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The Facial Evaluation
Dr. Ress will spend time with you to discuss your areas of concern and to make recommendations for how to maximally improve your appearance and to achieve your goals. These treatments may range from non-surgical options to facial surgical procedures that you may not have considered.
Dr. Ress will evaluate the shape and position of the nose, check the internal septum, check how your nose fits in to the overall appearance of your face.
Part of the evaluation will review your health history, current medications, use of vitamins, herbal supplements, alcohol, tobacco and drugs. The best candidates for surgery are healthy individuals who, if they have any medical conditions, have them well managed and well controlled and who are non-smokers.
The Rhinoplasty Procedure
Nasal surgery, except for very minor revisions, is always performed in an accredited operating room at an outpatient surgical facility or local hospital, as an outpatient procedure. Depending on the operative plan, which is uniquely customized to each individual, incisions are typically made inside the nose and on skin bridge (columella) between the two nostrils. Most modern rhinoplasty techniques attempt to conserve as much of your tissue as possible, removing cartilage and bone when absolutely necessary. Many times permanent internal stitches are precision placed to literally sculpt a new appearance for you. On occasion extra building materials, both natural, from other parts of your body, or artificial, must be used as grafts to build up, help define or support your nasal anatomy. Dr. Ress avoids nasal packing unless absolutely required.
The Anesthesia Myth
Dr. Ress performs rhinoplasty surgery, as well as most cosmetic surgery, under general anesthesia specifically for your safety. The modern anesthetic medications, both intravenous and gaseous, are so short acting and specific that they have very few side effects and are especially safe. In fact a recent science has proven that driving your car on the interstate is riskier than general anesthesia. Your medical history (i.e., smoking, heart disease, diabetes) determines the relative risk of surgery or anesthesia for you.
Twilight anesthesia or light sedation is paradoxically less safe than general anesthesia because the air passage is not controlled. Your anesthesiologist will use a breathing tube during the surgery to make sure you receive good oxygen and prevent fluid from passing into the lung passages.
Recovery and Healing
Recovery from cosmetic nasal surgery is relatively straightforward. A plastic cover or splint will be on the outside of the nose to help reduce swelling and prevent you from bumping your new nose. Pain after surgery is well controlled with pain pills. Swelling is controlled with ice packs, elevation of the head and steroid medications. You will feel a small gauze pad under the nose. The splint is removed after one week and any external stitches removed in two week’s time. Internal stitches dissolve on their own. Most swelling and bruising resolve within two weeks and an intermediate result is apparent 6 weeks to several months after surgery with a final result 6-9 months later.
Dr. Ress recommends taking off one week from work; you may return to deskwork after one week.
Cost of Surgery
At the time of your initial consultation you will be quoted a price of Dr. Ress’ fee as well as the fee for the hospital and anesthesiologist. Fees are due in full at least two weeks prior to surgery and a security deposit will reserve a specific time and date for your surgery.
Insurance except in rare circumstances (work related injuries in Florida) will not pay for cosmetic changes to the nose. Dr. Ress accepts auto injury patients only on a case by case basis.
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