Revision Nose Job: Top 5 Reasons to come to Bev Hills

"A lovely woman looks at her revision nose job"

Happy With Her Nose

We’ve already noted that 20 to 25 percent of first nose jobs leave patients unhappy. Having been burned once, patients looking for a revision nose job are twice, three times and more cautious.

Many in distant states and nations consider coming to Beverly Hills for a revision nose job. Why? Here are their top 5 reasons.

  1. Beverly Hills is also a busy, thriving medical campus. During a typical day, you’ll see every fifth person is a plastic surgeon in surgical scrubs. So Beverly Hills has a tremendously high number of super-specialist cosmetic plastic surgeons. Revision rhinoplasty is a much more difficult surgery than a first nose job so some cosmetic surgeons specialize in the revision nose job, performing it weekly.

           (Read more about cosmetic surgery super-specialization.)

2. If you need a quick, before-surgery check by, say, a dermatologist, your journey often amounts to a walk across the street, or two streets, on your lunch hour. All type of medical specialists are near your surgeon’s office.

3. An entire support industry exists helping Beverly Hills’ cosmetic plastic surgeons. Most surgeons have arrangements with hotels – some within walking distance of the surgeon’s office – that lower fees for visiting patients.  Special recovery houses have sprung up to tend patients after surgery. Equipped with nursing staff and transportation to and from surgeons’ offices, the recovery hideaways are far, far less expensive than hospital care.

4. Los Angeles International  Airport is only twenty minutes from Beverly Hills. Friends, spouses and children often make the trip with the patient to enjoy the beach, theater, museums and world-class restaurants. Nose job revision patients are free to go along, usually after one or two days of rest.

5. One service of extreme interest to revision nose job patients is the availability of, and expertise in, permanent, non-surgical rhinoplasty which avoids the operating room altogether. Many cosmetic plastic surgeons offer temporary non-surgical rhinoplasty. The permanent procedure is also offered on the American East Coast but, west of the Mississippi, only by one Beverly Hills cosmetic plastic surgeon.

(Look at some non-surgical revision nose job before and after pictures.)

Nose Job? Get the Pulse of the Practice First!

"A man stands on a tall wall searching for a nose surgeon"

Looking for a Nose Surgeon

Before you ever step foot into a cosmetic plastic surgeon’s practice, you can get a good idea of the mojo you may expect when you do get there.

Regardless of the type surgery you may want – rhinoplasty, revision rhinoplasty, non-surgical rhinoplasty or internal nose surgery for troubled breathing – markers are everywhere.

Take a simple phone call, for example. Award black marks for being put on hold, if an answering machine picks up or if the receptionist chats on the side with others while talking to you. But give kudos for a warm receptionist who sounds enthusiastic and answers your questions, including costs of cosmetic surgery.

The telephone receptionist slot was once given to new or younger employees. However, one sign of a top notch practice is the receptionist who knows which staff member can best help you. Sometimes, it’s a patient consultant while at other times it’s the practice administrator. Bottom line: you should be warmly greeted while your questions are fully answered.

Next, bring up the practice website. Most people first look at the before and after pictures. Hint: there should be many, as in hundreds. (Read more about what to look for in nose surgery before and after pictures.)

Then, check out the surgeon’s bio/resume. (Here’s our own nose surgeon biography.)

Has the surgeon had a fellowship after his or her post-M.D. surgical training? A fellowship is when a younger surgeon allies himself with an older Master plastic surgeon as an apprentice, usually for a year. Find all that and you may be looking at a top nose surgeon’s website.

Scan the content and see what subjects are discussed. Can you learn anything about the various types of  cosmetic surgery? Does the site offer any books on the procedure you want?

But the first step toward getting the results you want from cosmetic plastic surgery is doing homework and becoming more knowledgeable about nose surgery, if that’s your goal.

Top nose surgeons also have deep experience in correcting breathing problems caused by a deviated septum and in turbinate reduction surgery.

Finally, look at the plastic surgery reviews in which former patients tell how their surgeries turned out.

Rhinoplasty Surgeon: Is He or She Busy?

"The inside of an operating room is shown with busy rhinoplasty surgeons"

Busy, Busy Surgeons

Cosmetic surgery insiders know that the most gifted, talented cosmetic plastic surgeons are also the busiest.

In medicine, some surgeons go through extra training and become Specialists. A few others go through that same training, have yet more training, perhaps at the side of an older, more experienced plastic surgeon and then have a ranking as Superspecialist. That is not a marketing buzzword, but strictly a medical term.

(A middle ranking, Subspecialist, offers slightly more training than the Specialist.)

In India and a few other nations, a Superspecialist surgeon would hold an actual degree marked “Master Surgeon.

(Read the actual training of a rhinoplasty Superspecialist.)

Potential patients with the most difficult rhinoplasty cases would then beat a path to the door of the Superspecialist. That, in turn, also means that surgeon would operate a very busy surgical schedule.

His or her patients would have additional success because the more the surgeon operates, the better he or she operates.

You can easily find out if the surgeon you have in mind is a Master Surgeon who superspecializes in a particular procedure like Rhinoplasty or Revision Rhinoplasty.

Just phone the office and ask receptionist: “How many times in a typical week does the surgeon perform rhinoplasty (or revision rhinoplasty, septoplasty or turbinate reduction surgery)?

The minimum number of surgeries should be two weekly. Some rhinoplasty Superspecialists perform two nose surgeries daily during a typical week.

Look at it from the viewpoint of the manual trades:  Any electrician, carpenter or car repairman who works in a technical function uses repetition and consistency to generate excellence and a good outcome. The busier that worker is, the better the hand-eye coordination becomes and stays at a peak.

The world of cosmetic plastic surgery is no different. Over the last 40 years, we have observed that the most accomplished, successful and important surgeons are those that do a high volume of surgery.

The key? Not doing 100 operations once, but performing one operation 100 or more times.

For the best, most natural outcome, search for a cosmetic plastic surgeon who is focused on only five to seven procedures and maintains what is known as a “boutique practice.”

Otherwise, you may find a plastic surgeon who is a jack-of-all-trades but a master of none.

Nose Job Consultation: Make Sure it’s Tops!

"A plastic surgeon in mid life appears in the O.R. in his surgical garb."

Cosmetic Plastic Surgeon

Like many things in life, there are few ironclad guarantees. That includes rhinoplasty surgery which may, or may not:

  • Improve how your nose looks
  • Allow you to breathe through it properly

The final results depend on the skill, experience and training of your rhinoplasty surgeon, the strength of your cartilage and how thick or thin your nasal skin is. Next hoop to jump through: the healing process.

So you want to work very carefully with the cosmetic plastic surgeon who is going to do your nose job. In addition to filling out many forms, if you are having a revision rhinoplasty, you should bring all the records of that procedure.

When the surgeon examines your nose, he or she will use a spray that slightly numbs the nose. To open the nostrils for a better look, the surgeon then uses a non-invasive tool known as a speculum.

If you are seeing a nose surgeon about functional surgery (a breathing problem), the surgeon will also closely examine your ears and throat.

If you have not already looked online at the surgeon’s before and after rhinoplasty pictures, a good time would be while you’re in the office.

Another tip while you’re in the office: if you see patients who have already had a nose surgery procedure, buttonhole them, ask how the surgery and everything else went.

During the consultation, tell the surgeon exactly what you do not like about your nose and what changes you want.

If you’re in an advanced cosmetic plastic surgery office, the surgeon will enter a picture of your nose as it is into a special computer. Then, working with a graphic artist, doctor and artist will generate a picture of your nose’s most likely appearance after surgery and healing. That technology is known as computer imaging.

If you live in location far-flung from the surgeon, you can accomplish all this over Skype and by snail or e-mailing your pictures to the surgeon’s office.

Tobacco use is bad on all fronts – it interferes with anesthesia and proper healing. So you’ll have to quit using any nicotine-containing substance at least two weeks before surgery. If you need help, ask the doctor for a prescription for Chantix which contains no nicotine.

Carefully read all the instructions the surgeon gives you.

For instance, it’s now common for cosmetic surgery patients to wash hair and body with an antibacterial soap the night before, and the morning of, the surgery

(Read more about what happens just after nose surgery.)

Rhinoplasty Revision: Top 5 Reasons to Choose BevHills

"A lighted Beverly Hills city sign is shown on a lawn at dusk"With America leading the world in the total number of first nose jobs – 242,000 in 2012, says the American Society of Plastic Surgeons (ASPS) – it follows that a fair number of those rhinoplasty procedures unfortunately result in unhappy patients.

Sometimes, Mother Nature is at fault and the nose doesn’t heal as expected. In some cases, the surgery was done by a young, unqualified or inexperienced surgeon. In other cases, the really difficult part of the surgery like – refinement of the nasal tip — is lackluster.

Whatever the reason, as many as one-fifth to one-quarter of first rhinoplasty patients start the process over, looking for a Master rhinoplasty surgeon to make the nose look attractive and fit the patient’s face and profile via a rhinoplasty revision.

But why come to Beverly Hills? Sure, it’s known as the globe’s Mecca for all cosmetic plastic surgery  procedures, but that must make it unaffordable, right? Not necessarily. A skill set exists in Beverly Hills not found in other U.S. locations.

So what are the top five reasons for journeying to Beverly Hills for a second rhinoplasty?

  1. Unhappy experiences with first nose jobs. Beverly Hills surgeons specialize in certain procedures – like revision rhinoplasty – and do the same few procedures for decades. Yet the costs of plastic surgery are affordable, thanks to competition among many, many specialists in one place.
  2. Unhappy nose job patients now know nose surgery is far more difficult and want surgeons who concentrate on the nose. You could do pre-surgery consultations in one Beverly Hills building for a week.
  3. Beverly Hills is a dedicated travel location, with a wide selection of hotels and even professional plastic surgery recovery hide-a-ways with nursing staff and rides to and from a surgeon’s office. (Learn more about cosmetic plastic surgery for patients in states other than California and abroad.)
  4. Beverly Hills is only 20 minutes away from the Los Angeles airport (LAX.) Some patients include the kids on the trip, making it a short vacation. After several days, virtually all patients are able to be out and about to world-class museums, hitting top spots like the Norton Simon Museum, world-class beaches, fine restaurants and top theaters offerings.
  5. Consider permanent, non-surgical rhinoplasty. While many cosmetic plastic surgeons offer the procedure, the vast majority use facial fillers that dissolve within about one year. But only in Beverly Hills can you often repair a botched nose job permanently without surgery.(Read more about permanent, non-surgical rhinoplasty.)

Cosmetic Surgery & Anesthesia: What type?

Link

"A love woman is shown being given anesthesia before 'going under'"It’s no big secret that cosmetic plastic surgery is pain-free. Nonetheless, some are concerned – and many more overly concerned – about being “put under.”

Actually, with modern anesthesia, day-long drug hangovers and throwing up after surgery are rare.

But the actual type of anesthesia varies according to the type and length of cosmetic surgery you are having.

1. Local anesthesia only:

You remain completely awake and are having a minor, most likely in-office procedure. A local – given by only the cosmetic surgeonnumbs only the treatment area as in, say, removal of a mole or scar reduction. (Dentists also give locals to numb tooth and gum treatments.)

2. Locals with I.V. Sedation:

Many types of cosmetic plastic surgery procedures go with this type anesthesia. The patient receives sedatives, numbing agents and tranquilizers through an intravenous line. The patient sleeps, is unaware of the surgery and feels nothing. An anesthesiologist, a physician who is trained for three years in giving anesthetics during surgeries, is at the controls.  You may have this type for:

  • An uninvolved rhinoplasty
  • Run-of-the-mill upper and lower eyelid lift
  • Otoplasty, the cosmetic surgery of overly large, stand-out ears

3. General anesthesia:

Once given only in hospitals, general anesthesia is now used more often in freestanding surgery rooms after which the patient goes home the same day. (Continued below.)

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Just below and on the left, a face & neck lift patient talks to her surgeon only four minutes after coming out of anesthesia. In the center picture she is fully awake and pleased with the surgery and anesthesia. On the right, she is getting ready to return home, only an hour and one-quarter after surgery. (Photos, Robert Kotler, M.D.)

"A surgery patient is shown waking up, sitting up and smiling within 75 minutes"_________________________________________________________________

(Continued.) A “general” is used for more involved cosmetic plastic surgery cases and puts the patient into unconsciousness. But the patient is no less safe, thanks to high-tech gizmos that monitor the body’s vital signs, including brain waves.

Combined with modern, easy-on-patients drugs, this type is used during face lifts, neck lifts, difficult revision rhinoplasties and surgeries that combine procedures like performing a neck lift with a nose job.

Under a general, patients can remain under for even the longest procedures of seven or eight hours. The anesthesiologist concentrates on the unconscious patient, his vital signs, drugs given and keeps a hawk’s eye on lung and heart functions. Meanwhile, the plastic surgeon attends to the various tasks of the surgery.

One other lesser-trained specialty – the RN nurse anesthetist – gives anesthetics during surgery in some cosmetic surgery practices.

A key question to ask a cosmetic plastic surgeon before surgery: “How often do you operate with your anesthesiologist?” Why? Teamwork! The longer, the better.

Nose Job? Get the Pulse of the Practice First!

"A lovely young woman with a smiling voice fields business calls"

A Smiling Voice?

Before you ever step foot into a cosmetic plastic surgeon’s practice, you can get a good idea of the mojo you may expect when you arrive.

Here are some things to look for:

Markers are everywhere, regardless of the type surgery you may want, including:

  •     Rhinoplasty
  •     Revision rhinoplasty
  •      Non-surgical rhinoplasty or
  •       Internal nose surgery for troubled breathing

Take a simple phone call, for example. Award black marks for:

  •    Being put on hold
  •    If an answering machine picks up
  •    If the receptionist chats on the side with others while talking to you

But give kudos for a warm receptionist who sounds enthusiastic and answers your questions, including costs of cosmetic surgery.

The telephone receptionist slot was once given to new or younger or employees. However, one sign of a top notch practice is a friendly receptionist who knows which staff member can best help you. Sometimes, it’s a patient consultant while at other times it’s the practice administrator. Bottom line: you should be warmly greeted while your questions are fully answered. (Continued below.)

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A non-surgical nose job can be done even when the patient is looking for a revision rhinoplasty, provided correction is only needed on the outside of the nose. For instance, in the photo below and left, the patient suffered a failed nose job elsewhere that left a long groove on the right side of her nose. After non-surgical rhinoplasty with a syringe only, her nose looked normal,  right. (Robert Kotler, M.D. photos.)

"A woman shows the results on non-surgical rhinoplasty"

Non-surgical Rhinoplasty Before and After

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(Continued.) Next, bring up the practice website. Most people first look at the before and after pictures. Hint: there should be many, as in hundreds. (Read more about what to look for in nose surgery before and after pictures.)

Then, check out the doctor’s bio/resume. (Here’s our own nose surgeon biography.)

Has the surgeon had a fellowship after his or her post-M.D. surgical training? A fellowship is when a younger surgeon allies himself with an older master plastic surgeon as an apprentice, usually for a year.

Scan the content and see what subjects are discussed. Can you learn anything about the various types of  cosmetic surgery? Does the site offer any books on the procedure you want?

But the first step toward getting the results you want from cosmetic plastic surgery is doing homework and becoming more knowledgeable about nose surgery.

Top nose surgeons also have deep experience in correcting breathing problems caused by a deviated septum and in turbinate reduction surgery.

Finally, look at the plastic surgery reviews in which former patients tell how their surgeries turned out.

Find all that and you may be looking at a top nose surgeon’s website.

Rhinoplasty & Troubled Breathing

"A man is shown in closeup putting nose drops into one nostril"

Nose Drops to Unblock Breathing

Imagine seeing a rhinoplasty surgeon about a nose job and discovering your breathing is blocked and unhealthy.

It happens a lot. So it’s not for nothing that rhinoplasty surgeons – make that master rhinoplasty surgeons – offer a procedure known as septorhinoplasty, a nasal surgery that cosmetically improves the shape of a nose while – during the same surgical session – restores the septum to its rightful place and unblocks a  nasal breathing channel.

The septum, a thin wall of bone and cartilage separating your two nostrils, is easily displaced via:

  • Birth
  • Accidents
  • Sports injuries
  • Disagreements involving male fistfights

Patient Sandra P. penned a letter after she came in to eliminate a bump on her nose and found she also had obstructions in a nasal breathing channel caused by a broken nose two decades ago. (Continued below.)

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A nose that is bent, twisted or crooked usually has blocked breathing, too. In the patient before surgery photo below, left, a deviated septum leans into a nostril, blocking breathing. The right hand picture, taken three months after septoplasty, shows an unblocked nose that allows healthy breathing. (Robert Kotler, M.D.photo.)

Deviated Septum, Before and After Surgery

 

 

 

 

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(Continued.) Moreover, Sandra’s hubby noticed she had a snoring problem at night. Result? She had septorhinoplasty to correct both breathing and appearance. Sandra’s take? She writes her nose job fits her face so well and looks so natural “my own sister did not notice I had rhinoplasty….Also, I can breathe better than I have in twenty years!”

(Read more nasal surgery patient reviews.)

Our patient J. G. had surgery on a deviated septum from a plastic surgeon who J.G. says was “one of the best nose surgeons in Texas.” Nonetheless, the surgery failed and J.G’s breathing situation became worse. Having been burned once and now being twice cautious, J.G. spent two months doing global research on nasal surgeons and came to us to finally repair the septum. She concludes: “I will never again settle for a good or even a great surgeon because it is just too risky. I will always go right to the very best without hesitation…”

Additional nasal surgery is often done to structures in the upper nose known as turbinates which are prone to swelling and blocking breathing.

(Read more about turbinate reduction surgery.)

Sometimes, it works the other way around. Patient T.D. wanted to correct a deviated septum and found it’s cost-effective, convenient and an overall savings of travel and recovery time to have several nose procedures like rhinoplasty done at once.

After nasal surgery, T.D. wrote: “Before my surgery, I could not take a deep breath with my mouth open…now, I can do it with my mouth closed. I never realized how restricted my air flow actually was.”

Cosmetic Surgery Questions Doctors Want to Hear

"A handsome senior doctor talks with an attractive senior woman"

Cosmetic Surgery Consultation

First-time visits to cosmetic plastic surgeons can be much more productive and meaningful if the patient has done at least a little research online and knows the best questions to ask.

What normally goes on during a first consultation could be considered basic Q&A.

Those typical questions often include:

  • How long have you been a surgeon?
  • What types of surgery do you do?
  • How long does recovery require?
  • Can you make me look good?

But that’s just scratching the surface.

There are quite a few questions that plastic surgeons wish you would ask. Why? Because it lets them know you are a savvy consumer who wants to get the best from surgery for the best possible price while being as safe as modern medicine and highly trained, experienced hands can make you.

Here are some of the questions that cosmetic plastic surgeons would like to hear more often:

  • “Do you only perform cosmetic plastic surgery procedures of the face and neck like nose jobs?”

(Or, for plastic surgery body specialists)

  • “Do you only perform plastic surgery procedures of the body like breast augmentation?”

Reason: medicine today is highly, highly specialized. A surgeon who offers all plastic surgery procedures will not be as adept as the surgeon who specializes in only six or seven.

Those patients recover faster, with less bruising because the highly specialized surgeon disturbs less tissue and has seen every unlikely wrinkle and unexpected complication that can possibly crop up.

Another rare question doctors would like to hear:

  • ”Where are your hospital privileges?”

Hospitals are past masters in knowing which surgeons are excellent and which cause problems….in which case privileges are withdrawn. It’s important for a cosmetic plastic surgeon to have these privileges because it’s another level of safety for the patient. If anything were to go wrong during surgery, hospital admission is only a phone call away.

One question you probably never thought of:

  • May I speak with a former patient of yours who has had this same surgery?”

Or, maybe make that: “…speak with a former patient…..outside your presence?”

That way, the patient is free to ask all sorts of questions from the cost of plastic surgery to treatment by the doctor’s staff, to the recovery process to the look of the final result.

In the best of all worlds, you would run into such a willing former patient while you’re on the initial, or first, consultation.