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Explore what others have to say about Rhinoplasty Plastic Surgery of the Nose with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

  • Why did you choose to have the surgery?
  • How did you choose your doctor?
  • How much did it cost?
  • Was the final cost the same as what you were told before the surgery?
  • How was the recovery?
  • Were there any complications? How were they resolved?
  • How do you feel about the results?
  • Did it have any effect on your life
    • emotionally
    • socially
    • sexually
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  • How did others react to your surgery?
  • Did you learn any lessons?
  • What would you advise others?
Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

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Rhinoplasty Nasal Surgery Important Information

Question: Re: questions septoplasty

I just had a pre-op exam for septo-rhinoplasty. I have been experiencing breathing problems since I originally broke my nose (twelve years ago). I was expecting the doctor or physicians assistant to do a routine physical (blood pressure, maybe even take blood) as well as examine my nose. This doctor was a referral from my insurance co. and I don't feel that I can go elsewhere. Is this normal? My entire consultation took about 10 minutes! They did not have computer imaging - how important is that? Also, I just found out that I will have an overnight stay in the hospital. Is that common? I would appreciate an e-mail response as soon as possible. I am scheduled for surgery in less than a week. Thank you for your time.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

These are all good questions and they should be asked to your doctor and insurance company. Ask you doctor. If you are uncertain, having surgery without answers may make you worry unnecessarily. There may be simple explanations that you doctor can help you with to make your surgical experience more pleasant.

Most insurance companies have groups of doctors that patients can choose for their care. Others let you go to what ever doctor you choose. Some companies have tried to change the way medicine is practiced by contracting with small numbers of doctors at very reduced fees. Your rates may not go down but someone else is getting the money, not the doctor. You get what you pay for. You may want to investigate if there are other options, such as additional charges to you to "go out of plan".

I will not join certain "insurance" plans that lower the surgeons fee to such low amounts that I am forced into mass production medical care that cannot have the time spent with each patient I feel essential for the type care I want to deliver. My typical rhinoplasty / septoplasty consultation takes 1 or more consultations of over 1 hour each. There are just too many options and much to discuss for me to do this in less time. Not all doctors want to practice this way. I cannot adequately examine a nose in 10 minutes for a septoplasty rhinoplasty.

Computer imaging can be a useful tool in understanding the EXTERNAL changes that surgery offers. In the wrong hands bad communication can leave false expectations with the patient. I cannot make tissue do what I can get my computer to do. Helping a patient understand their options is a very valuable method of visual communication I like to do with my patients now after they sign a consent warning the limitations of computer imaging. Imaging has little to offer in internal changes at this point in time.

I do not understand the overnight stay in the hospital for a septoplasty unless there are medical reasons to help monitor and protect a particularly risky patient. If the surgery is late enough in the day, it may be unwise to discharge the patient until the next morning.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Nose Job

hello, I reside in Montreal, Canada. My problem is my nose. I think that its just too big. I also have acne problem, my derm has been prescribing me accutane 10mg for almost a year. My skin is too oily, but I am taking accutane, the oil is under control but not at the point that I would prefer. My nose is just covered with black head, its OILY and BIG. Help me out here, what should be my course of action here.

Plastic surgery is an option for me, but I have no idea about the cost of

it. HELP ME HERE.

Reply soon.

Thanx.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

"Big noses" can from many causes. Severe acne sometimes can be part of acne roseacea (Rhinophyma). Thickened skin can make the nose look very large. Check out my website for information about patients who have this problem. Your dermatologist is most likely very aware of this condition and you could ask if this condition pertains to you. A nose can also be large from the elements that go into making the nose. The bones, cartilage, and skin envelope all contribute the shape of the nose. Plastic surgery can be used to modify both problems. Check out the rhinoplasty sections for some other examples.

Cost depends on what surgery is necessary for what problem.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Post surgery swelling

I had open rhinoplasty 2 1/2 weeks ago. Mine was fairly comprehensive in that my bones were narrowed and I had "strut" put in because the tip of my nose was nonexistent, just a big squishy mess (I am African-American). The healing was going fairly well until one day I bent over to pick something up and rose up fairly abruptly. My nose started to swell up bigger than it was right after I got out of surgery and then I started bleeding for a few minutes. It's still abnormally swollen. My doctor was baffled and thought it may have been the pressure. Still, I'm very concerned about all this swelling. I would expect it to have subsided a little more quickly than it has so far. Is there anything I can do to minimize the swelling (i.e. ice)?

A

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

I suggest that patients who have rhinoplasty surgery by me limit their activities for a short time after surgery to lessen trauma and causes of new bleeding. However as healing continues, normal activities should be able to be resumed. Bending over can create the feeling of swelling during the early healing phases. Vigorous exercises can cause bleeding.

This is a good question for your doctor or someone who has examined you. Trauma causes swelling which can be minimized by cool compresses. Ice directly can cause frost bite. There are other problems that can cause swelling that cool compresses will not help. Bleeding under tissues will cause swelling. This extra blood needs to be absorbed by the body. Once the bleeding has stopped, cool compresses would be of little value. Sometimes localized collections of blood need to be evacuated. Check with your doctor that is your best source of information.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: I need help!!! (Rhinoplasty)

Thank you for responding. I did not want to go on the bulletin board, I wanted to write to you directly. I am very new to all of this.

I have interviewed two well respected doctors in New York. They are both highly regarded in their field. I just can't make a decision. Is it alright that I say their names to you and get your opinion?

Thank you, D

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

You can mention their names but I do not know how I can help you chose between them. Each doctor patient relationship needs to evolve on their own. You will need to find one that you trust. You will have to choose. Surgeons with national reputations sometimes are ideal for their patients, others are not. You could check with prior patients.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: ? for Dr Mike

Dr. Mike,

I posted eariler about post-surgery swelling, and I thought that since you seem to enjoy 'surfing' in this message board, I'd throw another question your way. When I had my tip-plasty done, I had my sides narrowed. They aren't as narrow as I would have liked, but I guess I still need to breathe! Anyway, my question is, I have 'ridges' on the side of my nose - like peices of hard skin right next to my scar. My doctor said it was glands that will go down in about three months. I'm a little disapointed because I did so much research about this before I decided to do it, and I read nowhere about this. Its only a problem because its impossible to cover with make-up. Make-up actaully makes it look bigger!

Thanks for being here, you do us a great service!

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

I do not understand your question. Most tip plasty and nasal width reduction surgery do not have external "scars" except for the columellar (lower post between the nostrils) in an open rhinoplasty approach, and tiny skin puncture marks for external osteotomies (bone breaking to narrow nose). Neither of these sites usually scars severely. There are more prominent scars when the lower nose (ala) are reduced. These alar wedge scars do start out somewhat thicker and become more natural over time (usually by 6 months). Most scars evolve and soften as they heal.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: rhinoplasty and skydiving

Dear Doc:

I live in VA and I am thinking about rhinoplasty. My only problem is that about 8 months after surgery I would be scuba diving and sky diving at fairly great depths and heights. I was wondering if having rhinoplasty would restrict me from participating in these activities because of the amount of pressure involved with each of these?

Thanks a lot,

N

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

If you have no problems with your sinuses and do not need sinus surgery, these activities should pose no problems. Patients with nasal obstruction sometimes have problems with sinus drainage. The turbinates that provide humidification for the air passing through the nose cover the holes that connect the nose to the sinuses. Surgery on the septum, turbinates, or these holes can improve or worsen the drainage of the sinuses. Obstruction of the sinus draining holes can cause pain with rapid changes in barometric pressure.

Most patients asking about rhinoplasty do not need this type of intervention. You would need an evaluation and examination to learn what rhinoplasty has to offer you. There are just so many possibilities since rhinoplasty is not just one operation, but a name for a whole series of possibilities.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: nasal tip reshaping

Dear Doctor,

I just had nasal tip reshaping done. I had nostrils which flarred out and a tip which drooped. The tip now looks more pointed and still looks like it droops. It looks like I will be scarred where the stitches were put in at the base of the nose. Also, the right nostril hole now looks so much larger. I can see the slit that was done inside the nose and it seems like my nose keeps pulling away and flarring out more because of the open slit. It has been two weeks since surgery. Do you think something went wrong?

S

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

The nose can change shape radically in the first few weeks after surgery. These are good questions you can as your doctor. If your doctor does not want to spend the time discussing your concerns, perhaps you chose the wrong person to do your surgery. It is impossible to comment on your description of your nose. You need an examination and evaluation to determine if anything is wrong. Probably all you need however is a little patience and see how the nose evolves. When in doubt, ask your doctor.

Good luck.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: thinking of rhinoplasty

dear Dr. Mike

i have been thinking of having rhinoplasty done for some time. i always have had difficulties breathing and seem to be in the doctor's office with a sinus infection every few months or so. i do get headaches regularly. i am happy with my appearance but my nose is out of porportion. it is too large. i don't believe i broke it in the past, but i have injured it many times and it has changed shape from those injuries. llike being sharper on one side and rounder or smoother on the other. i have a bump on the top ridge and a long but high nose. the tip like a ball and is very movable. i would like some information on what exactly is done to reshape the nose and correct the breathing difficulties. also, how long does this procedure generally take, and take to recover and heal. i was planning on doing my research and many specialist consulations and possibly get the procedure done next june, 98. would i pushing it for recovering for my mid-july wedding. i would really love to have a new nose for my wedding pictures. i live in the king of prussia area outside of philadelphia, PA. thanks and i'm waiting for your response.:)

Dr Bermant responds:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Rhinoplasty is the name for an operation that has many possible components. Which subset of components would apply to you would be appropriate are determined during an in office consultation after an examination and evaluation.

Elements that often are addressed in rhinoplasty include trying to establish a more natural proportion between the various facial features. Attempt at making the nose more symmetrical. There are many other options that could be explored during the consultation. Realistic expectations however are important for a happy outcome. Anything can be done visually on the computer, reality is a little different. The adjustment of nasal features in this fashion is usually cosmetic in nature.

Nasal breathing problems is sometimes covered by insurance policies. Several options also are possible to correct or improve this problem

Recovery depends on what was done. Nasal reshaping occurs over several months. You may want to give yourself more time to heal than you are planning. Early swelling and bruising will probably not be much of an issue at 6-8 weeks for a major operation. Fine evolution of the rhinoplasty continues for months - years after that.

If you have not done so, check out my web page. Look up the sections on rhinoplasty septoplasty and patient questions / answers. This is the beginning of your education process. Our office consultations are very extensive both to learn what would be appropriate for the patient and the education process. Choose your surgeon carefully but remember there are many ways to achieve a certain result.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: jaw balance and rhino

Dear Dr. Bermant,

first, i wanna say that you have great web site ! I think its one of the best sites about plastic surgery.

Second, i have a question; I have a slight difference in size and shape between the right side and left side of my jaw . The left side seems to be in a better shap . So i'm wondering if you ever encountered such case ,if so please give some info about this operation and the material used to attain "balanced" jaws . Also, is it possible to perform this surgery along with a rhinoplasty ?

I would appreciate your response very much.

Thank you.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Facial asymmetry is more the norm than not. Large degrees of asymmetry can be disfiguring. Yes I have treated some of the more asymmetrical problems but would need to evaluate a patient before commenting on what might work best for any one patient. Small degrees of asymmetry are usually best left as they are. Jaw repositioning is used for major problems and is best done before rhinoplasty, not at the same operation. The nose should be balanced to the final face and this can be difficult during the operation.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: rhinoplasty

hi im an 18 female conidering rhinoplasty. i had a few questions and i wopuld very much appreciate it if u would anwer them for me. if u have any info about rhinoplasty i would be grateful if u sent it. thank you

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Yes I have information about rhinoplasty and have built an extensive website explaining aspects of surgery and showing before and after cases. For patients scheduling consultations, we also have an extensive patient education package that continues with in office patient education.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Questions about rhinoplasty...

To whom it may concern:

I would like to know how much it cost this kind of surgery. I have difficulty breathing, I am 39 years old and had the same surgery when I was 16 for the same reason. Also, could you explain the procedure? Are you using laser now?

Thank you so much for the information.

Sincerely,

M P

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

This information is the kind of education my patients get in a consultation. There are many kinds of rhinoplasty / septoplasty and the cost varies. To ask for a treatise on rhinoplasty by E-mail is a little unrealistic. There are many heavy textbooks on this topic that cannot easily be condensed. That is why we have consultations - so doctors like me can examine a patient and give advice. There are no reasons that I know of to use a laser during a rhinoplasty. Please browse this bulletin board and my website for more information and then set up a consultation with a doctor to continue your education process.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Rhinoplasty

Dear Dr. Bermant.

I am in a bit of a bind. About a year ago I decided on having rhinoplasty done to remove a hump which amkes my nose sit very high off of my face. I chose a surgoen in my area who was not yet board certified but was in the process of completing his boards. His price was SIGNIFICANTLY less than any other doctor I had visited. He was a great guy and was basically the only surgeon I trusted. The surgery was very trumatic for myself (a 22 year old male) and my family. I also had a problem with my septum pulling up the top of my lip. Following the surgery I knew I had a problem. My expectations were not met, and I immediatley went to other plastic surgeons in the area and they seemed amused at the result of the surgery. THe problem with my septum was corrected, however my nose was still "big" and still had the same exact shape as it did prior to the surgery. I am still very self-conscious about my nose. I told the facts the the doctor who completed the surgery and he stated that he was unable to touch the hump because of the fact that it lies to close to a sinus at the top of my forehead. He told me that he was not going to be the doctor who got to close to this sinus cavity. I then visited the most well-respected plastic surgeon in this area and he informed that all of this was not true. He then showed me via-computer imaging that I would also be a candidate for chin-implants as well. His price is 3 X's the price of the first doctor. The doctor who performed the initial surgery recentley contacted me and imformed me that my case (1 of 8) was chosen for his oral-boards which are held in November in Houston. I am considering writing the American Society of Plastic Surgeons and informing them of how I feel about the case. I feel cheated and this is the only way i can vent my frusration that I may have to go through this procedure again after getting "cheated " the first time. Please tell me what my options are and if this letter which I am considering writing will get me anywhere. I just want my nose to look normal and to move on from this whole situation, without emptying my bank account for a second time.

Sincerely Yours,

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

You should go back to your original surgeon and express your thoughts vented here. Remember you went into the first operation with a less experienced surgeon at a significantly reduced price at your own choice. Rhinoplasty is a very complicated operation that takes many years to master. A well trained surgeon will tend to be more conservative with ANY operation until their experience shows them how far they can push the procedure. The respected surgeon's higher price may not seem outrageous when you include the experience and probability that a revision is less likely. I do not understand what you consider cheating? The doctor took the time to help you understand the surgery, his training, and offered you services at a lower price. How can anyone expect to get a the performance of a high priced car out of a lower priced bargain model?

Discuss the recommendations of the other surgeons with your first doctor and see where that takes you. Without before and after photographs and a clinical examination it is difficult to tell if this is a case of unrealistic expectations, communication problems, less than spectacular results, or the competitive nature of the other doctors. In this highly competitive economy some doctors put down results of anyone else but their own cases.

Computer modeling is not the same as surgery. We can do on the computer things we only wish were possible in the operating room. Remember unrealistic expectations will also lead to an unhappy patient!

Our board selects cases from a list of ALL cases performed by the surgeon. There is no choice by the candidate. All cases performed must be submitted. Choices are made from the name of the procedure and complications reported by eximiners who have not seen photographs of the patients nor the chart. The candidate then must supply the chart, operative summaries, photographs and answer examiner's questions about the case. Patient satisfaction is important to all plastic surgeons.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

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