A) “Are silicone implants a good option for augmenting my nose?”
Some noses may be under-developed or slumped in the upper part or you may simply want to increase the height of your nose. Something needs to be added to the dorsum (top) of your nose to achieve this. Presently, there are two viable options – silicone implants or your own cartilage.
Silicone implants are synthetically made and available in various shapes and sizes. However, they may be limited by their pre-determined size and shape. Similarly, there is a greater risk of implant being “rejected” by your body after surgery.
On the other hand, your own cartilage is your own tissue and therefore is rarely rejected. Cartilage can be harvested from the septum, ear or from your ribs. However, cartilage has a tendency to bend in an unpredictable manner. Although there are techniques to prevent this “warping” they may not always be full proof.
Based on the available scientific data, cartilage is the preferred substance by most rhinoplasty surgeons around the world today.
Please feel free to discuss these options with your nose job surgeon as the final decision will be based on your choice, your surgeon’s preference as well as your proposed surgical plan.
B) “I am worried that my nose surgery will affect my breathing!”
Most nose surgeries should not affect your breathing pattern. However, attempts to overzealously narrow the nasal tip may lead to collapse of the nasal tip region that may affect your breathing. This may require immediate corrective surgery. On the other hand, the initial swelling as a part of your healing process may also give you a “blocked nose” sensation. This is a temporary problem and you will be prescribed medicines to counter this issue.
Some patients may have severely deviated septum with associated functional airway obstruction (nasal congestion, mouth breathing, nose bleeds, sinus infections, headaches, ear problems, sleep disturbances etc). These problems can be improved by functional nose surgery – septoplasty, turbinate reduction, removal of polyp (if any) and FESS (Functional endoscopic sinus surgery). I routinely perform these surgeries (as and when required) with a cosmetic nose-job along with a qualified ENT surgeon. A CT Scan of the nasal and para-nasal regions will be advised for planning these procedures.
C) “I am unhappy with the result of my nose-job, how soon can I correct it?”
Revision nose surgery may be required in some cases. In most cases, the result is masked by the initial swelling and bruising as a part of your healing process. Your nose will appear wider and broader than planned for several weeks after your surgery. Judicious patience is advised in such cases as it almost inevitable settles with time. Some cases with protracted swelling or excessive scarring may benefit by conservative use of Kenacort (steroid) injections.
If you are still unhappy about your result, then you may consider corrective revision surgery 12 months (ideal) after your last surgery.
Early revision surgery is recommended in some cases – severe twisting, pinching, collapse of nose. These conditions tend to worsen with time and therefore it is better to operate once the initial inflammation process is over.