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Rhinoplasty

INTRODUCTION

“I do not want a Michael Jackson nose.” We hear that frequently from our rhinoplasty patients. Our goal has always been to keep the nose looking natural and keep the patient’s character, while making it look better. There are few perfect noses in this world. Since the “hey day” of the Greeks, many criteria have been proposed to guide us towards the ideal dimensions of the aesthetically-pleasing nose, given that it is the centerpiece of the face. As our society becomes more ethnically diverse, so do the noses that a plastic surgeon has to address.

You may seek a rhinoplasty for a variety of reasons. Sometimes the reason is self-consciousness about the appearance of your nose, and the belief that it makes you less attractive. Other times, it is for functional reasons – for example, difficulties breathing due to a deviated septum – but perhaps you will opt for “a little touch-up of the tip” while you are under anesthesia. Whatever your reasons may be, a rhinoplasty on a patient who is realistic about his or her reasons and expectations will yield tremendous satisfaction, as long as they remember that a rhinoplasty offers improvement, not perfection.

BENEFITS OF SURGERY

Common concerns addressed with a rhinoplasty include:

• The bridge of the nose can be either augmented or shaved.
• The width of the nose can be narrowed.
• The nasal tip can be altered in shape and size.
• The angle between the upper lip and the tip of the nose can be increased or decreased.
• The nostrils can be reduced.
• The septum can be straightened.
• Breathing can be improved by doing several maneuvers.

PREPARING FOR SURGERY

We believe a well-prepared patient leads to a successful surgery and recovery. Whether you are flying in internationally or a local, our staff strives to give you a great experience. During your initial call to our office, one of our patient care coordinators will discuss the different options available to improve the areas of your concern. A consultation is scheduled with the doctor who best fits your personal situation. The doctor will review your medical history, spend the appropriate time to review all surgical and non-surgical options, and discuss whether surgery can be performed in-office under local sedation or at the hospital under general anesthesia. In sharing our before and after photos, you get a better sense in the quality of surgery our doctors offer and what outcome you can expect to achieve. We will review pre- and post-operative care so you can be prepared for what your role is in surgery. You will be asked to stop smoking two weeks prior to and post-surgery. Safety is our top priority, so we will ask you to see your primary care physician to perform a physical exam, lab work and, in some patients, an EKG 30 days prior to surgery. Next, we see you for a pre-op appointment two weeks prior to surgery to discuss any questions you may have and review surgery details, ensuring everyone is on the same page. You will then receive a courtesy call the evening before surgery to review instructions and any questions you may have.

PROCEDURE DESCRIPTION

We perform both open and closed rhinoplasties. A closed rhinoplasty is performed where the incisions are hidden inside the nose. An open procedure is performed where an incision is made across the columella, the narrow area of skin that separates the nostrils.

With closed rhinoplasties, there is the avoidance of the scar at the base of the nose (columella), and perhaps quicker healing. In our opinion, this technique has limitations, such as good exposure, creating excellent symmetry with both nostrils, and the ability to shape the nose according to a patient’s desires.

The open rhinoplasty approach offers great exposure and ease of visualization of the entire nose, when the skin is lifted up. Since every nose is different, so is every procedure. However, there are common problems that are fixed in a nasal surgery:

• The bridge of the nose can be either augmented or shaved.
• The width of the nose can be narrowed.
• The nasal tip can be altered in shape and size.
• The angle between the upper lip and the tip of the nose can be increased or decreased.
• The nostrils can be reduced.
• The septum can be straightened.
• Breathing can be improved by doing several maneuvers.

RECOVERY

Our office will provide a comprehensive post-operative plan to ensure the best possible outcome. The plan will include what to expect postoperatively, such as estimated recovery time, pain management, garments or dressings, and anticipated activity level. For your safety, we require that an adult stay with you at least the first 24 hours after surgery and drives you to your next day follow-up visit. With most facial procedures, you will be instructed to limit activity for the first week or two, which could include restrictions on driving, prolonged travel and flying. In addition, we ask you refrain from exercise until cleared by the physician, usually around four weeks post-op. You are asked to refrain from smoking for a minimum of two weeks. To optimize healing, we recommend that you eat a high protein diet. You should anticipate a variable degree of bruising and swelling, as with any surgical procedure; light make-up may be used to cover bruises starting a week after surgery. We also offer scar creams at an additional cost to optimize results.

To promote healing and minimize complications, you will be seen in a series of post-op appointments, including the day after surgery. These appointments will continue throughout the first year after the procedure to make sure you are healing as planned. For your added convenience, you also have direct access to Dr. Bitar’s and Dr. Lickstein’s cell phone numbers if you need to reach your physician after hours. The final post-op visit, one year after surgery, is one of our favorites since the results are fully apparent and we love seeing our patients happy. You are always welcome to come back and see us, even years after your surgery.

MAXIMIZING POSITIVE OUTCOMES

At the Bitar Cosmetic Surgery Institute, we take pride in providing our patients with the best surgical experience possible, emphasizing patient safety while trying to optimize surgical results. This is a process that includes comprehensive pre-operative preparation and patient education, the development of a personalized operative plan, and a thoughtful post operative care regimen emphasizing patient comfort and promoting recovery.

There are a number of strategies which the Institute has adapted to further ensure patient safety. We are selective and only offer surgery to patients whose general health and lifestyle choices permit healing and facilitate recovery. To minimize risk, we require a preoperative assessment that includes a thoughtful history and physical exam, as well as targeted laboratory tests.

We operate at accredited hospitals and surgicenters that have demonstrated a commitment to the highest standards of care, employing board certified anesthesiologists and nurses. We adhere to well established surgical principles designed to ensure patient safety and have developed policies and protocols to minimize the risk of infection. Our surgeons are committed to continuing education, honing their skills and introducing new techniques always with the aim of improving safety and surgical results.

We emphasize patient safety in our peri-operative care plan, advocating early mobilization, optimizing nutrition, and providing detailed care instructions. After surgery, patients are seen in our office frequently and early, starting the day after their procedure, and a staff member is available around the clock for any questions or concerns. Our entire team is committed to our patients’ well being and every measure is designed to minimize potential complications, promote comfortable and rapid recovery, and optimize surgical results.

WHY CHOOSE BITAR COSMETIC SURGERY INSTITUTE?

Our commitment to excellence and exceptional patient care is in every step of your doctor-patient experience. Dr. George Bitar and Dr. Larry Lickstein are distinguished board certified plastic surgeons, with over 30 years of combined experience, who exclusively perform cosmetic surgery. Our doctors stay on the cutting edge of advancements in cosmetic surgery and technology to offer the best possible results. With a blend of artistry and meticulous surgical technique, they are able to achieve beautiful and natural results for our patients. We provide a high level of patient safety and our experienced and caring staff will be with you every step of the way. Our institute offers a wide variety of surgical and non-surgical options, from skin care, injectables and lasers to in-office or hospital options, to provide a versatile approach to fit individual patient needs. Your aesthetic goals are our priority and each procedure is customized to ensure you receive the best possible outcome.

For more information, call our office at 703-206-0506.

Content on this website is for information only and should not be used to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.