Miami Cosmetic Surgery

I think that anyone that is considering nasal surgery should consult with a surgeon that specializes in rhinoplasty. Rhinoplasty, or cosmetic nasal surgery, is one of the most challenging surgeries plastic surgeons perform. For that reason , I think it’s very important to seek a specialist that experienced in this type of surgery.

I prefer to use hyaluronic acid fillers in the nose. This is because they resorb over time and do not leave any traces. Radiesse, although a great filler for soft tissue, can leave traces behind which can become a problem if the patient is going to have surgery in the future. Hyaluronic acid fillers last about one year in the nose.

Grafts are structural elements made from cartilage ( septal or ear) that are used in rhinoplasty. They are used to help shape parts of the nose. For example, some are used to strengthen or shape the tip. They can also be used to correct a collapsed nostril. The main risk of using grafts is that they may become visible. This risk is highest in patients with thin skin. When I use grafts, I am very careful to shape them and bevel the edges so they blend in with the rest of the nasal cartilages.

I tell my patients that they will be presentable at one week. This is because most of my patients do not bruise with rhinoplasty. However, there are sometimes when they do bruise. Usually, this can be easily concealed with some base make-up.

I think it is a good idea to let you surgeon know exactly what it is that most concerns you about your nose. I also think it is a good idea to show him pictures of some of the noses that you think are appealing to you. As your surgeon, I will examine you during the consultation and then let you know the particular issues that I believe can be improved with the surgery. At this point, I will take pictures and place them on my computer, where I will perform digital imaging. We will then go over the digital imaging and see if the ideas you have regarding your ideal nose are possible to realize for you. Although every nose is different, there are some features that can be given in certain cases. For example, if a patient wants a tip rotated up, this can be incorporated in the procedure. Although noses cannot be duplicated, certain features can be translated during surgery. It is important to realize that all noses are different and that surgery cannot duplicate an exact nose. Posted by Dr. Bustillo

Nostrils are normally not symmetric in many patients. In fact most people have differences between both sides of the face. So, I would say that if the difference in your nostrils is very small, it probably something that only you are able to notice. It is probably safe to say that he average person does not notice the small asymmetry. That being said, if this is something that concerns you, it is possible that it can be corrected with small procedure under local anesthesia. Many times, one of the nostrils may be more elevated than the other. In cases like these, the use of a small "rim" graft can be place via a small incision inside the nostril. The graft is used to "pull" down the retracted nostril rim. The recovery for this procedure is approximately two to three days.

Posted by Dr. Bustillo

The rhinoplasty procedure is generally not a painful one. In fact most patients that undergo cosmetic nasal surgery, rhinoplasty, are pleasantly surprised that they do not need or take any pain medicine after surgery.

After surgery, patients sometimes have a light pressure over the nose that resolves over an hour or so. From there on after, the patient will typically not feel any pain or discomfort. I ask that the patient use cold compresses over the eyes. This help to decrease the swelling t a faster rate and it helps to sooth the patient after surgery. In addition, I prescribe a small dose of steroids for five days to all patients. This helps to decrease the swelling and helps to alleviate the pressure that some patients can experience after surgery. There are several homeopathic treatments that I recommend to al patients undergoing cosmetic facial surgery. These include arnica, which helps to cut down on bruising and swelling.  I also recommend pineapple juice, helps dramatically to bring down swelling in the first week after surgery. On another note, I would like to mention that sleeping with the head of the bed elevated with at least two pillows helps to bring down the swelling after the surgery. In conclusion, if these measures are followed, the post-operative swelling can be alleviated in an expedited fashion.

Posted by Dr. Bustillo

Parents often bring their children to consult with me regarding cosmetic nasal surgery, or rhinoplasty. The age at which they can have surgery depends on two factors. One whether they are male or female and the second is if the patient has physically developed adequately for their age. In general, the rhinoplasty procedure can first be performed in girls from age fourteen to sixteen. If the girl is a well developed fourteen, then the surgery can be performed. However, if the girl is physically underdeveloped by age fourteen, then it is best to wait a year or two.Boys can undergo the rhinoplasty procedure between ages sixteen through eighteen. Again, the determination of whether to do it at sixteen or eighteen depends on their physical development.

Posted by Dr. Bustillo

Patients often ask me what the recovery will be like after the rhinoplasty procedure. I like to explain it in the following way. The first forty-eight hours will exhibit the highest amount of swelling. During this time, cold compresses over the eyes will help to bring the immediate swelling down. Approximately eighty percent of my patients get some swelling of the lower eyelids, but they do not get “black and blues” in the lower eyelids. Days three through seven there is a gradual decrease in swelling. At day seven, the patient is presentable in public. Any minor bruising can be covered with mild make up. Seventy percent of the swelling resolves in the first three weeks following surgery. The next twenty nine percent of the swelling will resolve over the next six months. At the six-month mark, the nose is about ninety nine percent of the final result. The last one percent of swelling resolves over the last six months. The nose is said to be fully healed at one year after surgery. In conclusion, the nose begins will look better than the pre-operative appearance at five days after surgery, when the cast is removed. From then on after, it improves on a daily basis.

Posted by Dr. Bustillo

Patients that undergo rhinoplasty  surgery may swell after surgery. My patients typically do not swell much, as I  try to do everything during surgery to avoid swelling. However, this is surgery  and everyone reacts differently. At this point there are things that can be  done to help reduce the swelling at a faster rate.

I recommend that patients take a  medrol dose pack the week after surgery. This is a low dosage of a mild steroid  that is very effective at reducing the immediate post-operative swelling. I  also recommend that patients drink plenty of pineapple juice after surgery.  This juice has many nutrients and minerals that help to reduce swelling.  Patients that undergo surgery with me are started on high dose vitamin C (2000mg  a day) for two weeks before surgery and two weeks after surgery. All of these  work together to help relive post operative swelling.

Posted by Dr. Bustillo