You should tailor your questions about rhinoplasty (Dr Young is in Bellevue Washington) based on your desires for the type of changes you are interested in.  If you were to ask questions about all aspects of rhinoplasty, you could be in for a long day / night so to speak.  Your questions should be really centered around your interests.  This will take also some research on how this procedure is performed, recovery, preparation etc.  You should go into the consult informed of the procedure as much as possible to facilitate the discussion about your particular concerns based on your anatomy.  Some common questions for your doctor though should be if he is board certified in this procedure, is he fellowship trained, how many rhinoplasties they have done, you should look at the before and afters of his procedure, you may consider asking for references from former patients as well.  You really should look over all of his credentials.  Where they studied can have a huge impact on their skills.

One thing to consider is that sometimes the number of rhinoplasties that a surgeon has done is not necessarily an indicator of how well the rhinoplasties are done. I used to know a surgeon who would always tell his patients that he has done over 3-4 thousand rhinoplasties.  Well that is great, but how many of those are done well.  Some surgeons stick with the same techniques and never get better.  You want to know that your surgeon is continually improving on his technique and constantly learning about new techniques and ways to improve older techniques.  This is more important, sometimes, than how many they have done.

You should find out if the surgeon does his rhinoplasties using open or closed techniques.  Closed techniques are based on older set of skills.  Although the recovery might be faster. These techniques, in my opinion, are much less accurate.  The main difference between closed and open techniques is that with the open technique there is an incision at the base of the nose in between the nostrils. Rhinoplasty link, the before and afters are further down, so you’ll have to scroll down to see it. As you can tell, you can barely see this incision. I totally prefer the open technique.

Another question you should ask your surgeon is how he performs his rhinoplasties and his techniques.  Does your surgeon do destructive maneuvers that lead to uncontrollable outcomes.  These destructive techniques are based on traditional and older techniques that many surgeons still use because they have not learned the newer less destructive techniques.  Nowadays, surgeons that are versed in more advanced up to date techniques tend to use sutures to affect the tip structures and shape them to the desired shape and size.    A surgeon that gives you a brief and easy to understand approach on how he would design and plan your rhinoplasty is probably better than someone that doesn’t.  I have some other blogs that describe how procedures are briefly done during a rhinoplasty. To also help, here is a video on Rhinoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery is located in Bellevue near Seattle, Washington

The type of anesthesia used during rhinoplasty depends on what is being done. If is a small change, you may use just local anesthesia.  Meaning, you will inject a local anesthetic, that is, you numbing fluid will be injected into the exact local area that you are working on.  Sometimes, regional anesthesia can help. That means that you inject a nerve where the region the nerve controls or innervates is numbed from the local numbing anesthesia to numb the region.  When the procedure that you are doing is more extensive, it could require local, regional anesthesia and then systemic anesthesia which is done throug either gases that are inhaled and anesthesia that are made from fluids that are injected into your veins to create a whole body anesthesia. I have done rhinoplasty under just local; with local and iv sedation; and local and general anesthesia.  I do most of my rhinoplasties under iv (intravenous) sedation, with local and regional anesthesia.  With Iv sedation, I get my patients very relaxed so that they don’t remember a thing after the procedure.  The less extensive the procedure, the less anesthesia.  The more extensive the more anesthesia you will need.  Also it depends on your tolerance as well.  If you are really afraid of needles, and the whole thing you will need more anesthesia compared to other people. Here is a video on rhinoplasty done under intravenous (iv, through your veins) sedation.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

Rhinoplasty is the best way straighten a crooked nose. This procedure entails making an incision at the bottom of the nose and then exposing all of the elements of the nose that is creating the outward appearance.  Then manipulating each of these structures will then change the shape of the nose. For the crooked nose, you must change the structures by releasing the forces that are holding the nose in a crooked fashion and essentially weaken these structures then strengthening them in a straight position.  The question of what is it like is variable among patients, their personalities, their tolerance for pain, their genetics that affect their healing / tendency to bleed / tendency to swell, etc.  Generally the first week is the most challenging, then its the first month.  You get most of your healing in the first month.  Generally what I tell people is that you will get 60% of your healing the first 6 weeks, 80% at the first 6 months, and at 2 years the healing will be 89% of what you used to be.  So most of the improvement is within the first month. Here is a video showing a rhinoplasty and an explanation of the tip part of the rhinoplasty.

Thanks for reading, Dr Young

Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

There are techniques in rhinoplasty that can be done to decrease the roundness of the nostril.  Usually it entails placing the cartilage as a graft along the rim of the nostril, above the nostril to push it down and sometimes grafts that have both cartilage and skin that are placed inside your nose to push the rim of your nostril. All of these techniques serve to push the rim of the notril down so that they are not rounded and retracted. As you can see below where the label lateral crus is located.  Most techniques entail placing the cartilage grafts above or below the lateral crus to push down the nostril margin or rim to correct the retraction and rounding of the nostril.