Watch a closed rhinoplasty, minus the gross bloody part

UPDATE: Ok, the animation linked below doesn't work for some reason. Try going here: http://www.plasticsurgery.org/patients_consumers/procedures/procedure-animations.cfm and mouse over "Face Procedures" and click on "Closed Nose Reshaping." Sorry.

This animation demonstrates pretty much what I'm having done, the closed rhinoplasty. Doc explained this to me, but I'd sort of pushed out of my mind the part where they saw off the top of the nose and crack the bones together. It's a gruesome-looking operation but at the same time makes you appreciate the delicate work that plastic surgeons do.

Talking to Strangers

I told my friend, whom I'll call "Elle Woods" (but not because she's ditzy--she's a cute blonde lawyer), that I was having my nose done and by this point, I just assume I've told everyone on planet Earth--strangers in the elevator, people I haven't talked to in ten years, everybody. Evidently, she's one of the five people I had left to tell.

Elle has a friend who had a nose job four years ago, and she put me in touch with Hillary (no, not Clinton...oh, criminy, I'm not going to get into the stupid free-association ways I come up with pseudonyms for people). I talked to Hillary on the phone for nearly an hour. She's very happy with her nose and it sounds like she had pretty much the same thing done that Doc is doing to me.

One of the most interesting things we talked about is that she had a lymphatic drainage massage done before her operation and she passed along the name of the therapist that did hers. She went three times on the days prior to her surgery for 1/2 hour each time. Hillary didn't have any bruising after her surgery, and she had to have her nose broken! This massage gets your lymph moving, which detoxifies your body and speeds healing.

I'm going to her therapist (for $1000 Trebeck!) next Friday, Saturday, and Sunday--I'm very excited about maybe not having any bruises!

The other thing Hillary said is that the anaesthesia really messes you up for a day: you forget things and are kind of loopy. Well, last time I went under, I woke up shaking and throwing up blood and I was seven and had my tonsils out, so I'm not hoping for a repeat...I'm banking on improvements in anaesthesia in the last 22 years. One other weird thing I've read about anaesthesia with a nose job--sometimes you don't go under general, you just get local...I can't imagine that, it sounds barbaric.

Anyhow, it was nice to actually talk to someone about the surgery who has been through the same thing. Even if you just jibber at them about how freaked out you are, it's nice to have someone to jibber to who isn't going to pooh-pooh you, or tell you that you really don't need surgery (nobody NEEDS cosmetic surgery), or many of the other well-meaning but doubt-inducing things that people who aren't having plastic surgery say. For example, a friend of mine asked me if I was still going to talk to him after I had the surgery, as if I'm going to be transformed into Aphrodite. I'm sure that was meant as a compliment, but, geez. It makes you wonder if your friends actually think you're a shallow ass. You don't need any more dumb things going through your head than you already have. Illegitimi non carborundum. I'm not much of a support group kind of person, but let me tell you, it's enormously calming to be able to have conversations with people who aren't going to unintentionally make you feel bad about yourself.

Another, unrelated, thought: I have ten days left to go. I'm ready to go, I want a new nose...NOW!!! The waiting is really starting to bug me. Like Elvis, I'd like a little less conversation, a little more action, please. Oh well...Tomorrow morning, pre-op appointment.

Advise and Consent

I realized I never talked about my first meeting with Doc, so I'm going to get on that right now.

People are curious about plastic surgery (you're here, aren't you?) When I made my appointment with Doc, I had a couple of dear friends offer to come with me for moral support. It's not like I'm going to the doctor for a real health problem--no one wants to deal with that or offers to come along; it's pretty unpleasant (Hey! Come on over and watch me get sensors stuck to me to check out my heart murmur!), but folks are more than happy to tag along for this.

Doc's office is over in Annandale, Virginia, near the hospital. It was an icy day in mid-January and, well, who am I kidding, I was running late because I always am, ice or no ice. I felt sort of bad going in to the MOB (that's Medical Office Building...I work at an architectural firm and was SO CONFUSED as to what that meant for...a while...an embarrassing long while, so I'm doing you a public service here in case you ever find yourself working with some architects, or if it's ever a question on Jeopardy) because in the elevator with me were an old couple, clearly in their declining years (what do I know, it could be their declining months, or days), probably there for some serious condition, and I felt so frivolous. cf. Catholic guilt complex.

The office was very nice, they were very accommodating of my rude lateness, and I sat in the waiting room flipping through Doc and his partners' brag book, which was a big binder with all the glowing feedback from his patients. Look at all these people, I thought. They're happy and, most importantly, alive and presumably not disfigured!

I met with one of the nurses and we talked a little bit about why I didn't like my nose and I mentioned aforementioned heart murmur and we talked about my medical history. Then Doc came in and we chit-chatted about why I was there and we covered my questions which were mainly about the pain (not supposed to be too bad), what could go wrong, wrong, horribly wrong (could have to come in and have it done again in a year if it doesn't heal correctly, which happens to about 10% of patients, could have burst blood vessels, things of that nature, but he said he hasn't had anything really awful happen), and healing time (swelling will go down after the first few weeks, and my nose will look smaller even though it'll be swollen, but the end result won't be apparent for about eight months) .

Oh yes, exercise, which I've mentioned before...As Doc put it, everyone in the D.C. area is too type-A and is mad about working out but basically, I need to just lay off strenuous activity because it encourages the nose to swell. I can pick back up in about six weeks or so, but let me tell you, based on my running-into-a-glass-wall trick, exercise really does make you swell up. Plus, who wants to jeopardize a rather costly and delicate (for a while, anyway) new nose just to be a hotshot on the tennis court for an hour? It reminds me of this classic exchange in one of my favorite movies, Clueless:

Amber Mariens: Miss Stoeger, my plastic surgeon doesn't want me doing any activity where balls fly at my nose.
Dionne Davenport: Well, there goes your social life.


The surgery itself will be done in Doc's own operating room as opposed to the hospital (with which, as I'm told by another patient, I'm better off since hospitals tend to put you on the back burner and you can be sitting there for ages, starving and dehydrated, waiting to go into the OR). It'll take about an hour, and then the nurses will keep an eye on me for a little while before I'm allowed to go home.

The worst part of it all is supposed to be the packing--everybody always talks about the packing. Back in the bad old days, they stuffed a bunch of cotton in your nose, so much so that people say they didn't realize that much cotton could be stuffed up your nose. Nowadays, they just put some small absorbent things up there that I take out myself the next day. I'm still not clear on that...Will let you know how that goes.

So after we went through all of that, Doc looked at my nose: in the nose, side of the nose, other side of the nose, up down, tilt my head back...Yep, it's a nose. Then we talked about what he's going to do. My main concern was that my nose is too wide on the top part and maybe a little too long. Doc intends to narrow that wide part, take down a wee bump, and define the tip. The latter two I didn't even think about; I've always been so irritated by how wide my nose is. Apparently this cartilage part is what take the longest to heal (which surprised me) and which stays swollen the longest (I think it's mainly because of the number of oil glands there, I've forgotten).

Then we looked at some pictures of his patients (very nice work--no one looked overdone) and some pictures of Michael Jackson and Doc started talking about what went wrong with the King of Pop. In a plastic surgery sense, anyway. I guess a lot of people worry about looking like Michael Jackson. I'm not worried about that, mainly just confused as to how you can have all that money and have whomever you want do your nose and still end up that screwed up.

That was pretty much it with Doc. Then I went over and talked to his patient coordinator who talked about the financials and scheduling. It's going to be $5375 for the whole deal--anaesthesia, actual surgery and operating room fees. The prescriptions will be covered by my regular health insurance, so there's just the co-pay for that. The schedule was pretty wide open to me at that point, I guess it picks up a bit more in the spring and summer, but I didn't book that day, I wanted to call my aunt, who, after all, is footing the bill for this, before I did anything.

My aunt was a-ok with it, it was actually less money than she anticipated, so I called up Doc's office to book. I could have gone in as early as February (you need at least two weeks to do the required no-drinking, no-aspirin, meet-with-the-doctor prep work), but I had a business trip planned, and there's this big yearly event at work that I have to attend, so I had to schedule around that. Oh yes, and I had to put $500 down.

So that's what you can expect when you go in for your appointment with your plastic surgeon. My next appointment is on Friday--I might actually put up some pictures of me (eek). I'm not exactly sure what-all is going to happen, but as always, stay tuned.

Crazy Thoughts, Part I

I think when you're going through a big life-altering event, you lose it a little. The summer before I went away to college, I would drive through red lights at rush hour, not realizing it until a near-miss accident. The same thing is happening to me now--I'm banging into everything (my nose is much better in case you're wondering) and I have a huge bruise on my knee--and I have all sorts of things running through my mind, so much so that I'll split them into parts.


To my knowledge, the Catholic Church doesn't have anything to say about plastic surgery. I went to Catholic school for 13 years and we never really touched on that. We sang a lot of really awful post-Vatican II music ("On Eagle's Wing's", anyone?), did the Cliff's Notes version of Summa Theologica, and were made to feel guilty about having money (but keep the tuition checks coming) and just about everything else, but I'm ill-prepared for this one. Would it fall under the cardinal sin of vanity/pride? Am I going to be carrying a stone on my back in Dante's version of purgatory (why are the proud in purgatory if it's a deadly sin, by the way?) Wouldn't that apply to wearing makeup or dying your hair, then, too? Maybe only if you're a Pentecostal. And anyway, in the afterlife, would I have the old or new nose?


On another note, my confirmation saint is St. Rose of Lima. I really did St. Rose a big disservice. I picked the name Rose because it was my great-grandmother's name; she had died shortly before I was born. This isn't a good enough excuse for your 7th grade religion teacher, so I had to go find a St. Rose, and the only one I could find in the school library was St. Rose of Lima (back in the days when we all tried to claim dibs on the lone Commodore 64 in computer class over the TRS-80s, and the World Wide Web had barely been invented.)


If you follow the link on St. Rose, she's a little alarming. In short, she made herself ugly and put herself through a great deal of intentional physical pain in order to get closer to God. I vividly remember my embarrassment when the religion teacher asked me after my oral report to the class on my confirmation saint WHY St. Rose was a saint and I couldn't give an answer. St. Rose is exactly the sort of Catholic I am not and will never be. If I weren't so hell-bent on picking Rose, or if I were confirmed at a time when my thoughts were a bit more fully-formed, or perhaps had seen A Man for All Seasons, I'd probably have picked Thomas More or somebody.

Anyway, the point is, I sort of feel like I'm betraying my saint. Why can't I just be a good person and be happy with whatever I've been given? Is what I'm doing immoral and decadent? Where is the bright line on that, anyway? Maybe it doesn't even matter.

Forty Lashes With a Wet Noodle. So I realize that I've been bad at keeping up the blog, I've been on travel and vacation, but that's no excuse because the real cause is laziness...I have about four in-progress posts saved and a bunch of others swimming around in my head unformed, so I'm going to really try to publish a little more in the days leading up to my surgery, and should definitely have some material for you after my pre-op appointment with Doc on Friday, I have to tell you about the massage tip I got during my conversation with another nose-job patient, and some more loony things, put down in pixels.

The Official Rhinoplasty Handbook

So the other week (weeks seem to be running together on me lately), Doc's office sent me a short guide to my surgery, including the scariest part of all this, the anaesthesia bit. I learned who my anaesthesiologist is going to be, whom I'm going to call Sleepy here on out, and I'll get to meet this person the day of the surgery.


The crux of the book can be summed up as follows: Don't. Ok, there are some Do's; very few, however. Do wash your face with Dial or Purpose antibacterial soap, take a multivitamin, wear loose-fitting clothing to the surgery.


There is a three-page laundry list of things to avoid starting immediately: vitamin E, smoking, anything with aspirin--which evidently includes Pepto Bismol, who knew?--or ibuprofen (Tylenol is apparently OK), random other stuff that I've mostly never heard of (including garlic--note to self, ask Doc if this is just garlic supplements or if I should avoid crushing a half-dozen cloves of it into everything, as I'm wont to do), and then any herbal supplements and birth control pills and patches. Not a problem. Except the garlic. Oddly, the book seems to leave out the no-drinking for two weeks part that he mentioned in my consultation: I planned my surgery around a vacation for this reason! That's going to be a tough one; I suppose I could make it a late-in-coming Lenten resolution.


The day before the surgery, I can't eat or drink anything after midnight (except a sip of water if I had any prescriptions I have to take, which I don't, at least at this point) and it looks like I have to take some pre-op sedatives? The book is a little vague at times.


The book then goes on to talk about what the surgery is going to be like and what the risks are (weird! your voice can change!) One strange thing I heard from a friend is that sometimes you can't feel your nose, and this can be somewhat permanent, and it's like you have a phantom nose. Another problem I'm curious about is tip swelling (this can be permanent!?!) I wonder if it still hurts if it's swollen? Doc's book doesn't have this, but I've also heard some people have lost their sense of smell--yikes! I have a pretty formidable sniffer (aside from it being so large I'm having surgery): I used to drive people (mainly my Mom) insane with my "can't you smell...?", "something's burning", "this smells icky", that no one else could smell. I can't imagine life without this ability.


After the surgery, you simply must have someone drive you home, they can't just throw you in a taxi and they are adamant about this. Fortunately, my Mom is coming up from Florida to take care of me/spend Holy Week and Easter. What a way to spend your vacation, watching after a bloody and sedated person! Thanks, Mom! Mom's actually pretty excited about the whole thing, I think...she's been sending me plastic surgery websites and things, so I'm really fortunate in that I'm not having to fight with family members. The decision to have surgery is scary enough and you have doubts ALL THE TIME as it is (am currently writing a post about all the crazy things that are going through my head; it's not ready for prime time yet); I can't imagine having parents and aunts and uncles and cousins giving me the business about changing a "family trait," as is the case with some people you read about.


Also afterwards, you have to sleep in a propped-up position, so I need to figure out a way to not roll into my usual facedown position. Other things: eat dry crackers and non-carbonated liquids because you might be nauseated; use a bag of frozen peas as an ice pack, unless it hurts, then don't; don't drive for at least two days, preferably five; don't smoke, don't drink while you're taking pain pills; use a vaporizer since I'll have to breathe through my mouth for a while; bruising gets worse for the first couple of days before it gets better in 10-14 days.


On exercise: No aerobic activity for three weeks, no strenuous exercise for 4-6 weeks, and I'll have to get the go-ahead from Doc anyway. In case you're wondering, this also applies to sex. This part freaks me out: who wants to have a small nose all the while turning into Jabba the Hut?


Oh, and also, no sun exposure. And there's a bunch of gross stuff about nasal dripping and blood crusting, which I'll spare you.

There's also an anaesthesia information sheet and a questionnaire to return to Sleepy. They ask you just about everything, including if you have any dental work since they shove a tube down your throat. This part is the scariest, especially since I have a heart murmur and sometimes get chest pains (generally associated with stress, from what I'm told), and I really don't want "died on the plastic surgeon's table" as my epitaph. Anyway, the last time I went under was for a tonsillectomy when I was seven; I remember this vividly and it was horrible.


The most fun part of the book is the emotional section: it's filled with drawings meant to illustrate your expected emotional trajectory, post-op. Apparently, being a nut case is completely acceptable and I should expect wild mood swings and random crying jags for a few weeks.


So on Wednesday, I'm going to have drinks and talk with a friend-of-a-friend whose had her nose done...Will give a full report!

Arnica Update!

So I had a date tonight, and I went wearing what I'm now going to call my "Home By 10" dress. I think I look pretty flash hot in it, however, both times I've worn it, my evenings have ended with me in flannel pajamas by midnight.

What does this have to do with my nosejob? Well, I didn't want to just go straight home, and there was an accident on the Beltway anyway, so I took the back way and stopped off at a CVS that I might say is --err-- not my neighborhood (I did need things other than Arnica; I'm not obsessed...maybe a little).

I wandered around for a while and found that this particular CVS has what I might call the "hoo-doo section." It was pretty random stuff in other languages, or with just very straightforward labeling like, "Gas Relief Drops" with a crying baby on the front. Then, I came across a "bonus pack" of De La Cruz Arnica Salve! It was packaged with Pomada de Azufre, which is a sulfur ointment for pimples. Kind of an odd combination, you'd think, but as it happens, I have a really offensive pimple on my chin (the kind you can't see, but feels like you're growing a conjoined twin) so that kind of worked out. I'm going to try it out tonight on the nose bruises.

And, as an update from the other Arnica tablets, my nose is less swollen and hurts less when I squeeze it since this morning. I took about 9 more during the day.

Want to know some fun trivia about Arnica Montana? It's also called Wolf's Bane. [Caution: Nerd Alert] If you're a Harry Potter fan, this might sound familiar--Snape made wolfsbane potion to keep Lupin from turning into a werewolf. Arnica is also known as Dumbledore's Delight (because bees like it and dumbledore is an old name for a bumblebee).

It was also mixed with snuff in Elizabethan times for its intoxicating effect. It's apparently used more widely in Europe.

OK, so enough about that. This CVS also carried Vichy Dermablend makeup, which I played around with for a while. They didn't have my shade, so I'm going to keep looking for that, too. It looks like the CVS is supposed to have a consultant there to match your skin tone? They had chairs, lights, and mirrors as if you're at the Bobbi Brown counter. I don't know about you, but having your makeup done in a CVS is a little...odd. However, this is supposed to be great stuff for covering up your post-op bruises. People even cover up tatoos with it! It's a wee bit expensive for makeup you buy at CVS ($25 for the foundation, plus you have to buy the setting powder, I think, which is another $20). I promise a full product review.

Anyway, I have 15 minutes to get into my flannel pajamas (ones with big coconuts and pineapples on them) so I can keep to my dress curse.

I did a trial run….

…into a glass wall. Ouch! But who am I to turn up my (bruised, swollen) nose at lemonade when life hands me lemons?

Backstory: At a Super Tuesday election night party, I was walking (walking, nay, striding forcefully) down a hallway that had a bunch of televisions tuned to the news networks. I remember looking at the crawl on one that said that Mitt Romney won Massachusetts and mused that he better have! I turned my head forward again only just in time to have my gait violently interrupted by aforementioned glass wall, with the old nose taking the brunt of the trauma. [In case you’re wondering, as my roommate did, if there were witnesses, it was just three girls on their way to the ladies’ room, so public humiliation was kept to a minimum].

Anyway, my nose HURTS. It’s swollen. It’s bruised. I see this as good practice.

In the manner of war heroes, I put up a brave front (“no, no, I’m totally fine”) even though I was dying (Ok, ok, Washington cocktail parties aren’t quite like being shot at in a war zone, but it sometimes seems like it). I didn’t actually ice the schnoz until after I got home several hours later. I got two bruises and the bridge swelled up.

Today is Friday. Lessons learned so far: Sunglasses HURT. Swim goggles are uncomfortable for about the first 20 laps and then they HURT. Washing your face HURTS. No one really looks at your nose until you point out that it’s bruised and swollen. Or else they’re just being polite. I’ve had a slight headache for three days.

On Wednesday, I called up Doc’s office. They didn’t think it was broken, but offered to take a look at it. Most importantly, they told me they could still do the surgery even if I’d broken it.

So I’d read that a good homeopathic drug to take for bruising is Arnica Montana, and some doctors recommend it after surgery (haven’t asked Doc about this yet), so I thought I’d give it a try. It is also very difficult to find. A chucklehead pharmacist at the completely useless CVS in Old Town asked if perhaps I was looking for Hannah Montana. I didn’t know they gave out pharmacy degrees at clown college!

I finally found it in the GNC section at the Fox Chase RiteAid, but it’s actually marketed as a backache medication and the Arnica is not as concentrated as it should be for bruising. I bought it anyway, and will keep looking. Very bizarre little tablets: you stick three under your tongue and they dissolve kind of like powdery cotton candy. I took some last night and this morning and my nose seems to be less swollen.

In any case, I'd better get used to it. In other news, I got my pre-surgery information packet from Doc yesterday...More on that--and an amazingly sexist and racist (even for stoical me!) book on noses I found and simply must write about--to come!