South Florida Plastic Surgery Associates - Don R. Revis, MD

Nose Reshaping (Rhinoplasty)

Refining the Nasal Contour with Rhinoplasty

Rhinoplasty is a surgical procedure to reshape the nose. It can be used to remove a hump, straighten the nose after trauma, shorten or lengthen the nose, and to narrow the nose. In certain instances it may also improve airflow through the nose, making it easier for you to breathe.

If you are bothered by the appearance of your nose, you may be a good candidate for rhinoplasty surgery. Rhinoplasty surgery is performed on teens as young as sixteen, and on older patients well into their 80s. This page will give you a basic understanding of the procedure and the results you can expect.

The cornerstone of Dr. Revis' approach is to individualize treatment to your specific circumstances and goals and to ensure that you have an adequate understanding of the issues involved so that you are able to make a fully informed decision. This will help you achieve the appearance you desire with the least invasive procedure available, thus creating a mutually rewarding experience. Dr. Revis invites you to visit his office for a complimentary consultation to discuss the procedure in greater detail. You are also invited to email Dr. Revis with your questions, or we can mail you more detailed information regarding the procedure.

As you consider plastic surgery, one of the most important decisions you will make is choosing your surgeon. Our pledge to you is to provide the latest, state of the art cosmetic plastic surgery in a safe and professional environment. Dr. Revis is a recognized specialist in the field of cosmetic plastic surgery and is board certified by the American Board of Plastic Surgery, the only plastic surgery board recognized by the American Board of Medical Specialties. He is also an active member of the American Society of Plastic Surgeons and has also been named among "America's Top Surgeons" by the Consumers' Research Council of America.

Our goal is to provide you with the ultimate patient experience. Our well-trained staff will help you understand your procedure, our financial policies, the scheduling of your surgery, and your post-operative care. We are available to assist you during our regular office hours, Monday through Friday. Dr. Revis is also available 24 hours a day to post-surgical patients; he will give you his cell phone number after surgery so that you will always be able to reach him with any questions or concerns you might have during your recovery.

The Consultation

During your initial consultation, Dr. Revis will inquire about your medical history, prior procedures, medications, allergies, and your motivations for seeking plastic surgery. It is very important that you be thorough when providing your medical history, as this information helps to prevent complications during your care. When asked about medications, be sure to include any vitamin or herbal preparations, as these can affect your blood pressure and clotting ability. Honesty regarding your use of tobacco and alcohol is also very important, as these may have a profound impact on your recovery period and your ability to heal following your procedure.

After reviewing your medical history, Dr. Revis will discuss your concerns, priorities and motivations for pursuing plastic surgery, as well as your fears. After examining you, Dr. Revis will be able to offer advice and options to help you achieve the appearance you desire. He will explain the advantages and disadvantages of the different options you have before you.

At the completion of your consultation, our Patient Coordinator will give you a written estimate of the cost of your procedure. At this time, you will also have the option to schedule your procedure if you so choose. The decision to undergo surgery is a very important one, and the final decision should be given very careful consideration. Dr. Revis realizes the importance of this decision, and at no time will you be pressured to make a decision. You are also encouraged to bring your spouse, significant other, family member, or a friend to your consultation.

Where Your Procedure Will Be Performed

Dr. Revis has been granted staff privileges at our local hospitals and outpatient surgery centers. In the interest of the safety of his patients, he only performs surgery in fully accredited facilities with the proper services and staff. Dr. Revis usually performs rhinoplasty surgery at Broward General Medical Center or Imperial Point Medical Center (fully accredited hospitals) or the Imperial Point Surgery Center (a fully accredited ambulatory surgery center). The staff of these facilities are very experienced in the care of plastic surgery patients in general and specifically in the care of Dr. Revis' patients.

Types of Anesthesia

Anesthesia is an essential part of any surgical procedure and must be performed safely. General anesthesia is the deepest form of anesthesia. You are asleep, feel no pain, and will not remember the procedure.

Intravenous sedation, called twilight sleep, is a combination of local anesthetic administered at the surgical site by Dr. Revis and intravenous sedation administered by the anesthesiologist. You breathe for yourself, but you are in a deep sleep throughout the procedure. You should feel no pain, and you will not remember the procedure.

An intermediate form of anesthesia, the laryngeal mask airway (LMA), is a relatively new technique. This technique is similar to twilight sleep in that you are breathing on your own, but the method of sedation differs. With an LMA, you actually breathe anesthetic gases administered by the anesthesiologist, rather than receive intravenous sedation via your intravenous line. These anesthetic gases cause you to sleep during the procedure. At the completion of the procedure, the gases are turned off and you wake up from your sleep. You will feel no pain, and you will not remember the procedure.

The prevention of post-operative nausea and vomiting is also a focus of Dr. Revis' approach to rhinoplasty surgery. To improve your overall experience and ensure you feel better faster following your rhinoplasty, he has developed a technique that has resulted in a very low incidence of post-operative nausea and vomiting. You will be given an intravenous dose of Zofran at the beginning of your operation. Zofran is a new drug which is currently the best medication available to prevent nausea and vomiting. Dr. Revis feels it is a very important component of his overall approach to make sure that your experience is as pleasant as possible.

Dr. Revis will discuss all of these options with you more thoroughly at the time of your consultation, and please ask him about anything you do not understand.

Details of the Procedure

Rhinoplasty may be performed through a variety of incisions, depending on your individual needs. Dr. Revis will make the appropriate incision after you have been adequately anesthetized. He then lifts the overlying skin off of the underlying framework. Dr. Revis will reshape the cartilage and sometimes the bones of the nose to achieve the appearance you desire.

After your surgery has been completed, he may place one or more stents in or on your nose. If you have work performed on your nasal septum, Dr. Revis will place internal stents in your nostrils. If you have your nasal bones reshaped, Dr. Revis will also place an external stent over your nose which serves to protect it in the early post-operative period.

Products to Help You Heal

SinEcch Arnica Montana is a natural product from Sweden which has been shown in clinical studies to reduce post-operative bruising and swelling. Begun the evening prior to surgery, this product is continued for four days post-operatively.

Scarguard MD A combination of hydrocortisone, silicone and Vitamin E, this product is painted on your scars topically like nail polish beginning three weeks after surgery, and it helps your scars fade so that they fade as much as possible.

These products are available for purchase in our office. Please ask us about these products and others if you have any further questions about whether or not these would be beneficial for you during your healing period.

After Your Procedure

Rhinoplasty is performed as an outpatient procedure. After recovering in the recovery room for approximately one hour, you will be able to go home in the company of a friend or family member.

The antibiotics that were prescribed during your preoperative visit (usually Augmentin) should be taken twice daily beginning on the evening prior to surgery. Continue this medication until it is gone. The pain medication prescribed by Dr. Revis during your preoperative visit (usually Lortab or Vicodin) should be taken fairly regularly, every four hours or so, during the first 24 hours (when you are not asleep, of course). Most patients find that they are able to transition to Tylenol after three or four days. It is not safe to drive a car within 24 hours of taking pain medication, as your reflexes and alertness may be altered.

You should plan to take it easy following your surgery. No strenuous activities, heavy lifting (over 20 pounds), aerobic exercises, swimming, contact sports, tennis, or golf should be planned for the first several weeks. It is also very important that you not blow your nose and resist the urge to sneeze if it should arise, because these activities may increase your risk of bleeding. As Dr. Revis monitors your recovery, he will advise you when it is safe to resume specific activities.

If you have internal stents placed at the time of your surgery, Dr. Revis will remove these on the first day after your surgery. If you have an external splint placed, Dr. Revis will remove this on the seventh day following your operation. He will also remove any sutures on the seventh post-operative day.

The Results You Can Expect

You will notice the change in the shape of your nose after the external splint is removed. You may experience moderate drainage from your nose and bruising around your eyes for the first several days, but this rapidly resolves. A mild swelling usually takes several weeks to subside, and your nose will actually continue to change for several months, although it may be imperceptible to you because it is extremely gradual and minor. You should be able to resume your normal daily activities the day after surgery, and you should be able to resume all of your physical activities within two weeks of surgery.

Nose Reshaping Before & After Photos

Please call (954) 630-2009 or email Dr. Revis for further information or to schedule a complimentary consultation.



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