A lot of surgeons are comfortable with using scarring procedures when it comes to performing Rhinoplasty, but Dr. Dugar goes above and beyond for his patients. At Beverly Hills Rhinoplasty Center™ located in Los Angeles, CA, Dr. Dugar offers Closed Scarless Rhinoplasty for his patients.
What to Expect with Scarless Rhinoplasty Surgery:
The week before surgery we welcome you to come back to see Dr. Dugar to review the goals of surgery and the game plan. For out of town patients, we schedule a pre-operative appointment the day before surgery to meet Dr. Dugar and undergo a full thorough consultation. The weeks preceding the surgery, our surgical coordinator will be in constant contact making sure all your questions are answered and you are entering the surgery day with a calming sense of relaxation. The night before surgery, our Anesthesiologist will call you to review your medical history and answer any questions you may have. The day of surgery you will arrive at the surgery center (the same location as our office) and be admitted by our friendly nurses who will help get you changed and comfortable. You will then meet your Anesthesiologist who will go over any questions you have. You will then see Dr. Dugar who will give you the final confidence and ease any tension you may have. It is completely normal to be nervous and we will walk you through every step. We will ice your nose and slowly give you carefully titrated doses of medicine to allow you to gently drift off to sleep. The surgery usually lasts between 1-2 hours and when you wake up in the recovery area, you will have a small cast over your nose. After you have deemed safe for discharge, all instructions will be given to a loved one or caregiver accompanying you and you will be taken home or to a hotel or recovery. The night of surgery, Dr. Dugar himself will call to check in on you and answer any questions you have. Dr. Dugar will see you 1-2 days after surgery to clean out your nose and make sure you are comfortable and breathing well. 5-7 days after the surgery Dr. Dugar will remove the cast (no cast if only breathing surgery performed). For out of town patients, you may fly back to your respective city or country the day after cast removal (which is generally day 8).
What to Expect after Scarless Rhinoplasty Surgery:
1 week post op: During this time, you will be recovering with a cast over your nose (no cast if only breathing surgery performed). Most patients require NO pain medication after day 1-2. Due to our Scarless Technique, you are surprisingly comfortable usually with little to no swelling and minimal to no bruising. ~50% of our patients get NO bruising at all; the other ~50% get minimal bruising that is usually completely gone by the day the cast comes off. You will be using a special icing technique to reduce swelling and bruising as well as other special techniques to improve the healing. On day 5-7 post-operatively, Dr. Dugar will remove the cast. By day 7, almost all the swelling of the face is gone and usually most, if not all, of the bruising is completely gone. You can put on a small amount of makeup and go out for dinner that evening and no one will know you had anything done. Due to our scarless technique, since there are no external cuts or scars and no unnecessary dissection, the healing process is much quicker. For out of town patients, you may fly back to your respective city or country the day after cast removal (which is generally day 8).
1-6 weeks post op: During the first 6 weeks, you can resume all normal functional activities such as work, socializing and light physical activity. Heavy physical activity (running, jogging, heavy weight lifting, downward face poses for yoga/pilates) are restricted until after week 6. During this time the minor swelling of the nose will slowly start to subside (but even with the swelling, the nose generally still looks smaller than it did pre-operatively).
6 weeks – 1 year post op: It truly takes 1 full year for the entire dorsum (profile) and sidewalls of the nose to fully heal and for all the swelling to dissipate. Rhinoplasty healing is a tedious process because it is one of the only surgeries where we are not removing excess skin. We reduce the cartilage and bony framework but leave the skin the same size, so it takes time for the skin to shrink down to match the new framework underneath.
1 year-3 years post op: It truly takes 3 years for the tip to fully heal (only if significant tip work is performed). The tip takes the longest time to heal and mold to the new framework because it is the thickest skin of the nose. The skin over the profile is thinner than the skin over the tip. Patience is required during this healing phase. When surgeons are too aggressive during surgery, and the tip looks good with minimal swelling immediately post-operatively, there is major concern, as the tip will likely begin to cave in and look pinched as it heals. With our conservative scarless technique, most of the swelling of the tip is gone in 6 weeks, but it takes 1-3 years for it to fully complete healing and molding.
The Five Things I Hate
These five things are constantly in my mind during every consultation and every surgery. This is where being the only surgeon in the USA whose entire surgical practice is dedicated to Scarless Rhinoplasty allows a superior advantage of finding the perfect delicate balance of meaningful refinement to a nose without drastic uncomfortable change. Natural noses are mandatory in my practice.