Every Rhinoplasty In Beverly Hills Or Anywhere, Is An Ethnic Rhinoplasty

Posted on July 31, 2009 by admin

Every Rhinoplasty In Beverly Hills Or Anywhere,

Is An Ethnic Rhinoplasty

The United States has a different ethnic makeup than it did even 25 years ago. And while the great wave of immigration to the United States occurred between 1880 and 1920, there has been a second wave of immigration primarily in the last 25 years. While the great wave of 19th and 20th century immigrants came from Eastern and Central Europe, this wave of immigrants comes from a wider swath of territory including the Middle East, Central and South America and Asia. That means that in a sophisticated, superspecialist rhinoplasty practices such as many of us have in Beverly Hills, we are going to see patients whose ancestors came from all over the world. In a sense there is such a large mix of patients that every patient is ethnic. The classic northern or central European American who is fair skinned, blonde and blue-eyed is now in the minority. Patients with black, brown or yellow skin and different noses are the norm. The nose is different in terms of lower bridges such as we see in Asian patients, wider nostrils in Asian and Hispanic patients, bulbous tips in all ethnic groups and even in select areas of the world like the Middle East offer different challenges. Patients from Iran, Iraq, Syria and Egypt, often have a bump on their nose as well as a flat, plunging tip.

Beverly Hills rhinoplasty superspecialist surgeons have experience dealing with all these patients because Los Angeles has become America’s most internationally-flavored city.

Five Good Reasons Why Patients Come To Beverly Hills For Second Rhinoplasty Surgery

Posted on July 28, 2009 by admin

Five Good Reasons Why Patients Come To Beverly Hills For Second Rhinoplasty Surgery

Beverly Hills indeed is a Mecca for people seeking improvement in their appearance. This applies for all the procedures done including facelifts, eyelid surgery, chin augmentation, chemical skin peels, breast augmentation and reduction, tummy tuck and liposuction. There is a skill level in Beverly Hills that is not found in most American cities. With the high concentration of cosmetic surgery superspecialists, there are at least five reasons that patients come to Beverly Hills for a second rhinoplasty surgery:
1. The patient had an unsatisfactory experience with a less specialized and less-experienced surgeon elsewhere.

2. Patients recognize that a revision rhinoplasty is a more difficult case and this calls for
the talents of those who make rhinoplasty the featured procedure in their practice.

3. Patients know that Beverly Hills is well equipped to handle the out-of-town visitor and
patient. Nearby hotels cater to patients. There is a professional recovery
hideaway where one may have round-the-clock nursing services, within a hotel, which
provides 24-hour room service. This “recovery hideaway” provides transportation to and from the office.

4. Beverly Hills is only 20 minutes from Los Angeles International Airport. Patients often are accompanied by friends or family. Some families with children take the opportunity to make it a mini vacation. After revision rhinoplasty, patients are not prisoners in their hotel room. After one or two days, it is possible to be outdoors and out and about and participate in some tourist activities.

5. There are some surgeons in Beverly Hills who do specialize in non-surgical rhinoplasty revision surgery. Using temporary or permanent injections, often a revision rhinoplasty surgery can be avoided. The service is generally not available in most other American cities.

Beverly Hills Crooked Nose Can Happen After Rhinoplasty Too

Posted on July 24, 2009 by admin

A Crooked Nose Can Happen After

Rhinoplasty Too

There is an old adage among surgeons that “The only surgeon who has no complications is the surgeon who does not operate.”

Sometimes after a well-intended rhinoplasty surgery, the nose may have a bit of crookedness where there was no apparent crookedness before. The answer to that surprising fact is that typically when one has a rhinoplasty, the bridge is lowered as the hump or bump is removed. When one lowers the bridge of the nose, it may be discovered that the internal support of the septum is crooked. If the surgeon did not either recognize this crookedness or did not deal with it adequately, the end result may be that the nose is crooked. Now there is a remedy for that. If it is minor, it can be improved by injecting the concave part of the crookedness with a filling injection. But that is limited to those cases where the nose is not already wide. More commonly, it would require a 20-minute touchup whereby entirely through internal incisions, the crooked septum which is now playing a part in the appearance of the nose is straightened.

Pain Management After Plastic Surgery in Beverly Hills

Posted on July 20, 2009 by admin

Pain Management After Cosmetic Surgery in Los Angeles

Postoperative pain varies from patient to patient. It depends on the procedure. Operations that are performed on tissues or areas that are in motion tend to be a little more sensitive. Therefore, tummy tucks can be a bit more uncomfortable because every time one sits up or changes position, there is the requisite tightening of the abdominal muscles and some discomfort. Breast augmentation and breast reduction tend to be less uncomfortable. Likewise, nasal cosmetic surgery and nearly all the facial procedures carry little postoperative pain burden because there is less movement.

However, the pain threshold is different from patient to patient. The discomfort can also be a function of swelling and bruising. For that reason, cosmetic surgeons will typically provide for the patient anti-swelling and anti-bruising medication and, of course, pain medication. The best indication for what the ideal pain medication is for a given patient is their past experience.

The surgeon should ask: “Have you ever had previous surgery, and if so, what pain medications did you take that were effective?” This will be a guide. Our experience has been that for most patients, mid-level pain medication such as Tylenol with codeine or Vicodin suffice.

For those patients in whom Vicodin or Tylenol with codeine are not satisfactory, the practice can provide stronger pain medication. Typically, this is only necessary for a day or two. Please remember that in the postoperative period, when one is taking narcotic pain medications and less active than usual, there is a greater chance of developing constipation and so that should be foreseen and properly addressed.

Beverly Hills Nostril Narrowing

Posted on July 15, 2009 by admin

Some patients presenting for cosmetic surgery need to have a change in nostril size and shape.

The most common reason for narrowing the nostrils is that the width of the floor of the nostrils is too great, in proportion, to the remainder of the nose.

It is often a feature of certain ethnic noses that the nostrils require attention. Typically, wide nostril floors are common in Asian people. Combined with that are rather thick walls of the ala or wings which are the outer portion of the nostril. If the walls are very thick and the width of the floor of the nostril is wide, then there is a strong reason to narrow the nostril. Note that it is not possible to reduce the thickness of the nostril wall, however, effectively, the nostril wall “moves in” as the nostril floor’s width is diminished.

The procedure is usually done at the time of the other cosmetic nasal surgery procedures. In order to hide the incision it is placed in the crease between the nostril and the upper lip. The incision is carried into the floor of the nose. The external portion is closed with several layers of stitches. The outer layer of which is typically removed in 5-7 days. Deeper hidden incisions ultimately dissolve, but remain in place for up to 90 days to reduce the chance of any separation of the incision, therefore maximizing the cosmetic appearance.

Dr. Kotler's Patient After Nostril Narrowing

It is important that symmetry and a natural look be achieved. Further, over-narrowing of the nostrils, in addition to producing unsatisfactory appearance, might have an influence on breathing.

Beverly Hills Cosmetic Plastic Surgery Aftercare

Posted on July 13, 2009 by admin

It’s important to recognize that there is the possibility of complications that occur after “the last stitch” is placed by the surgeon. To reduce that chance, it’s important to know your doctor’s philosophy on aftercare.

Since cosmetic surgery does not involve a major body cavity such as the chest cavity or abdomen and involves itself only with the skin and tissues directly underneath, routine post-operative hospitalization is rare. But you do need to ask yourself the following questions: Where will I recover? Who will be with me during my recovery period? And how often will the doctor need to see me after surgery and how will I get to his office for those visits?

Some patients will be most comfortable convalescing at home. This can be appropriate after nearly all cosmetic procedures if there is either a responsible adult available and willing or, better yet, a trained medical professional present. There are professionals who do home care. They may be registered nurses, practical or vocational nurses or medical assistants. Since there is no major nursing duty involved in routine cosmetic plastic surgery post-operative care, their title and credentials are less important than their experience. I would be reluctant to have an attendant who has not cared for cosmetic surgery patients. So be sure to ask about the nurse’s experience with your procedure.

For those patient’s desirous of complete care outside the home, there is the “recovery hideaway” alternative. Cosmetic surgery in Beverly Hills is fortunate to have several facilities who have long been on the scene to care for our patients. Shanteque, nearby in Century City, and Serenity, in adjacent Santa Monica, are very well established and very sophisticated facilities that provide for all needs for the after-cosmetic surgery patient, including transportation to and from the office.

Such hideaways are professionally-staffed, hotel-like facilities offering appropriate meals, around-the-clock nursing attention and, of course, act as the eyes and ears of your doctor.

Typically patients from out of town will find it convenient to stay in such a facility since without family or friends to provide a locale, this is their best option.

Beverly Hills Sinus Problems

Posted on July 1, 2009 by admin

The sinuses are the most maligned of all body parts. Radio and television ads, newspaper and magazines constantly remind patients that various nose drops, nose sprays, pills and decongestants will all help their “sinus problems.”

In fact, true sinusitis or infection of the sinuses is rare. More commonly, the patients suffer from blocked nasal passages, but the patient can’t distinguish between an infection of the sinuses and just a blocked nasal passage, which can be due to deviated septum and/or enlarged turbinates.

The sinuses, which are air-filled chambers numbering 7, all rely on an open nasal passage to pass air into their openings. There are sinuses within both cheek bones, on either side of the eye, just above the nose on the forehead, and one far back in the skull underneath the brain and above the highest part of the throat.

True sinusitis is a diagnosis that will always come to the attention of a physician because the symptoms are so profound. The patient will be acutely ill with high fever, weakness and lethargy. Green, yellow or brown pus will come out of the nose. There will be a severe headache or, if the sinuses involved are those within the cheek bones, the sensation of an upper toothache. There may be swelling and redness on the face. In extreme cases, one may even have the eyeball pushed forward.

Typically the patients who are most susceptible to attacks of sinus infections are those who have nasal obstruction due to a broken nose, deviated septum, enlarged turbinates and nasal allergy. Also a contributor is cigarette smoking.

Typically patients that have sinus problems will be those who live in a cold weather climate in the winter where indoor heating to compensate for the outdoor cold carries with it dryness. Dryness is the enemy of normal nasal and sinus function.

It is very important that before patients have rhinoplasty, a purely cosmetic surgery, that there is a determination as to whether or not they have harbored sinus infections in the past. The reason is that if there is still an ongoing indolent sinus infection then there is a chance that the nose is seeded with bacteria which is not a good idea if one is contemplating an elective procedure.

There are x-rays and CT scans available to either establish or eliminate the diagnosis of sinusitis, and these should be performed prior to surgery if there is any question about the patient’s history of sinus infections.