Somenek + Pittman MD: Advanced Plastic Surgery

Bruising can occur after rhinoplasty. If you do experience bruising after rhinoplasty, there is usually a mild discoloration under the eyes that resolves by your one-week follow-up. Dr. Somenek will recommend a few tips leading up to and following your surgery that can decrease your overall chances of developing bruising after your rhinoplasty.

Rhinoplasty is considered an outpatient procedure. This means that you will go home after the procedure and see Dr. Somenek at your follow-up for cast removal.

Most of the time a rhinoplasty is considered a cosmetic procedure. There are some instances where the patient has breathing concerns preoperatively which are determined to be a functional issue. These can include septal deviation or internal or external nasal valve collapse to name a few.

There are several factors that can contribute to a larger nose. The underlying structures, including the cartilage and bone can create a larger appearance in the form of a dorsal hump or large, bulbous nasal tip. In some cases, particularly with certain ethnicities, the nasal skin can be thicker and create a larger, amorphous shape to the nose. Because there may be multiple contributing factors, Dr. Somenek believes that the preoperative assessment is essential to discuss the reasons for the appearance and set expectations for how much refinement can be expected with a rhinoplasty.

“Open” and “closed” rhinoplasty are techniques that are used by rhinoplasty specialists to access the nasal structures. The “open” technique allows the surgeon to visualize the structures more clearly and is frequently used when there is complex nasal tip work that requires meticulous refinement.

The risks of a rhinoplasty are similar to any type of surgical procedure. Even though risks exist, they are exceedingly rare and uncommon. These can include bleeding, infection, and minor asymmetries that may require a touch-up procedure.

As with any cosmetic procedure, there is always a possibility that someone may need a touch-up after their rhinoplasty. Although this risk is very low, Dr. Somenek will frequently recommend waiting up to a year to allow the nose to fully heal and let the swelling subside to better understand what the touch-up will entail.

The preoperative analysis is essential when considering a rhinoplasty. This allows the surgeon to examine the nose and determine the cause of the cosmetic and functional concerns that someone may have with their nose. This also allows Dr. Somenek to perform simulating 3D imaging for his patients, so they are better able to see what an expected result is and establish appropriate expectations.

Rhinoplasty, commonly referred to as a nose job, is a procedure that is performed to refine certain aspects of the nose. This can include a dorsal hump, a bulbous or poorly defined nasal tip, or an overall wide nose. It can also be used to address breathing problems that may or may not accompany cosmetic concerns.

Implant type (silicone or saline, smooth or textured) and size are discussed at length in your initial consult. In this consult, your plastic surgeon will discuss your “breast goals” with you. The surgeon will also take measurements of your chest wall, evaluate your existing breast tissue and take a 3-D scan of your breasts using the Crisalix virtual imaging system. Once this information has been obtained, the surgeon will make a recommendation on a range of sizes and even show you in the imaging system how a variety of implants will look on your specific chest.

Women who have undergone breast augmentation should continue to follow the normal screening mammogram recommendations. Most centers performing mammograms are experienced with women with breast implants and, in most cases, the mammograms do not put the breast implants at risk.

Breast implants are medical devices which means that they are not meant to be “lifetime” devices. Women with breast implants should remain under the care of their board-certified plastic surgeon who will periodically examine the implants to look for rupture. Women with implants should also notify their surgeon if they feel that their implants are changing in shape, size or position. If the implants are not causing an issue, they do not need replacement. Optimal follow-up care is key to long-term health with implants.

Breastfeeding after breast augmentation is safe. Breast augmentation will also not prevent women from breastfeeding. However, all women, whether they have had augmentation or not, will produce varying amounts of milk.

In many instances, your plastic surgery will be performed under general anesthesia which means you are asleep. However, with some procedures, your plastic surgeon will recommend that the procedure be performed under local anesthesia which means that the surgical area will be numbed with an injectable numbing solution, but the patient is comfortably awake. As always, patient comfort is a primary concern, and your options can be reviewed during your consultation.

Depending on the surgery being performed, recovery can vary. In many instances, a week is a reasonable expectation. However, in more involved procedures that may require a longer recovery to ensure optimal results. A more detailed description of the recovery process is discussed with you during your consultation. Each patient is different, and a customized recovery plan will be curated by your surgical team.

Traditionally, cosmetic surgery is performed as an elective procedure with the goal of improving a patient’s appearance or to address areas that may be of concern to the patient. Reconstructive surgery is performed to return the patient to “normal” after injury or illness. While these tend to be the traditional definitions, there is an overlap between the two categories. Cosmetic surgery can be reconstructive or restorative in nature and reconstructive surgery can be cosmetic in nature.

Prior to any surgical procedure, a consultation is essential to determine if you are an appropriate candidate for plastic surgery. This is also an opportunity to meet the plastic surgeon to see if they are the right doctor for you. In the consultation, your plastic surgeon will perform a thorough history and examination, review your options, discuss the risks associated with the procedure and answer any questions you may have.

Thankfully many options exist to address cosmetic concerns that patients may have. During the consultation process, your plastic surgeon performs a thorough examination of the concerning areas that one is looking to improve upon. One of the main objectives during the consultation is to determine the expectations of the patient. If it is determined that the expectations are in line with treatments that are minimally invasive or non-surgical, then you may be an appropriate candidate.

The majority of plastic surgery procedures are considered outpatient which means that you will go home after your surgery. In some rare cases, it may be recommended that you stay overnight in a hospital setting.

Preparing for your surgery is a process tailored to the specific procedure. These will be clearly outlined in your consult and preoperative visit where you will receive instructions to guide you through the pre- and post-operative process. Patients are advised to discontinue certain prescription medications, abstain from smoking and in some cases achieve or maintain their ideal body weight. Following these recommendations will ensure that you are doing everything to achieve an optimal result.

It is always important to go to a board-certified plastic surgeon when considering any type of cosmetic surgery. To obtain board-certification in plastic surgery or facial plastic surgery, a surgeon needs to go through an accredited residency program that is usually six years in length and many times followed by specialized fellowship training. Following the formal training, a rigorous and thorough board certification process takes place which includes written and oral board examinations. This is to not be confused with a physician that is certified as a “cosmetic surgeon” which many times is a one-year training program not endorsed or recognized by the American Board of Medical Specialties.

Generally, plastic surgery is considered safe. Prior to performing plastic surgery, your plastic surgeon will thoroughly review your medical and surgical history to ensure that you are an appropriate candidate for plastic surgery. Many patients may be asked to get a medical evaluation and/or medical clearance from their primary care physician prior to surgery. Your safety is always of the utmost importance.

During your consultation, your board-certified plastic surgeon will be able to determine if you are an appropriate candidate for plastic surgery. Many factors are considered when making this decision, including age, underlying medical conditions, patient expectations, and surgical history.

There is no absolute age range for the “ideal” candidate. Depending on the procedure being considered, your plastic surgeon will be able to determine if you are an appropriate age for plastic surgery.

Absolutely. We are more than happy to see you for a consultation and discuss options. Please call the office at 202-810-7700 to setup an appointment.