Rhinoplasty

The American Board of Plastic Surgery (ABPS) IS THE ONLY BOARD specialty recognized by the American Accreditation Council for Graduate Medical Education (ACGME). This is the regulatory body overseeing resident education in ALL medical specialties including internal medicine, general surgery, etc. Any board which is not recognized by this entity is not subjected to its rules and regulations. The ACGME therefore does not recognize anyone trained in any program recognized by such an ARBITRARILY defined board. The truth of the matter is that if anyone wanted to set up the American Board of Facial Upper Outer Eyelid Lash Surgeons, they could do so without any problems, without even so much as a medical degree. To the general public it would seem as though anyone trained in a “program” recognized by such a “board” has special training in the upper out part of the eyelid, and the upper outer eyelid surgeon would bask and revel in the fruits of this flagrant lie. The truth is that ACGME plastic surgery training takes from 6 to 8 years and encompasses all of plastic surgery, in its every detail. Surgeons not trained in such a manner typically have one year of so called “plastic” surgery and think themselves expert. Because they claim to be specialists in a particular area, an implication is made that they underwent plastic surgery training followed by specialty training. This is another blatant lie. Of course the public is unaware of any of this because the industry is only regulated on the postoperative lawsuit end. Don’t get me wrong, there are a few cosmetic surgeons, who are not plastic surgeons, who are quite good; there are exceptions to every rule. There is also a fair amount of ASPS surgeons who are quite bad, again not the rule. But to say that one NEEDS a surgeon who has this board certification not recognized by the ACGME is a preposterous flagrant lie. Another important consideration that is often ignored is the ethical character of the “surgeon.” Let’s suppose someone is not certified by the American Board of Plastic Surgery, let’s also suppose that they are really good with their hands, and have done many, many aesthetic procedures. How many people would have had to be their “first,” in any given procedure before they accumulated enough experience to obtain good, reproducible results. Would you really want a “physician” of such limited moral fiber to do your surgery? The bottom line is this; what you need is an honest physician, who is safe, gets good results, and is strongly endorsed by his or her patients, not the founder of the American Board of the Middle Upper Lip Cosmetico – Aesthetic Surgery.

Congestion, inability to breathe through swollen air passages, the taste of blood are all problems that most rhinoplasty patients are bothered by more than pain. Pain is normal with any surgery, and is no worse with rhinoplasty.

My patients are typically seen twenty four to forty eight hours after rhinoplasty. Packing is removed at this visit. Weekly visits follow for the next two weeks. The patient is then seen at three, six, and 12 months after surgery. This regimen varies from surgeon to surgeon.

Though all rhinoplasty patients recover at their own pace after nose reshaping, there are some general trends. The initial pain subsides over the course of two to three day. Swelling and discoloration may worsen after a rhinoplasty over the course of the same several days. It is a good idea to have someone at home to assist the patient in the immediate postoperative period. Strong pain medication will be needed in the first two weeks after rhinoplasty. Thereafter, normal, non-strenuous activities and work or school may be resumed. Swelling and bruising may persist for up to two months after nose reshaping surgery. Heavy exertion, and any activity, or contact sport that may result in injury should be avoided for first two post-operative months, as should sun exposure.

Any surgical procedure carries with it three types of problems. The first is related to anesthesia; general, and less commonly local. The second category is common to all surgical procedures. This is the risk of bleeding, infection, loss of soft tissue, loss of skin, numbness, etc. The third is specific to the particular surgery being performed. In the case of rhinoplasty, this would be asymmetry, changes in appearance over time, etc.

A minority of patients experience more discharge. This typically persists for half or a year, but may last longer.