About the Rhinoplasty Patient
I am 36-years old, married and a HS Algebra teacher. I have 3 children, ages 10, 13, and 16. I am 5'6" tall, weigh 140 lbs, and currently wear a 38B. I decided to submit my story to Terri's FaceForum website in case anyone else who was curious about getting it done could learn something.
Most of my life I've felt that my nose doesn't quite suit me. It was long, crooked, and (I felt) had a bulbous tip. Because my septum was deviated, I also had a lot of stuffiness as well, and I couldn't smell very well.
As for my breasts, a late growth spurt in my early twenties brought me to 5'6" and a 38 baby B cup. I thought a nice bust would "round out" my figure. I have wide shoulders and hips, and tops that fit my shoulders are loose in my chest. So, I've decided to have a breast augmentation, as well.
If I had 3 bits of advice to offer, they would be: 1) Do your research, 2) Realize that plastic surgeons are people, and as people, they have preferred methods of doing things, and finally, 3) Realize that individual results will vary, and it will take up to a year for you to see your results.
I read books from the library, bought them from Amazon, including books reaching back a decade or so, because some plastic surgeons may be using methods that are a little older. Not worse, just older. I read accounts of surgery from people who'd been through it. I read advice and professional web sites for plastic surgeons, especially the American Society of Plastic Surgeons' web site. I watched the facial cosmetic surgery discussion boards to see what kinds of problems and worries people were having.
Plastic surgeons have ways that they feel are most successful for them. Pay attention to their reasons for doing things they way they do (they should have good reasons for it). If you disagree, check with another plastic surgeon.
Research and Pre-op Preparations:
Two months in advance, I started wearing gel inserts in my bra to get used to how they looked and felt, but also to get my colleagues used to seeing me at that size. I want to be discreet and do it over summer break. Unless you make a big deal over the size of your breasts publicly in advance, nobody will notice if you go from having a little something to more. I did this because I'm planning to get a Ph.D. and, professionally, I people who work with me to be thinking about something other than "boy, those look pretty good".
At first, I thought that a C cup was just too large. I got used to it and chose a D cup, especially after hearing that the largest complaint is that the surgeon didn't go big enough. I met with each of my plastic surgeons twice, once for the consultation and once for the pre-operative exam. I paid all the fees at the preop.
The medical correction of my nose was being covered by insurance and I only had to pay for the surgeon's fee for the cosmetic part. My PS (plastic surgeon) for my nose surgery is also an ENT. His ideas for my nose were very similar to mine, so I knew he was a go. I found out from my research that straightening a nose is often difficult.
Next, I met with the other plastic surgeon about my breasts. They operate out of the same clinic. He answered my questions, and we made another appointment. Doing them both on the same day is no problem, he said. We decided on the following for my breasts: round, smooth saline implants, 360 cc inflated to 390, under the muscle, using a crease incision.
For my nose: The ENT/PS thinks that my nose will do well, because "big noses are strong noses". (eek). We set a date.
I was told: 2 weeks before surgery, don't take aspirin, ibuprofen, or Aleve; vitamin E, or St. John's Wart during the 2 weeks before the surgery--they can cause thinning of the blood which may cause bleeding problems. Don't eat after midnight before the surgery. Don't wear nail polish (I learned from my research that they need to be able to tell if my nails are turning blue) or any kind of cosmetics or body oils or cremes. Nothing in my hair or on my skin.
Leave all valuables at home. Have my asthma inhaler, and all my meds. My doctors have prescribed a pain med, something to keep me from throwing up, a muscle relaxer, and an antibiotic. I'm told to have those by my bedside when I awake. Wear something that buttons up and is loosely fitting. Bring the bra I intend to wear home. I have to order a "breast augmentation bandeau". I ordered one.
Rhinoplasty and Breast Augmentation Surgery:
The week before my surgery, I made up a tray with all my stuff on it, bought bottled water, Gatorade, and bags of frozen peas, as well as vitamin e gels and hydrocortisone cream to put on the BA incisions after they've healed. I also bought Tylenol PM, valerian, some homeopathic med called "Arnica Montana" that's supposed to be good for bruising and swelling.
I prepared some foods in advance and froze them. I also took lots of vitamin C. I put myself on a completely liquid diet the day before surgery, fruit smoothies, herbal tea, and miso soup, so that my stomach will be completely empty tomorrow. I know that when you have to fast after having a large meal your stomach contracts, which can be uncomfortable, and a sudden blood sugar drop.
A liquid diet will gradually shrink my stomach and there won't be any sudden drop. I also started taking my antibiotics. Oh, and all day long, lots of water. I was a little nervous, and often had thoughts like, "what am I doing? I'm letting someone cut up my body!" I was fortunate to be in contact with someone I could blather all my thoughts too, so I didn't feel so isolated.
The discussion forums here and on Nicole's Breast Augmentation & Breast Implants Website (for breast augmentation) were wonderful in that regard, and so was my husband. On the day of surgery, I felt like my liquid "fast" yesterday paid off. I didn't feel hungry or shaky. I did take one antibiotic pill early in the morning.
I went in at 10:00 am, my reporting time. I wore a huge hat because I knew that I wouldn't be able to wear sunglasses because of my nose surgery. I filled out forms stating what I'd brought in with me, clothes and such. Because of a back-up, I didn't get prepped until 11:45. I was weighed, my temperature taken, and blood pressure read.
Recovery from Breast Augmentation & Rhinoplasty Surgery - Days 1 and 2
When I woke up about 5 or 6 hours later, there was a lot of pressure on my chest and my nose hurt. I was pretty nauseated, too, but I found out that was much less from the anesthetic than from the fact that I swallowed a lot of blood during my nose surgery. I found out later on that my nose was fragile because it had been broken numerous times (news to me!).
During surgery, it collapsed and the surgeon had to rebuild the framework. He was able to do it, it just took him by surprise. While I was still in recovery, I took a Percocet and anti-nausea meds, but threw them up. I threw up a couple times after that, but it came up easily and I wasn't in pain, and of course I had blood in my stomach that needed to come out anyway.
There wasn't any packing in my nose. Instead, it drains into a "mustache dressing" which is a piece of gauze placed directly and loosely across the font of my nostrils, resting on my upper lip area, and helped in place with a strip of tape attached to my cheeks.
I got home and was in bed about 8:00 pm. I don't remember getting down to the car. It was a 45-minute drive home, and I threw up once. My husband drove SLOWLY and CAREFULLY. My nose had stopped hurting, and because I'd thrown up that Percocet and felt that all my other discomfort was bearable, I chose not to take either that or the anti-nausea med. I took a Tylenol PM, a muscle relaxant, though, and my antibiotic.
I was very unsteady on my feet when I first got home, and my chest felt full. My headache was gone. I had to change the dressing about once every 90 minutes, or so, because the blood was still draining draining. There was some bruising under my eyes, but much less than I anticipated. The front of my nose is covered with dried blood. I dabbed at that gently with a cotton pad soaked in warm water and got some of it off. My nose was pretty purple, what I can see of it, and very swollen. It itched. I used a soft facial brush to gently scratch it.
The first three days were the hardest. I was uncomfortable and swollen and very stiff and sore when I got up. My breasts felt like a combination of having bronchitis and lactation. My nose just ached a little, and was very stuffy. I had pen markings on my breasts, which I could remove in the shower, but my nose doc said I couldn't get my face wet so my husband had to help me and we used the shower massage to reach without getting my face wet.
There was tape covering my stitches on my breasts, and a hard white piece of plastic stuck over my nose (the outer splint). After the surgery day, I had no more nausea. On day two, my appetite started to come back, slowly. I decided I wasn't going to "tough it out" any more, and took some Percocet, antispasmodic, anti-nausea, and my anti-biotic, and used an ice pack on the top of my breasts but my nose was a little too sensitive for even the frozen peas until the end of the week.
I had a fairly limited range of movement, because of my sore chest, but it's bearable. My lower back hurt quite a bit, so I've been putting a heating pad on that. I gently cleaned off the front of my nose with a damp cotton pad, and the area just inside my nostrils, and started gently swabbing the openings with a swab covered with Neosporin.
Rhinoplasty & Breast Surgery Recovery - The Weeks After Surgery
On day 3, I no longer had the "mustache" dressing, and my nose didn't hurt any more. It was sensitive, though. My chest felt a lot better, too. I sat outside a lot in the shade, with a wide hat on to keep the reflected sun off my face, and took lots of deep breaths.
By day four, I decided to switch from the antispasmodic and Percocet to Tylenol. That meant that I could give up the anti-nausea meds, too. I felt like I was feeling a lot better. For the rest of the week I started feeling more "normal" but I tired easily. I move my arms a lot to keep from getting stiff, but opening the car door is hard. Anything that involves using my chest muscles was uncomfortable. Everything itched! Especially places I can't reach.
I had a bit of cramping in my abdomen, which is probably my body getting used to solid foods again. I was having all sorts of doubts about whether I should have done this or not, but today I'm feeling pretty good. I'll have to be careful not to overdo it. I had my first post-operative (breast augmentation doctor) and I got lots of compliments on my big straw hat, which I wear to keep the sun off my face and especially today, to keep eyes off my face. I still had a tiny bit of bruising and some swelling next to my nose. There is a lot of crustiness inside my nose, mainly dried blood, and I've been working on that little by little with cotton swabs doused in saline, but gently.
The Benadryl, which I started taking for the itchiness, made me tired. The heat makes me uncomfortable and swollen. I had an aching back, both because I'm sleeping while sitting up, and because my body is trying to adjust to the extra weight hanging off the front of me now.
By the end of the week, I met with my nose doc, and he removed the splint, which hurt a little, but left the internal splint in. The breast doc stopped in to see how I was doing. By now I was a little constipated; you wouldn't think that a Vegan would be constipated, but I am, a little. There's parts of it that have nothing to do with my nose that are a little swollen, and I still have a few yellow bruises here and there.
My breasts feel good, a little itchy, but when I take off my bra I feel like they are about to fall off. They are so full, and there's so much more of them than I'm used to. Finally I can wash my face and really soak my nose. I irrigated it at home using the kitchen sprayer turned on LOW and the nasal saline. When I'm done, I swab out the inside with Neosporin again. It helps with the dryness and the crustiness. I was a little bloated after surgery, but by the end of the first week that disappeared.
It's hard to shave under my arms because there's a hollow there where there used to be a flat space. I've felt the implant move a couple times. It's not painful, just a little disconcerting. I had to grab the cat when he ran out and I moved so fast to do that that I felt a little pain, more of a reminder than of actual pain, to TAKE IT EASY! When I feel pain, or pulling, it's usually in the center of my chest.
My nose feels like it's kind of weird and crooked, but I'm patient. I've lived with it this long. 10 days post-op I tried on a bunch of my old clothes for my husband, so he (and I) could see how they fit, and what will need to be replaced. I still feel like I'm "all implant" and no breast, but I'm getting used to them. The right one is starting to soften up and drop a little, but the left one is still a little high. In my reading, I have found that this is the rule. They may very well be quite uneven for a couple months. They'll continue to soften up and drop for a while. I found out that I may actually have a larger bra size when all is said and done, so I should put off bra shopping for now.
Over the weekend, the swelling in my nose went down quite a bit, and it's starting to look more like my old nose. The doc took out the internal splints, which was uncomfortable but not painful, and fussed over what seems to be a little anomaly on the right side of my bridge, (and may require some revision).
Finally, I can breathe so well that I can smell things that ! ! I might rather not smell. He (the nose Doc) said that I shouldn't do any exercise that raises the blood pressure in my head (like weight lifting). I'll wait until Thursday to find out from the BA doc if I can race walk. I was worried about porking out sitting around like this!
The next day, my nose was a little stuffy, but he said that might happen temporarily after he removed the internal splints. By 2 weeks, I had my stitches removed. It was a little ouchy, like getting poked with a pin. He said I should wear my augmentation bandeau (the strap) another 2 weeks, and that I can start doing very gentle weight/resistance exercises, and get back into speed walking, and my husband and I can finally resume sex, gently. I was surprised at how small the incisions were, and how neat. They were just dark pink wide lines with a darker thin line running though them.
It's been nearly 3 weeks, and according to my reading, the scars under my breasts will be raised and dark for several months, then they'll gradually flatten out and fade. Also, according to my reading, I was going to try a combination of vitamin E and Hydrocortisone cream on them each night, rubbing it in. However, my PS said that some people develop allergies to Vitamin E, and I should use Aloe Vera instead. He also said there's no harm in using the hydrocortisone, but it's most useful for people who develop thickened scars. I tried the Aloe, but it was itchy, so I'm sticking to the hydrocortisone. I also use it now to swab out the inside of my nose each night and morning, after I've sprayed the inside of my nose with saline.
I rotate my shoulders and arms and do some gentle stretching, and I'm looking forward to exercising again. I'm very happy with my results so far, even as soon as it's been. I know that recovery will be uneven and happen in spurts, but I'm patient because I've lived with my breasts and nose this long; I can certainly wait it out for a year to see what the results will be.