In The Months Ahead

"Patience, although a virtue, is almost non-existent in rhinoplasty. Especially revision rhinoplasty."

Unfortunately, with nasal refinement surgery the slight results may not be evident for many months - but fortunately the major differences, such as now vanished "hump" or extreme crookedness is apparent almost immediately. Depending upon the work that has been done you may have to wait a bit to actually see definition. Many patients become very anxious and work themselves up into thinking already that they do not like their "new" nose when in fact the result is no where near apparent. Just be patient and understand that the surgery you have gone through will cause trauma to the tissues and expect one side to heal faster than the other. This is very normal. 

Then again, you may notice marked crookedness of the cartilaginous portion of the nose (lower 2/3 of the nose) during this time as well as  bumps, lumps, and all sorts of inconsistencies. Just give it time to fully heal before you request another revision. Cartilage swelling takes quite a while to subside - especially of the revision due to the scar tissue build up that was more than likely separated from the remaining cartilage. This is intensive work so please be patient or you risk depression and anxiety and obsessive behavior. I am only saying this to save you from needless misery. 

Just be sure that if you quit smoking, to remain so as smoking greatly increases the risks of necrotic tissue and can severely impair proper healing during this time.

Depression is very common during the healing time. This could be quite traumatic in some and it is very important to remain calm, positive and realistic until the healing process is over. Please do not stress yourself out during this time. You may think you nose is crooked, ugly, big, small, bumpy, long, short, piggish, bullish, scooped, pointy, etc. Please remember that during the healing process your nose will change shape daily. Even though it may be ever so slight you must realize that even at times where you think that the swelling is gone - it returns. Also, perhaps you may think that your nose is humongous and twisted but usually other people do NOT notice. Please read more on Depression After Rhinoplasty. Also print out our Post-operative Emotions Reminder List to help you keep your emotions in check.

Just keep your chin up during this time as depression can only send you into a downward spiral and begat more anxiety. I have seen it happen before several times and months later the patients were happy.

Just remember your nose is going to change s l o w l y. Too slowly for many:) But in a way this is good because the shock is less and shock is not always  good thing when it comes to changing your appearance. Even going from long hair to short hair can put you into a downward spiral - and hair grows back! Imagine rhinoplasty where your nose has been one way your entire life and then BAM! It's different. There is a loss of the old familiar comfort you had with your old nose as you are forced into the unknown and insecurity of having something entirely different, that is permanent mind you, sitting in the middle of your face. 

It is enough to knock anyone senseless for a while. As long as you know what to expect and know that all will change slowly and that a full year is usually the amount of time before you can really pass judgment - you are better prepared for your post-operative recovery.

What To Do If Someone Asks?
This is entirely up to you - you can elect to scream it from the roof tops like me as this gives no one any chance to snicker and wonder or you can hide it and the fact that it is so gradual anyone no one may really notice unless they compare a "before" photo with an "after" photo. Unless of course your change was completely dramatic.

Actually it is no one's business and if they make a rude remark please do not let this get to you. I find rude remarks to be absolutely ridiculous, unnecessary and believe me, Karma has a way at getting back to people - what goes around, comes around. Just say "whatever"  and hold that head up high as you walk off. usually only very miserable or very judgmental people will respond this way and if they do, why waste your time on someone like that. You live to make YOU happy - not some idiot on an insecurity trip trying to divert his lack of self confidence on you. Life is too short to worry about what other people like that think. 

Okay, I've Waited & I Still Don't Like My Nose
Talk to your surgeon, but do it the right way. You can catch more flies with honey than you can with vinegar so do this is a constructive way not an offensive one. You don't want an extremely defensive surgeon upset with you - even if you have every right in the world. Besides it is easier to have a conversation when one sees eye to eye rather than a verbal war of sorts.Ask what your surgeon thinks and then point out what you do not like about your nose. 

Kenalog & Other Corticosteroid Steroid Injections
If it is residual swelling that plaques you, you may receive injections of Kenalog, a corticosteroid

cor*ti*co*ste*roid
(noun)
: any of various adrenal-cortex steroids (as corticosterone, cortisone, and aldosterone) used medically esp. as anti-inflammatory agents (Merriam-Webster Medical Dictionary)

to help reduce swelling but be advised surgeons will only give you about 1-2 and no more than 3 injections (usually 3 injections within a 3 months period) into the nose because these corticosteroids can actually degrade tissue when used excessively, especially cartilage because it is made of of proteins. Cartilage is actually a network of collagen fibers (protein) and a sort of durable type of gel, made primarily of proteoglycans/chondroitin sulfate molecules:

pro*teo*gly*can
(noun)
: any of a class of glycoproteins of high molecular weight 
that are found in the extracellular matrix of connective tissue (Merriam-Webster Medical Dictionary)

chon*droi*tin
(noun)
: any of several glycosamino-glycans occurring in 
sulfated form in various tissues (as cartilage and tendons) (Merriam-Webster Medical Dictionary)

Kenalog is a type of semi-synthetic cortisone derivative that is categorized as a steroid, although not the same as anabolic steroids The Kenalog when injected in large amounts of excessively can break up the protein of the collagen networks in both the skin, cartilage and even your joints. When used correctly your scar tissue and edema can be relieved. I urge you to wait until you really "need" these injections and let mother nature take its course. You will not stay swollen forever although excess scar tissue formation is possible, especially when the surgery was performed by a less than adequate surgeon or your body tends to over produce collagen.

Of course it is worth it to ask your surgeon what he thinks about Kenalog injections but don't be upset if he advises against it. He or she may only looking out for your best interest.


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