are inside the nostrils. Or you may have an "open" procedure, where a small incision is made across the vertical strip of tissue separating the nostrils.
When the surgery is complete, a splint will be applied to help your nose maintain its new shape. Nasal packs or soft plastic splints also may be placed in your nostrils to stabilize the septum, the dividing wall between the air passages.
After Your Surgery
After surgery, particularly during the first twenty-four hours, your face will feel puffy, your nose may ache, and you may have a dull headache. You can control any discomfort with the pain medication that we prescribe. Plan on staying in bed with your head elevated (except for going to the bathroom) for the first day.
You'll notice that the swelling and bruising around your eyes will increase at first, reaching a peak after three to four days. Applying ice compresses will reduce this swelling and make you feel a bit better. Swelling and bruising should disappear within two weeks or so. (Some subtle swelling, unnoticeable to anyone but you and your surgeon, may remain for several months.)
A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks.
If you have nasal packing, it will be removed after a few days and you'll feel much more comfortable. By the end of one week, all dressings, splints, and stitches should be removed.
Getting Back To Normal
Most rhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery.
You will need to avoid strenuous activity (jogging, swimming, bending or lifting) for two weeks. Avoid contact sports, and any other activity where your nose may be injured for one month.
We will schedule frequent follow-up visits in the months after surgery to check on the progress of your healing. If you have any unusual symptoms between visits, or any questions about what you can and can't do, don't hesitate to call us.
Your New Look
In the days following surgery, when your face is bruised and swollen, it's easy to forget that you will be looking better soon.
Rest assured that this stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within several weeks you will begin to see how your new nose will look. Healing time after a rhinoplasty is a slow and gradual process. Some subtle swelling may be present for months, especially in the tip. The final results of rhinoplasty may not be apparent for a year or more.
In the meantime, you might experience some unexpected reactions from family and friends. They may say they don't see a major difference in your nose. Or they may act resentful, especially if you've changed something they view as a family or ethnic trait. If that happens, try to keep in mind why you decided to have this surgery in the first place. If you've met your goals, then your surgery is a success.