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Men and Nose Jobs

Rhinoplasty is surgery to reshape the nose. It can make the nose larger or smaller; change the nose angle, alter the tip of the nose; or correct bumps, indentations, or any other defects in or around the nose. Popularity of Rhinoplasty among men has been steadily increasing over the years and gained wider acceptance in North America. Although cosmetic surgery was once the domain of female only, this has changed over the past 2 decades. The number of cosmetic procedures being performed on males is fast catching up. At least 2-3 million males have undergone some type of plastic procedure in the past 2 years- and like their female counterparts- males also undergo very similar procedures. For men, rhinoplasty is the second most popular plastic surgery procedure, behind liposuction. Men suddenly want to get plastic surgery for several reasons. They all want to look handsome and appealing. The other reasons include the availability of more minimally invasive methods of surgery- thus less time off work and less prominent incisions. Also, today, there are a lot more cosmetic surgeons and the prices are affordable. No longer is cosmetic surgery only for Hollywood. Other reasons for the rhinoplasty may be due to the number of nasal injuries men suffer- whether from sports or trauma. Finally, today’s, aesthetic Corporate world also demands that men look appealing and successful. Many older men feel that it when it comes to position or promotion in a company, a younger person is always favored. Thus, cosmetic surgery is one way to try and level the playing field. Rhinoplasty is almost always done to make the nose look better. The surgery can alter the shape, contour and angle of the nose and in most cases; it brings about a pleasing change to the face. The majority of men love looking good.

History of rhinoplasty

Surgery on the nose has been practiced since 3000 BC in Egypt. It was not known as rhinoplasty then, but basically involved cleansing and suturing of the wounds of the face suffered during the battles of those days. Rhinoplasty as a cosmetic procedure appears to have been developed in the 15th century. However, the nose contouring and shaping did not become a surgical art until the 18th century. Cosmetic surgery on the nose has been practiced for about 120 years to help people cope with their unsightly nose. With two major wars in the 20th century and the push towards anesthesia and anti sepsis, came better and more improved techniques to deal with injuries to the face. Over the last 3 decades, cosmetic surgery of the nose had been perfected into an Art (Michael Jackson is an exception –either bad surgeon, one too many surgeries on the nose or a lot of bad genes or bad luck). Today, the quality of surgery is excellent and most individuals remain satisfied with the procedure.

Age at rhinoplasty

Rhinoplasty is a permanent procedure and one has to have a firm commitment to the surgery. One cannot reverse the results after the surgery has been done. Generally, rhinoplasty should only be done in individuals who have completed their facial growth. The nose development is generally complete by the ages 17-19. The best time to have surgery is in the 20s. When surgery is done any earlier, the nose continues to grow and reshape, overriding the effects of the surgery- meaning that the surgery was a complete waste-both money and time. All individuals can have rhinoplasty, as long as they have the ability to consent and are older than 20. Overall, most individuals are satisfied with the surgery and have no complaints, On the other hand, some individuals who tend to have cosmetic surgery are also anal (obsessive compulsive) and never satisfied-even if the surgery has been done well. These individuals should try some Prozac instead of undergoing surgery. The best candidates for rhinoplasty are healthy men (both physically and mentally) and who have realistic expectations about what the surgery can and cannot do for them.

Realistic Expectations

Rhinoplasty is not for everyone. Some individuals are satisfied with their face and some aren’t. Rhinoplasty in most cases brings about a remarkable physical change in the face and this is usually accompanied by a positive outlook. The procedure can reshape, re contour, make the nose bigger or smaller, correct the breathing problem and correct any other associated deformity. Yet, it has limitations. Too many individuals seek plastic surgery to cure their emotional problems and for them rhinoplasty is only a partial cure. In search for vanity can sometimes lead to insanity. So one has to be realistic in their expectations and an honest discussion with the surgeon will go a long ways to help resolve any myths.

The Surgery

Rhinoplasty is a common procedure and thousands of individuals undergo the procedure. However, the surgery is technically demanding and requires a lot of surgical skill and judgment. Most of the surgery is done by a sense of feeling-which is acquired only by experience. There are two main techniques used: closed and open rhinoplasty. In closed rhinoplasty, the incision is located in the inside of the nose. There is minimal swelling and the post operative course is generally easier. However, the surgeon must be excellent to perform this type of surgery. In open rhinoplasty, the incision is located just below the nose and provides greater access for surgery. The swelling is more and the post operative course is a little difficult. The recovery period after surgery is also slightly longer. The surgery is either done in a clinic or the hospital. Once anesthesia is induced –either general or local, the surgery is performed. The incisions are usually made on the inside of the nose and are not visible from the outside. Some bone and cartilage is removed and rarely extra tissue is added to reshape the nose. One the surgery is done, a nose guard/splint is placed to support and protect the nose. Some surgeons also place nasal packing inside the nose to support the nasal surgery. The procedure takes about 2 hrs to complete. With newer versions of rhinoplasty, the post operative course is less troublesome. The pain is significantly less and the nose may not have any packing (it is the nose packing that most individuals hate about the procedure). The results of the surgery are obvious immediately after surgery.

After Surgery Results

The surgery is an outpatient procedure. After surgery most patients go home. The patient is not allowed to drive home and someone must pick up the patient. Depending on how the surgery was done, a packing may be placed inside the nose which is usually removed in a few days. A nose guard/splint and a dressing is applied on the nose for about a week. The facial and nose area are always bruised and swollen for a couple of days after surgery. It is recommended that the individual sleep with the head up and place ice compresses-this helps to decrease the facial swelling. The pain is moderate and controlled with over the counter pain medications. Most individuals stay at home for about 7-10 days. It usually takes at least 2-3 weeks before on can resume all normal activities including sports.

Complications from rhinoplasty

Like any surgery, rhinoplasty can be associated with some rare complications. These include: - Some bruising around the nose and face is common. This is transient and disappears within 7-12 days - Some individuals may develop skin necrosis or allergy to tape material - Difficulty breathing for a few days from swelling in the nose - Open rhinoplasty may have a surgical scar but the closed procedure has no visible scar. With the open technique the scar is typically just on the underside of the nose. - Repeat (revision) rhinoplasty maybe required in some cases. Depending on whom one talks to, this figure ranges from 2-15% of individuals. The revision procedure may be required to correct the remaining deformity. MJ had the revision and the result is obvious. It is also possible that the cosmetic results of the surgery will not be what you wanted (there are always some individuals who are not satisfied).

Cost of Rhinoplasty

After one is realistic and ready for the surgery, one should select a surgeon based on his skills, reputation and his results. Do not select a surgeon based on the cost. The most expensive is not always the best and vice versa. Rhinoplasty is an expensive undertaking and is considered a cosmetic procedure; most health plans and Medicare do not cover it. Costs range anywhere from $3,000 - $12,000, depending upon the surgeon and the location. In some cases where the nasal septum is deviated, perforated or one has had a traumatic injury or has difficulty breathing through the nose; part of all of the surgery may be covered by medical insurance. For the rest of the individuals relying on the medical insurance to pay for the surgery, call the insurance company and be certain that you have proper pre-authorization for your procedure. Find out exactly what will be covered and get it in writing. Medicine is a business (just in case you did not that) and every one wants your money. After consulting with the surgeon, get the total costs which includes the surgeon’s fee, cost of anesthesia, cost of medicines, splints, dressing and other hidden costs (doctors are notorious for these-just like car mechanics). For those who claim that their rhinoplasty was covered by medical insurance, this is a very rare exception to the rule. The Plastic Surgeon for your Rhinoplasty There are just too many plastic surgeons around, and not all are good. So select the best plastic surgeon for your surgery. One may be able to hide a complication near the buttock area, but any problem around the face is difficult to hide and embarrassing- and it becomes a life long feature for the whole world to see. The following are tips to selecting a surgeon: 1. Make sure that your surgeon is board certified in Plastic surgery. The lure of money has led to many surgeons doing procedures for which they are not trained in. 2. Make sure that the surgeon has a current license to practice and he is up-to-date with his plastic surgery skills. Verify the doctor's credentials and training. 3. Check if the surgeon has had any disciplinary actions and malpractice judgments. Many of the state websites have information on disciplinary actions. A few have information on malpractice judgments. A warning sign is if the surgeon has had more than three malpractice judgments over a period of 5-10 years, seek another surgeon. 4. Ask about the number of rhinoplasty the surgeon has done and his/her complication rates. Any surgeon who claims that he/she has had no complications is a damn liar. 5. Ask where the procedure is going to be done, who is going to administer anesthesia. There have been a number of incidences, esp. among cosmetic surgeons who have tried to cut corners and save money on essential nurses and anesthesiologist. Do not get the procedure in a rinky dinky office. Check out the clinic or the hospital first. You are paying for the surgery, so you will get what you pay for. 6. Most cosmetic surgeons have before and after photos of their patients. Ask to look at some of these illustrations 7. Talk to other patients, family and your personal physician. Always if in doubt, seek a second opinion 8. Ask about anesthesia. - Make sure that your anesthesia is being administered by a properly certified registered nurse anesthetist or a physician anesthesiologist. Men continue to seek cosmetic procedures, and the trend is definitely on the rise. With the continued development of improved and new minimally invasive procedures and wider male acceptance of plastic surgery, there is every indication that more and more men will seek cosmetic enhancement in the coming years. Rhinoplasty is strictly an elective procedure and one should never be rushed into the procedure. Always seek a second opinion if one is not happy. You do not want to wear a surgical mask like MJ for the rest of your life