JEFF: So I decided today to have rhinoplasty and septoplasty. When I was ten years old my nose was broken playing baseball. A baseball bat hit it. One of the kids swung the bat, hit the ball and then threw the bat and hit me in the nose. It healed and it was okay but as I have grown it has started to deviate my septum a little bit to the side so I have always had to breathe through my mouth.
DR. NASSIF: When I first met Jeff his main concern was getting his nose more symmetric. As we know, he got hit with a baseball bat many years ago and that caused significant deviation and crookedness of his nose. He nose was actually twisted.
JEFF: Because of the deviated septum, I have always had a little bit of raspiness in my voice. I am always having laryngitis. I also wanted to have a better, straighter, more esthetically symmetric nose because if I am going to go through all of the process, I would also like to have it look as good as possible.
DR. NASSIF: That would also help with the breathing, so those two go hand in hand.
In addition he has a little bit of fullness in his neck and jowl area and his chin was set back a little bit. We discussed doing the septorhinoplasty, straightening out the nose and make him breathe better, make it more symmetric, soften the profile, do a little liposuction of the neck and jowls and do a chin implant. That was our goal.
JEFF: Up until Dr. Nassif, I had never been referred by somebody that I really trusted enough nor did the doctor make me feel comfortable enough to ever follow through on the surgery.
When Dr. Nassif got done with me and I met with the different people in the office, everybody made me feel comfort. Dr. Nassif made me feel at ease that he would be able to do a really profession quality job. Just to be able to breathe a lot better and to have a much straighter nose. That is going to be really cool I think.
DR. NASSIF: I am going to take good care of you.
JEFF: I am about a half hour out from my surgery and really I think more than being nervous, I am just excited about a week from now or two weeks from now when the bandages are off and the swelling starts coming down and getting a chance to see if I can breathe better and how I look maybe a little bit better. I think that gets me kind of fired up about what is going to happen but as far as being nervous, I have a lot of confidence in Dr. Nassif’s ability to keep me as comfortable as possible and make the process as positive as possible; as long as I am not awake during it, than I am not cool.
DR. NASSIF: Vitals are good. Now we will go onto the liposuction and let’s go!
With Jeff we initially performed a liposuction of the jowl and submental area. After we performed the liposuction, we did a procedure call a platysmaplasty. We open up the incision in the chin a little bit wider and we take the muscles of the neck and we bring them closer together and tighten them. Following the platysmaplasty, we perform the chin implant. The chin implant involved using the different sizes of chin implants to see what looks best for Jeff and then we perform the chin implant.
We then perform the septorhinoplasty. The major issue when performing a rhinoplasty on a nose that has had nasal fractures before is that the bones of the nose sometimes are not as solid, they might have been broken where we try to refracture them and narrow them, they may not fracture the way we want them. We have to be very careful how we do this.
To fix the deviation of the nose, we had to do numerous things. First we had to perform a septoplasty. The septoplasty helps straighten out the septum which was in the form of a C, so it was really crooked and was pushing all the way over the right. After we did that, we still had a problem with the left side of the nose. It was still as collapsed. We performed reconstruction of the left side by using something call spreader grafts and onlay grafts. That helped reconstruct the nose and make it more symmetric. It was pretty severe but I have seen a lot worse.
We are just putting on the cast now. We are finished with the surgery.
After three and a half months Jeff looks fantastic. His neck, his chin looks wonderful. His jowls look great. His nose looks a lot better, about 95% better. He is still a little bit swollen on the tip and that will take a good year for that tip to completely settle down and look fantastic.
JEFF: After the surgery my nasal passages are now open. I can breathe through both sides much, much better. I can taste and smell food dramatically better now than I did before. So far in the last three or four months, breathing has been good and I have not had any nasal infections like I have had for the last five or six years, so that is good.
DR. NASSIF: Looks good! Kind of a natural look!
JEFF: As far as Dr. Nassif meeting or exceeding my expectations, I would say that he met and probably exceeded my expectations. I really appreciated him being as honest as he was and by being so conservative it is a pleasant surprise that now things are looking better than even what he had hoped that we could get.
DR. NASSIF: Neck and jowl liposuction is a very common procedure. If someone has good elasticity of the skin, we will do a bit of liposuction assuming that they need it and that is what is going to make the neck look a lot better.
JEFF: It gives me more confidence and makes me feel better about how I look now that my nose is straighter and it is not completely deviated to one side. It makes me feel better. I lost a lot of weight even before surgery but then having my neck muscles tightened and having a little liposuction under there obviously made my jaw a lot more defined and that makes me feel more confident too. I probably get double or triple the attention now than I got before I had the surgery.
I really think that you cannot judge the final results until at least six months to a year after the surgery because of the amount of swelling that you are going to have. I was pleasantly surprised with the amount of postoperative care that I was able to get and it was just fantastic!
