At one time, nose surgery was commonly referred to as a Nose Job, and just as the terminology has evolved, the procedure has too. A prominent focus of Dr. Zakhary’s practice, Rhinoplasty (AKA Nose Jobs,) is one of the most common procedures that plastic surgeons perform today. With extensive training in the areas of cosmetic and reconstructive nasal surgery, Dr. Zakhary’s extensive experience has helped her to perfect the techniques she uses, along with the overall patient experience.
Nasal development continues with a growing child, not reaching full completion until the age of between 16 to 18 years. For this reason, rhinoplasty is usually postponed until a potential candidate has become 18 years of age. There are always exceptions, and Dr. Zakhary is available for a rhinoplasty consultation for patients desiring one, at any age. Among Dr. Zakhary’s areas of expertise are the reconstruction of broken or misshapen noses. She has developed articulate methods for effectively correcting elements that are important to each of her patients, such as reducing, reshaping or augmenting the size of their nose. Dr. Zakhary’s techniques create pleasing facial harmony, thereby enhancing self esteem for her rhinoplasty patients.
Another area of Rhinoplasty involves repairing of deviated septums. Referred to as a Septoplasty surgery, this procedure is conducted to correct a deviated septum. This procedure can effectively be performed in conjunction with cosmetic nose reshaping.
Patients who have a deviated septum actually have a crooked internal wall between the nostrils, which may even produce breathing problems. Patients approaching Rhinoplasty surgery need to share details of their expectations regarding the surgery. Rhinoplasty can accomplish many excellent results, however like all surgical procedures, there are going to be some limitations and exclusions, depending on skin type, bone structure and placement of other facial features. Many factors come into play that will determine the extent of what different individuals can expect from cosmetic nasal surgery.
Dr. Zakhary’s extensive education and experience as a Calgary Cosmetic and Reconstructive Facial Cosmetic Surgeon – Otolaryngologist Head and Neck Surgeon provide her patients with the assuredness that they are in the best hands. During your consultation with Dr. Zakhary, you can expect her to complete the following:
• An opportunity to present and thoroughly discuss your desired results and to assess what results you can expect from your procedure.
• A thorough evaluation of your nasal structure and breathing assessment.
• Search for and identify conditions such as a deviated septum, nasal allergies and any particular structural deformities.
• Dr. Zakhary will examine your nose from the inside and outside.
• She will make a detailed assessment of your skin’s quality, the shape and size of your nose and record the general placement of your facial features and how they relate to each other.
• She will work with you to develop a plan specifically for your particular procedure.
• Because the nose and chin balance is important to facial symmetry, if your chin is comparatively small to the nose, Dr. Zakhary offers Advanced Computer Imaging.
The availability of Advanced Computer Imaging allows you to realistically look at what you will look like, following the procedure. To achieve this process, photographs are taken and then digitally manipulated, showing different results from different surgical techniques. This highly informative preview can be performed for $150, and will help you to know just what to expect from your impending procedure. To receive this evaluation, please let the receptionist know when you book your appointment, so that sufficient time will be reserved for your overall consultation.
When you are having reshaping surgery on your nose for the first time, it is referred to as Primary Rhinoplasty, and is an excellent procedure for anyone desiring to:
• Improve the side view of the nose by reducing a bump
• Build up the nasal bridge
• Change the width at the bridge of the nose
• Increase or reduce the size of a nasal tip
• Lift a droopy tip
• Narrow or reshape the nostrils
• Straighten a crooked nose
No matter how simple or complex the procedure, anyone considering rhinoplasty surgery should have theirs performed by only a highly qualified and experienced doctor like Dr. Zakhary, whose caring, skill and precision will ensure the best possible results.
Dr. Zakhary performs what is known as a "min-dissection" rhinoplasty technique, in which tiny incisions are made and manipulations are kept to a minimum to attain optimum results with minimum swelling. Scars are hidden and will fade away in time. Nasal cartilages are reshaped by the exacting process of removing excess bones and cartilage, preserving just the right nasal support and breathing function. Cartilage grafts (from inside the ear or nose) or an implant are what Dr Zakhary sometimes uses to augment or straighten the nose. If anything like this is needed for your procedure, it will be discussed with you during your consultation. Post-surgically, and very rarely, infection can occur. In the unlikelihood that an infection would occur, the implant is removed and replaced in a few months. Because of the low incidence of risk and the short duration (2.5-3 hours) of the procedure, rhinoplasty surgery typically is performed in an outpatient surgery facility, and then you can recover comfortably at home. Following Rhinoplasty, nasal packing is rarely needed, but in the occasional rare case, Dr. Zakhary will use a slender, small dissolvable nasal packing to reduce nose bleeding during recovery. This means that there is no uncomfortable nasal pack for patients to remove. In general, Dr. Zakhary's patients have an easier time with recovery from rhinoplasty surgery.
All in all, Rhinoplasty surgery is generally well-tolerated and painless, as procedures go. Most patients experience minimal discomfort after surgery. As pain tolerance varies from person to person, Dr. Zakhary always offers pain medication for her patients who need it, to help in the first few days following their procedure. In all cases, Dr. Zakhary will provide a prescription along with detailed instructions of how to help you recover best.
Typical patient experiences following rhinoplasty include bruising and swelling around the eyes, a stuffy feeling in the nose and miniscule bleeding from the nose. These generally disappear within the first week following surgery. In just one week from surgery, Dr. Zakhary will (painlessly) remove your nasal cast. Any upper teeth numbness and blocked nasal sensations will be gone after a few weeks. Patients can expect to expect to “reenter” society, with no surgical evidence, within two weeks following surgery. The nose will continue to heal for minimally one year after rhinoplasty surgery. The final result will not be what is first seen when the cast is removed. Continued improvement will take time.
For noses with thick skin, it it is not as easy to make the nose much smaller. Thick skin doesn’t shrink around the reshaped nasal bones and cartilages as nicely as thin skin.
Consequently, individuals with thick nasal skin will experience a slightly lengthier duration for recovery. Special injections are available after surgery to help shrink the nasal skin for anyone having thick skin, so just remember to be patient and realistic in the goals you have for your surgery going well.
The body’s method of healing from any surgery is by the development of scar tissue underneath the skin. The amount of scar tissue you develop, along with the manner in which it develops varies from individual to individual, and your surgeon has no influence over this. It’s normal for everyone to experience a bit of scar tissue following Rhinoplasty. Just know that cosmetic plastic surgery incisions and techniques are designed to produce maximum results with minimum trauma to the skin, thus resulting in the most fine and unnoticeable scars. If there is development of any unfavourable scars during the healing process, Dr. Zakhary is prepared to perform a simple and painless remedial procedure. Alternately, she may help to correct the healing process by applying a small dose of steroids injected into the site, depending on the situation: http://www.facialcosmeticsurgery.ca/plastic_surgery_calgary/mole_scar.html.
It’s critical that patients attend all postoperative follow up appointments with Dr. Zakhary, as it’s just as important as every other aspect of the surgery that will lead to the most effective healing over the course of around one year.
On occasion an additional, refining surgery (revision rhinoplasty surgery) may be needed to optimize the result, however it will take time to make this assessment.
Anyone considering plastic surgery of any kind needs to understand that effectiveness and results will depend not only on the skill and experience of the surgeon, but also on the nature of the patient's concerns, goals, health, skin type, facial anatomy, and healing. For this reason, its not always a matter totally up to the surgeon. Some of the post-healing cooperation of the patient contributes to the surgery’s success, as well.
In contemplating any surgery, and especially elective surgery, it’s important to fully address the risks along with the benefits of that specific surgery. This will be useful in helping you decide if any certain surgery is going to be a good option for you. Before you meet with Dr. Zakhary, you’ll be best prepared by reviewing the following list and discussing with her any concerns you may have.
The Risks Associated with Rhinoplasty Surgery Include:
• Skin typically shows swelling and bruising
• Skin and tooth numbness, which could continue for weeks
• Infection, while rare, can be treated with antibiotics and other medications
• Thick or uneven scar tissue formation
• Poor or slowed wound healing
• Spider veins (small surface vessels) forming on the nose
• Internal nasal scars and or adhesions
• Involuntary emergence of sutures through the skin requiring removal
• Nose asymmetry
• Breathing changes following surgery
• Postoperative hole appearing in the nasal septum (Septal perforation). These are difficult to repair, but are mostly found in noses of patients who use cocaine or traumatize their nose with (fingers or Q-tips) during recovery.
• Decreased sense of smell
• Adverse reactions to medications
• Possibility of revision Rhinoplasty is rarely but sometimes needed to correct or improve unfavorable healing.
• Risks of Anaesthesia
Your rhinoplasty consultation with Dr. Zakhary is where you will be presented with all the possible risks and concerns involved with your particular rhinoplastic surgery, especially as each person varies. You want to go into surgery knowing all the facts and possibilities, which Dr. Zakhary considers to be very important in the process.
Patients choose Dr. Zakhary because they want to make sure their rhinoplasty is performed by a highly trained, competent and skilled Board Certified Facial Plastic Surgeon, like Dr. Zakhary. This means that any risks and limitations are minimized and that complete and exemplary care will be given before, during and after the surgery.
While there are many assumptions that the goal of Asian rhinoplasty is to create a Caucasian nose, they are incorrect. The objective of Asian rhinoplasty is to create a refined, and natural nose that is in harmony with the rest of the facial features. This is often accomplished by increasing the size of the bridge, which ultimately better defines the nose and face. Sometimes augmentation is performed, with a small under-projected nasal tip. Noses are narrowed by decreasing the size of the nasal base. There are even some non-surgical options to achieve some of these goals.
One distinction exists when Asian rhinoplasty is being considered, and that is whether to use synthetic medical grade implants ( such as Solid Silicone implants) to build the bridge, or to use the patient's own cartilage from the nasal septum and/or ear. Silicone is a synthetic implant that many surgeons in Asia and North America commonly use. The primary reason for this is that most Asian patients do not have enough ear or septal cartilage to produce an adequately sized improvement to the nasal bridge size.
Dr. Zakhary’s most commonly use synthetic implants or injectable filler. At the time of your consult, she will present your options and discuss advantages and disadvantages with each one to help you determine the best for you.
With the unique challenges that Asian Rhinoplasty presents, the techniques required are different from Caucasian Rhinoplasty techniques. Dr. Zakhary has extensive experience performing Asian Rhinoplasty in Calgary for many years, therefore she is familiar with the techniques that are needed to produce desired results in Asian rhinoplasty surgery. There are altogether different methods and techniques required for Asian vs Caucasian rhinoplasty, and it’s vital that the surgeon you choose is practiced in the type you need to have performed. Dr Zakhary is one of Canada's most experienced rhinoplasty surgeons, performing in excess of over 1000 rhinoplasty procedures. She treats patients of all backgrounds and has extensive experience treating patients of Asian descent.
Patients with thick skin on their noses may gain improvement from rhinoplasty, but they will need to be patient during the healing process. Healing may be slower, and thus a little more patience will come in handy. If and when it becomes necessary to perform revision surgery, especially when it’s not their first revision, improvement and correction is possible. Dr. Zakhary has patients who have come to her, requesting that she repair surgical imperfections that have resulted at the hands of other surgeons. This type of surgery is typically more difficult with each successive surgery, but she has helped many patients achieve pleasing results.
Sometimes, patients are only looking at their nose, when, in actuality, their overall look could best be improved by the performance of other, small procedures to surrounding features like a small chin, thin lips, flat cheeks, double chin, etc..A procedure like augmenting a small chin goes far in making a nose seem less large, by comparison. Surgery to improve these features can be performed in conjunction with, or soon after rhinoplasty.
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