The key aspects for a successful rhinoplasty
With over 20 years of experience in plastic surgery and rhinoplasty, Dr. Carlos Fuentes explains his method to achieve beautiful and natural results in his patients.
“It has to go in accordance to the face.”
Q: For you, what is a good rhinoplasty?
Dr. Fuentes: A good rhinoplasty is one that has the nose that is consistent with the patient’s face, for example, the patient may have a round face and a certain type of nose would not work … or maybe has a long face and we cannot leave a very tiny nose, it has to have harmony with the face features. On average, people can go unnoticed even if they had a rhino. You can see someone in the street and think that she or he looks good without noticing that they had a surgery. On the other hand, there are other patients who you can see a block away and realize they had a nose surgery; I believe that the latter does not look good, because it reveals that the patient did something and it does not look natural anymore. The most important thing is that it looks harmonious with the rest of the face features that is what I consider to be the best rhinoplasty. Is not about overdoing it because then the appearance is not natural.
Q: What is a nose surgery ?
Dr. Fuentes: Since not all patients need the same surgery, then it varies. For example, there are patients who want to change the shape of the tip of the nose, in this case we do what is called an open approach or open rhinoplasty. There are patients who require other modifications and a closed approach is performed. There are also cases of people who already had surgery, had too much cartilage removed and it must be replaced. For these cases the cartilage is taken from the ear or ribs, and that’s a longer procedure. Then the procedure is different from patient to patient. For a person who has not had surgery before and maybe just wants to change the tip of the nose, surgery may last about an hour and half and its done under general anesthesia, after surgery the patient stays about 2 to 3 hours in recovery and after they can go home.
Q: What is expected during the recovery? How long does it take to look brand new?
Dr. Fuentes: After surgery if all is well, the patient only requires two or three hours of recovery and after that can go home. After a week, will have to come back to remove the tape or splint that we put in the nose to replace it with another. When we remove the splint the patient will notice that the nose is a little swollen. This is normal because there was a surgery in that area. After a week half of the swelling goes down … you will notice that it swells inside, there will be a bit of a difficult in breathing. After three weeks 70% of the swallowing will gone down, after 3 months it goes down to 85% and 6 months after surgery 95% of the swallowing will have disappear. The patient has to have patience for the swallowing to be completely down and see the final result, in general the nose will look better each day. Patients are able to go back to their normal activities after a week if the tape doesn’t bother them.
“The most important thing is that the patient visualizes how they will look, that we are talking about the same.”
Q: Do patients always get what they want?
Dr. Fuentes: Well, the first thing I do is ask patients what they want to change, what bothers them. Usually they tell me they do not like the width or the hump of the nose. Knowing what they want, I ask them how they want to see their nose, then the patient lets me know if they want to see it straight, lifted, or more narrow … that gives me an idea and I explain to the patient what we need to do in order to get the desired change; whether is to cut, fracture, or whatever it needs to be done. The most important thing is that the patient visualizes how they will look after surgery, so they do not feel that the doctor did not understood what they wanted. For this reason when they come to the consultation I take some pictures, one facing front and another from a profile, then we modify it by computer so they can see it. Once the patient has seen the alteration, then he or she can confirm if that’s what they want, or if they want it a little more lifted or a bit down, a little higher, or a little shorter … so this way we are on the same page.
Because if the patient says I want to lift it a little, and to me a little is a certain thing and for the patient is another, then I prefer that the patient has more or less an idea of how it will look. Once the patient saw how it would look, if they agree, if that’s what they want; then we proceed to do the surgery.
There are patients who tell me, “You know that is not what I want, I want it to be smaller or larger” if I see that is not possible I honestly explain them that the result they are looking for cannot be achieved with surgery because there are certain limitations.
It is important to mention that not all surgery can be done to please the patient, for some people we are able to correct an area and in some other patients this is not possible. If the patient really wants a certain modification and I can’t do it, then I say no because the patient will not be happy with the results.
Patients can also have a virtual consultation. They send me some pictures, and then I ask some questions, if they have any allergies, if they breathe well, weight, age, height, etc. Once I have reviewed the pictures I ask what they want to change, do the modification and I explain the procedure. After, if the patient tells me that indeed they would like it or if they want it bigger or smaller we discuss it until we reach the same agreement.
Dr. Juan Carlos Fuentes is a plastic surgeon specialized in various facial rejuvenation procedures and body contouring surgery, he’s a member of the Mexican Association of Plastic, Reconstructive and Aesthetic surgery and also of the American Society for Aesthetic Plastic Surgery (ASAPS) If you want have a consultation or inquire about a procedure, please call (619) 955-6845 from the United States or (664) 608-6460 if you are in México. You can also write to firstname.lastname@example.org