Rhinoplasty
From my early teens, I was teased about my large nose. More than once I wished I had the money to get a 'nose job', but that was something that was in short supply at the time. Over the years, I tried to rationalise my feelings. I wasn't conventionally pretty, but I liked certain other things about my appearance, such as my then-slim waist, or my green eyes. What's more, I felt it was intrinsically wrong to judge people by appearance, that I shouldn't be affected by other people's thoughtless comments. Nonetheless I was affected in spite of myself. I would forget about it for a while, and then someone would make a comment - directly or indirectly - and I would feel uncomfortable and hurt. I also had little self-conscious habits which I was half unaware of, like turning to face someone if they spoke to me, as I hated being seen from the side. Ultimately, no matter how much self-talk I gave myself about loving my body, I was never going to like my nose. I have seen people with large noses who look fine with them, but I just didn't feel it suited me.
In my midthirties, I decided to do something about it and have a rhinoplasty operation. When I decided, I was going a phase where all of my photos kept turning out awful. Partially this is because I am not as slim as I once was, but more than that, my nose was looking worse than before. I don't know if I knocked it at some time, but besides being large, it now looked as if it was sloping slightly to once side. I was in a position where money was less of an issue, and I decided that if I was to ever have a rhinoplasty operation, why not now?
The consultation
Once I made my decision, I was quite impatient to get moving. I got a consultation by somewhat unscientific means - I chose the Pountney Clinic because I'd read a recent newspaper article comparing the selling methods of several plastic surgeons, and they found them the least hard-sell in their approach. I had not heard of this site, and I did not do any research into the best organisations that surgeons should belong to, etc. I had a free consultation with one of the surgeons, Phillip Graham. I found him easy to communicate with, which was important to me, as I'm a pretty good judge of character. I had compiled a list of questions which mostly related to the post-op recovery, and I found he answered most of those in advance. He asked me what I wanted changing about the nose. I simply said "It sticks out too much", but he also pointed out the slight twist in my septum which caused the asymmetric look, and the rather heavy bone around the bridge of my nose. He said that if he operated he would work on all of those aspects, and also shorten the nostrils when he brought the angle of the nose down. A still video image was taken of my profile, and he altered this to show what he felt the likely outcome of an operation. It was a clear improvement, but I felt I would like it smaller still. He said it would be difficult to give me a 'small' nose with my current bone structure, but a medium-sized, more refined nose was certainly possible. In retrospect, I'm glad I had the video imaging done. If I had not expected a 'medium' sized nose, I might have felt less satisfied with the outcome. I decided to book an operation while I was there, and they were able to fit me in for two weeks later. Normally they recommend that people think it over for a couple of days first, so they asked me to phone to confirm the appointment in two day's time.
I thought I was sure, but I actually got cold feet about it for those two days. All sorts of objections popped into my head, and the more I researched the subject on the web, the more I got nervous. Fortunately I had a supportive husband to talk to, who loved me for the way I was, but also knew how much I hated my nose, and how often I'd talked about getting it done in the past. I phoned to confirm the appointment, and then I was committed to it. The week before the op, I thought I'd completely got over my nerves, and was feeling positive again, but on the big day itself, I found my hands were shaking during the drive over to the clinic.
The only basic pre-op advice I got was to avoid taking aspirin. I'd also been taking a 1000mgs Vitamin C with rosehips a day, and I'd bought some arnica cream as I'd heard this helps with bruising. I mentioned the arnica to the nurse. She said that many patients seemed to swear by it these days, and it was also worth taking arnica tablets. She also mentioned applying cotton buds soaked with chilled witch hazel to the bruising, so I asked my husband to get these for me, so that I could use them on my return from hospital.
The operation
I had decided to have the operations under 'twilight' local anaesthesia, not general anaesthetic. I was told that I would be vaguely aware of what was going on around me, but I would be drugged enough not to care. This turned out to be quite accurate. About half hour before the op. a nurse came in and gave me a cocaine pack up my nose (the packing is very uncomfortable going in but numbs the nose fast), two sleeping pills, and an injection in my buttock. When I was taken into theatre, the drugs had taken strong effect and my eyes were open but I felt a little like I was dreaming. The anaethetist added to the drugs'cocktail' by putting a butterfly into my arm -apparently in order that it could be topped up if it looked as if I was becoming too conscious at any point. During the operation I was aware of what wasgoing on, up to a point - for instance I could hear them talking. At one point I was also aware of a noise as if he was chipping away at bone. Though this sounds alarming, I did not feel at all bothered about it, just mildly curious. It demonstrates the effectiveness of the twilight anaesthesia. I could feel nothing, physically.
When I was wheeled out of the theatre, I was taken back to my room, and went to bed. I kept dozing off and then waking up over a period of a few hours. At some point packing was taken out of my nose, and a pad strapped underneath, to catch any drips - the nurses came back every so often to change this, and also to give me witch hazel pads for the eye bruising. I was warned that it might not be a good idea to eat too soon after the op, as nausea was a common side-effect of the drugs. In the end, I ate very lightly around 10pm and I did not get any nausea. I got up and checked my appearance in the mirror. At this point I felt grateful that I had seen some post op photos. Even if they had contributed to my nerves the week before, at least now I was prepared for the sight of myself wearing a splint, with two badly bruised eyes. My bruising was mostly on the upper eyelids, and the left eye was half shut with swelling.
Post-op recovery
The next day they removed the pad under the splint, gave me more painkillers and also antibiotics, and then I went home. I found it hard, spending a week wearing a splint. For the first couple of days, my energy levels were low, just getting out of bed to go to the toilet was an effort. I found my sleep was interrupted a lot. I had to sleep propped up, which I found hard to adjust to, and I also had to breathe through my mouth as my nose was completely congested. Bending down was a total no-no, I found if I kneeled down just to put a plug in a socket it hurt my nose, so I asked my husband to do a lot of things like that for me. During this time, I took painkillers, antibiotics, arnica pills and vitamin C, and I applied arnica cream to my bruising. I stopped the antibiotics after 2 days as they had begun to make me feel nauseous, and I had been warned to stop them if this happened. I also had some stitches to clean on the side of my nostrils (they had been shortened), just with a dampened cotton bud. Around midweek, my energy levels were coming back nicely, and I didn't need painkillers any more, but that's when I started to get really stir crazy from staying indoors. My skin began to itch under the splint, and I found this worse than all the other post-op symptoms. Fortunately, I had already asked the clinic if it was OK to take antihistamines in case I got hayfever that week. I took them for the itching instead, and it helped.
The splint came off a week after the operation, and the external stitches were removed. It's a strange feeling looking at yourself with a different nose for the first time. I can't say I thought 'Wow, I look great' as my skin was red and flaking where it had been under the splint. I felt the nose looked a little asymetrical, which was down to uneven swelling.
Nonetheless, right from the start, I felt it was an improvement. I liked my profile better, and felt that it had turned out fairly faithful to the video imaging. Despite the rough condition of my skin, I was able to go out that evening, as the bruising on my eyes had virtually disappeared. I think that's thanks to using arnica cream and pills. I was glad to be able to go back to sleeping with only 2 pillows, and by this stage I was able to breathe through my nose again, though when I talked I sounded like I had a head cold.
2 weeks later
At the time of writing, it has been 2 weeks since my operation. The swelling at the bridge of the nose has receded, though the lower half of the nose is still looking swollen. My skin (which is sensitive under normal circumstances) is still a little rough, my nose still slightly blocked up, though better than it was. And the small external scars at the side of my nostrils are not noticeable. At this stage, it's just a matter of letting time take its course. It's difficult to tell exactly how I will look in the long term, but I am glad that I had this done. I only regret not being able to do it 20 years earlier.
