Rhinoplasty in Newport Beach, Orange County CA

How can I prepare for rhinoplasty?

Patients are advised not to eat or drink after midnight prior to surgery on the day of the surgery. Also, it is advised to not have alcohol intake for a minimum of two weeks before surgery. Patients will be provided with specific instructions, including Dr. bandy’s vitamin protocol, during their pre-operative appointment.

Will anesthesia be administered for rhinoplasty?

You may have the options of being awake or asleep for rhinoplasty, depending on how detailed the surgery is. For a Complete Rhinoplasty, it is recommended for a general anesthesia rather than just a local anesthesia, because there will be times that it may not be tolerable for the patient.

Is rhinoplasty painful?

When having surgery under a local anesthesia, the most painful part of rhinoplasty will be during the injection of the local anesthesia into the nose to get the nose numb. After you are numb, there will only be the sensation of pressure and touching, but no pain. With a general anesthesia, you are asleep prior to the local being injected. After surgery, you may feel some soreness, however, most patients simply describe a feeling of a pressure similar to a cold or sinus congestion.

What if I am sick before my rhinoplasty procedure?

If you are sick, you should check with your surgeon, as you may have to reschedule the surgery until you are well.

How long before I see results of rhinoplasty?

The timing of results depends on the patient’s own tissues. Sometimes you see immediate results after removal of the splint. However, there will be some swelling. Other times, it takes a whole month to six (6) weeks to see results, because of swelling and thickness of the patient’s skin and tissues. Final results take up to a year to see, when all swelling has subsided.

Is scarring expected after rhinoplasty?

If the incisions are inside the nose, you would not see the scars. To reduce scarring, it is recommended to avoid the sun exposure or wear a good sunscreen and or silicone sheeting.

Can I drive home after my rhinoplasty surgery?

If you are having a general anesthesia, you will need someone to drive you home after surgery. Patients are able to drive home on their own if they are having a local anesthesia with no other oral medications or IV medications.

Should I try avoiding touching the nose as best as possible after rhinoplasty surgery?

Do not pick at the sutures, or tapes on the nose. If you have to sneeze, you should sneeze with mouth open. This allows for less pressure in the nose when sneezing.

What activity should I refrain from after rhinoplasty?

You should refrain from any kind of contact sports from the first 6 weeks after a rhinoplasty surgery and high impact workouts that elevate the blood pressure.

What is the average cost for rhinoplasty?

Rhinoplasty cost varies depending on the intricacies of the surgery. During your consultation, pricing specific to your case will be provided.

What is the average cost for Tip Plasty Surgery?

The cost of rhinoplasty varies depending on what needs to be done to achieve the patient’s goals. Tip Plasty (where just the tip is being operated on) pricing varies depending on what type of anesthesia is being used, and the amount of work that needs to be done to achieve the intended results.

What is the average cost for Complete Rhinoplasty?

A Complete Rhinoplasty can have a significant price range depending on the complexity of the case. Complete Rhinoplasty may be performed for a primary rhinoplasty (first time having rhinoplasty done) or reconstructive rhinoplasty that is being performed as a secondary surgery, or in situations where there has been an injury or previous damage. It is normally more expensive with the second or third surgery, because you will likely have more scar tissue and work involved. Sometimes you need to have cartilage harvested from different areas such as the ear or even the septal cartilage to reconstruct the nose.

What is the average cost for Septorhinoplasty?

The cost for septo-rhinoplasty can also have a significant price range depending on the complexity of the case. Although some of it can be considered cosmetic, some of it may also be considered reconstructive. Thus, there may be some coverage through insurance companies for septo-rhinoplasty. Patients are recommended to be aware and take caution with insurance companies, because even if you get prior authorization, it does not mean that the insurance company will pay; they may evaluate it and determine it was cosmetic.Some patients that have done primary rhinoplasty end up with partial blockage of the airway. Thus, a cosmetic surgery might turn into reconstructive matter. Some of the patients that come in to see Dr. Bandy are patients that have had such blockage caused prior by previous surgery.

Are there financing options for rhinoplasty?

The patient has multiple financing options. For example, the patient can pay for the surgery on credit card, and make monthly payments back to their credit card. Additionally, CareCredit is a financing company specific for cosmetic surgery; patients can apply for CareCredit, and there are multiple options for CareCredit. Sometimes, patients opt to make payments directly to the office. This is a prepayment plan where a patient would pay until he or she pays the entire balance for the surgery; then, they would have their surgery.

What is the recovery time and the healing process? (Tip Plasty)

Typically, no external splint is required if you do not need to break the bones of the nose, and are just working on the cartilage of the tip. Only tapes are required to support the cartilage. The tapes can typically be removed within three (3) to five (5) days. You will experience some mild soft tissue swelling. Patients are able to return to work as soon as they feel comfortable with their appearance. Often times, surgeries can be performed on a Friday and you can be back to work on a Monday or Tuesday.

What is the recovery time and the healing process? (Complete Rhinoplasty)

A Complete Rhinoplasty is a procedure where all the tissues of the nose are addressed. For proper healing after the procedure, an external nasal splint would be required and possibly nasal packing. If the packing is necessary, then the packing will be removed on approximately the third to fourth post operative day. The splint will be removed around the fifth (5th) to seventh (7th) post operative day. The majority of people having a Complete Rhinoplasty will require approximately a week downtime prior to returning to normal activities. Again, for a simple Tip Plasty, you only need a few days. For a Complete Rhinoplasty, you typically need a week off.

Is there a post-operative recovery facility that you recommend?

We do have a post operative recovery facility that we refer our patients to in Orange County, CA and Los Angeles, CA. In these situations, they will be picked up by the post operative care facility from our recovery room and brought to the recovery center where they are recovered overnight, and then brought back the next day for their follow up appointment.

Q: What is rhinoplasty?

A: Rhinoplasty typically refers to a cosmetic change to the nose. The procedure is done to change the shape of the nose. Rhinoplasty ranges from working on a small area of the nose (such as the tip of the nose) to performing a Complete Rhinoplasty (nose, bones, cartilage, and mucosa).

Not only can rhinoplasty involve the external nose, it can involve correcting the internal nose as well, such as the septum and turbinates. Reconstructive nose surgery, on the other hand, is generally a procedure to correct breathing difficulties (from injury, from birth, or complications from a prior rhinoplasty).

Q: How long is the rhinoplasty surgery?

A: A short surgery can be as quick as forty-five (45) minutes, and a more detailed surgery can be as long as three (3) hours. Primary Rhinoplasty (first time a patient has the procedure done) is typically a bit quicker than re-operations. Re-operations (subsequent rhinoplasties) typically take longer to perform, because there is more scar tissue; the length of the procedure is typically longer because it is a more involved surgery.

Q: What is Septoplasty?

A: Septoplasty is indicated for dysfunction of the nasal septum cartilage and/or bone that separates the two nasal vaults (right side from the left side) and contributes to breathing difficulties. Such dysfunction can create breathing difficulties and sinus problems. Septoplasty operating time can vary depending depending on whether the septum is just being scored and straightened or if a wedge of the septum needs to be removed and how deviated the septum is. However, if it involves doing the nasal septum strictly for breathing purposes, that surgery can be as quick as forty-five (45) minutes or as lengthy as 1.5 hours.

Q: What type of surgery should I get for an injury to the nose?

A: Reconstructive surgery is helpful for people who have any kind of injuries to the nose. This includes trauma to the nose resulting in a fracture to the bones and or septum or deviation of the septum. DUring your consultation, Dr. Bandy will thoroughly review what type of rhinoplasty procedure is recommended.

Q: What is a deviated septum?

A: A deviated septum is in irregular shape to the cartilage and or bones that separate the two nasal vaults and lies in the midline of the nose. Often times, a nose injury that causes a deviated septum will also have pathology with the nasal bones and or cartilage. To correct this, a “septo-rhinoplasty” is required to fix both the internal and external nose. not only is the septum being corrected, but also the nasal bones need to be straightened out to be able to have a straight septum and nose so you are able to breathe properly through your nose. Sometimes a deviated septum is caused by injuries. With an injury, you often would need the complete nasal framework reconstructed to be able to have good functional breathing through both sides of the nose.Patients are recommended to come in immediately after an injury to the nose for a complete evaluation. Sometimes you will not need a complete surgery if you come in sooner; you might still be able to reset the nose from a fresh injury.

Q: What is septoplasty with submucous resection of the turbinates?

A: Another type of rhinoplasty is “septoplasty with submucous resection of the turbinates.” Turbinates are bones inside the nose that help regulate the airflow. Often times when you have a deviated septum and or allergies, you will get hypertrophy or growth of the turbinate bones. Such growth would make it more difficult to be able to have enough adequate airflow through the nose. In that case, the turbinates are worked on as well as the septum. If you have had a previous injury, then a septo-rhinoplasty may be required to repair the entire bony framework as well as the septum in order to get adequate airflow through both sides.

Q: What type of rhinoplasty is popular?

A: Out of the various types of rhinoplasty, the most popular type that people generally come in for is a Complete Rhinoplasty. Complete Rhinoplasty is more than a Tip Plasty (procedure on just the cartilage on the tip of the nose), and may require removal work on the hump of the nose (dorsum) as well as fracturing the bones to narrow the width of the nose.

Q: Are there any other procedures commonly performed along with rhinoplasty?

A: Rhinoplasty is sometimes performed at the same time with other procedures of the face, such as surgeries involving the eyes or a chin implant.

Q: What is Clean-Contaminated Case vs. Sterile Surgery? (combination of surgeries)

A: Rhinoplasty is considered a “clean-contaminated” case. A clean-contaminated case means that the procedure is not completely aseptic and sterile, because bacteria lives inside the nasal conjunctiva. Similar to intra-oral surgery or vaginal surgery, these procedures are all considered clean-contaminated. Therefore, anytime that you are having another procedure done with a clean-contaminated procedure, it is important to perform the sterile surgery(s) first (ex. breast augmentation, tummy tuck) prior to the clean-contaminated procedure(s). Further, the patient should know that there is a slight increased chance of post-operative infection. This holds true even when everything is done in a complete sterile environment, because you can get some bacterial seeding into the bloodstream. Generally, patients can have different types of plastic surgery on the same day (ex. breast augmentation and rhinoplasty) as long as they understand the slight increase in risk of post-operative infection.

Q: Are there any new technological advances or medicine for rhinoplasty?

A: Rhinoplasty relies heavily on the artistry of the surgeon. Accordingly, not only should a surgeon be chosen on credentials, but also on his or her artistic abilities. Prospective patients are recommended to review Before and After photo galleries, because they are extremely important in choosing a surgeon to perform this type of plastic surgery.

Q: What is the ideal nose?

A: Patients will sometimes come in requesting to look like someone popular in the media such as Kate Middleton, Kim Kardashian, Natalie Portman, Britney Spears, or Selena Gomez. However, it is better for patients to focus on the specific changes they want in their nose, because they are not going to get the exact same nose that another person has. Patients are recommended to bring in a photo of what their ideal nose would be, if they could choose (not necessarily celebrities). During the consultation or pre-operative appointment, photos can be taken and computer imaging performed to give the patient an idea of what their nose would look like after rhinoplasty.

Q: What type of incision approaches are there for rhinoplasty?

A: There are two approaches to incisions for rhinoplasty: 1) Open Approach Incision, and 2) Closed-Approach Incision. For a closed approach, you do not have any external incisions. Thus, scars are well hidden inside the nose. Those incisions are all done in the mucosa inside the nostrils. An open approach is performed in a similar fashion, however, a small incision is made on the fleshy aspect between the nostrils (aka the columella) to assist in viewing the structures inside the nose. That incision can be done as a V shape or as a “stair-step” type incision. The remainder of the incision carries on into the inside of the nose.

Q: Which type of incision approach is best for my rhinoplasty surgery?

A: The approach that is chosen is dependent on the severity of the deformity. Sometimes, if a severe asymmetry is involved, the open approach will be the preferred method. Depending on the circumstances, even a mild asymmetry may require an open-approach. Often times, you will get a better cosmetic result if you do an open approach, because the approach allows for more cartilage adjustment. Thus, the incision depends on the individual patient’s nose.

Q: How long before I see results of rhinoplasty?

A: The timing of results depends on the patient’s own tissues. Sometimes you see immediate results after removal of the splint. However, there will be some swelling. Other times, it takes a whole month to six (6) weeks to see results, because of swelling and thickness of the patient’s skin and tissues. Final results take up to a year to see, when all swelling has subsided.

Q: Are there minimally invasive options for rhinoplasty?

A: Minimally invasive options to alter a nose can include injectables. For example, if you have a hump on your nose, you may be able to straighten it with dermal fillers. However, injectables would not be a final correction, and would require continuous procedures to maintain the correction (biannually).