Probably the greatest impact on how a person looks is the size and shape of their nose. Some people are unhappy with the nose they were born with, others are disturbed by the way aging has changed their nose. Many people have suffered an injury to the nose that has not only distorted it, but may have caused difficulty breathing through it. Because the nose is the most defining characteristic of the face, it is a common target of cosmetic facial surgery. Whether it is removing a small hump, tightening up a broad tip, or drastically reducing a large nose, nasal plastic surgery or “rhinoplasty” is designed to reshape the nose for a more pleasing and harmonious appearance on the face. Rhinoplasty, or a “nose job” is one of the most popular cosmetic facial surgeries.
David Hendrick, MD has been performing rhinoplasty and nose sculpting in Kansas for many years and has patients come from Kansas City, Wichita, Hutchinson and other communities around Kansas. Dr. Hendrick is a board certified plastic surgeon and a member of the American Board of Plastic Surgery. He is highly qualified to help you achieve your goals with procedures like rhinoplasty.
Rhinoplasty is widely considered to be the most difficult procedure in all of plastic surgery, for it is truly “surgery of millimeters”- very small changes can create dramatic differences in the nose, either for better or for worst. This is not surgery for beginners or the occasional nose surgeon. If you are planning to have plastic surgery on your nose, you want a specialist. Dr. Hendrick is such a specialist. Not only is Dr. Hendrick a board certified facial plastic surgeon, he is also a board certified ear, nose, and throat surgeon. Furthermore, Dr. Hendrick is “fellowship-trained” in plastic surgery of the nose, which is the highest level of surgical training this country has to offer. He trained in his fellowship under three internationally acclaimed nasal plastic surgeons - Dr. Eugene Tardy, Jr., Dr. Dean Toriumi, and Dr. Gary Burget. He has written and lectured on the subject of rhinoplasty and has an extensive background in cosmetic and reconstructive plastic surgery of the nose.
Although certain aesthetic “norms” for the nose have been described and well understood by many facial plastic surgeons, the most important feature of the nose is how well it harmonizes with the rest of the face. This is where the artistic sense of your surgeon comes into play. The ultimate goal of a rhinoplasty is to de-emphasize the unfavorable characteristics of your nose, create a more pleasing shape and size to your nose, and to draw attention away from your nose to your eyes, where people should be looking at you to begin with. All of the incisions for rhinoplasty are hidden inside the nose, or are carefully hidden beneath the nose so as to go unseen or noticed. Some rhinoplasties involve only soft tissue and cartilage work. Other rhinoplasties require cutting the bones of the nose. After a detailed consultation and exam, Dr. Hendrick can tell you which rhinoplasty technique will best achieve your goals.
Are there any visible incisions?
No. All of the incisions are inside the nose. Occasionally a small incision is necessary on the skin between the nostrils (so-called “open” rhinoplasty), but this incision is out of sight and heals virtually invisibly. In cases where the nostril opening needs to be reduced, a small incision is sometimes hidden in the crease beneath the nostril. This is also well disguised and not noticed.
Do you have to “break” my nasal bones?
Rhinoplasty doesn’t always require that changes be made to your nasal bones. In cases where the nasal bones need to be realigned or narrowed, the bones are cut with fine surgical chisels applied from inside the nose. So “breaking” the bones is really not necessary.
Do I have to have packing inside my nose?
Although many surgeons believe in packing the nose for several days after rhinoplasty, Dr. Hendrick finds that this is rarely necessary. Instead, Dr. Hendrick usually places small sponges in the nose overnight and removes these the next day.
Will I have a cast on my nose?
After reshaping the nose, Dr. Hendrick will usually apply a lightweight aluminum “splint” to the outside of the nose for the first week. This stabilizes the nose and reminds the patient not to bump the nose while it starts healing.
Will there be swelling or bruising?
Depends. When only soft tissue work is done there may be no bruising and only mild swelling after surgery. When bone cuts are made the amount of bruising and swelling can be more noticeable. This swelling typically disappears within a week and bruising clears after one to two weeks.
Is there much pain?
Not typically. The first night most people feel a sense of “pressure” where the nose is. If bone cuts are made these areas can be tender to touch for several days, but don’t usually hurt at rest. Most patients only take pain medications for a few days and don’t believe that pain was a significant part of there recovery.
How soon will I be able to see my “final result”?
There will usually be some change that will be immediately apparent. However, many of the changes that your nose will take on require that the wound healing process run its course first. As well, even miniscule amounts of swelling in the tissues can distort and hide the eventual final result. The goal is a good long-term result, not something that looks great right off the OR table only to contract and look bad months later. You can expect most of your final result to be apparent at six months. However, after rhinoplasty your nose continues to change in small ways for several years.
Will insurance pay for my nasal surgery?
If your surgery is strictly cosmetic, no. If there is a well-documented functional problem, such as severe nasal obstruction or chronic sinus disease, insurance MAY pay for some portion of the procedure. There have been abuses of nasal surgery and insurance coverage by others in the past and most insurance plans are very vigilant about reviewing these cases. If we believe that insurance coverage is reasonable, we will submit your photos and history to your insurance for “pre-determination.” Ultimately you are responsible for any portions of the bill that insurance fails to pay for. Most nasal surgery is strictly cosmetic or involves only a modest amount of non-cosmetic work that insurance may or may not cover. You should be prepared to cover the entire expense as a “cosmetic” procedure.
I’m not sure what I want my nose to look like - can you do computer imaging to show me some possibilities?
At Heartland Cosmetic Surgery we do not do computer imaging. It would be wonderful if surgery were as easy as manipulating a drawing tablet on a computer. This is not the case. What can be drawn on a computer is not necessarily what can be accomplished surgically. Instead of computer imaging, we rely on a very detailed examination of our patients, precise pre-op photography, and an involved discussion with out patients about the goals of surgery. We provide realistic feedback about what is or is not accomplishable with the surgery. In this manner realistic expectations are most successfully met.
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Salina, KS 67401
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