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As one of the most prominent features of the face, the shape and appearance of the nose isn’t something that can easily be hidden or disguised. For most people, this is an idea that would never come into consideration. However, there are some of us who have spent much of our lives unhappy with the look and shape of our noses. Perhaps it looks out of proportion with the rest of the face, or perhaps it was altered by an injury or a birth defect. Whatever the reason, we frequently meet patients who want to subtly correct their nose shape to bring it more in line with the rest of their appearance and to regain their self confidence.
This procedure is known as rhinoplasty. There are several different outcomes that can be achieved with this type of procedure. Your surgeon can make the overall size of the nose larger or smaller; change the shape of different parts of the nose, such as the bridge and the tip; change the span of the nostrils in order to make them more narrow; increase or decrease the angle that separates the nose and upper lip; and straighten a crooked nose that has been affected since birth or by an injury. Rhinoplasty can also be a really effective way to correct other birth defects in the nose, to improve other consequences of past injuries, and to help relieve a number of different breathing problems including those caused by a deviated septum or post-nasal drip. If you are interested in changing the shape of your nose, whether for cosmetic or for functional reasons, rhinoplasty might be the solution for you.
At The Plastic Surgery Clinic, Dr. Lista and his colleague Dr. Ahmad perform between 75 and 100 nose surgeries each and every year. They are both highly qualified and well established plastic surgeons with a vast amount of expertise and knowledge. Their goal is to give every patient natural looking results and to deliver them with the highest level of care possible.
Explore Your Options:
• Dr. Lista’s Rhinoplasty Philosophy
• The Best Candidates for Rhinoplasty
• Your Office Visit & Consultation
• How is Rhinoplasty Performed?
• Rhinoplasty Recovery
• Rhinoplasty Risks & Complications
Dr. Lista’s Rhinoplasty Philosophy
Long gone are the days of the one-size-fits-all rhinoplasty. Dr. Lista believes that a successful result can be achieved with nose surgery when the outcome is totally customized to each individual face. His focus is to move away from the “overdone” look of the past and to create a perfectly natural, born-with-it look . He understands that his patients should get noticed for their newfound confidence and not for their new nose.
Living and working in one of the most multicultural cities in the world, Dr. Lista has the pleasure of meeting patients who come from a wide variety of cultural backgrounds. He knows that the model of westernized facial features that once dominated plastic surgeons’ approaches to rhinoplasty is certainly not a model that works for every patient. His philosophy when it comes to nose surgery is to always preserve the patient’s ethnic heritage inherent to their facial features and to improve only the areas that they find unsatisfactory. The result is a nose that fits your facial proportions, maintains your cultural identity, and makes you look and feel great.
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The Best Candidates for Rhinoplasty
Generally speaking, good rhinoplasty candidates are people who want to improve the way their nose looks but also understand that total perfection is not a realistic goal. Nose surgery can enhance the way your nose looks and bring it more in line with your goals and desires, which often improves overall self-confidence. Feeling better about your appearance can lead to improved levels of self-esteem. Numerous studies have shown that these types of surgery can have a positive impact on quality of life for patients who have reasonable expectations.
It’s important to have realistic expectations about what this procedure can do for you—it won’t necessarily create a look that matches your ideal or inspire others to treat you differently. It’s important to think it over carefully and discuss your goals and expectations with Dr. Lista prior to undergoing any procedure.
Good candidates for nose surgery are also people who experience no underlying health conditions that would make any type of surgery riskier than normal. Non-smokers are much better candidates for surgery. If you are currently a smoker, it’s very important that you quit for at least two weeks before and after your operation. The best advice is always to quit for good, but if that’s not realistic for you, it is essential that you refrain from smoking during your recovery because smoking can really hamper your body’s ability to heal itself.
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Your Office Visit & Consultation
Every patient who undergoes surgery with Dr. Lista will meet with him personally before their operation. If you live in the nearby area, he prefers to see you twice before your procedure whenever possible. The consultation is an important part of the process because it gives you a chance to fully explain your concerns and to describe your goals for rhinoplasty surgery. You can bring in photos to help illustrate what you want to achieve and you should be very upfront about your desires. At The Plastic Surgery Clinic, we use digital imaging software to help give you an idea of what you might look like after surgery. With any cosmetic surgery procedure, it’s important to remember that not all expectations can be met. It’s essential to have a careful and frank conversation with Dr. Lista to make sure you can feel confident and comfortable with your decision, regardless of whether or not you decide to proceed with an operation.
A rhinoplasty is always a highly customized procedure. During your consultation, Dr. Lista will spend a significant portion of time conducting a physical examination and determining a complete medical history. Based on this evaluation, he will be able to better explain the type of result he can achieve based on your skin, underlying bone and cartilage. The office visit is also a great time for you to be able to ask any questions you might have and to address any concerns that might come up for you in between office visits. As he has been a practicing plastic surgeon for over 25 years, at this point, it’s difficult to imagine a question that Dr. Lista hasn’t heard before. No matter how big or small it might seem, he wants his patients to know that there’s no such thing as a stupid question, especially when it comes to a choice that involves your health, safety, and well-being.
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How is Rhinoplasty Performed?
Dr. Lista performs all of his rhinoplasty procedures personally. He’s also proud to work alongside Dr. Jamil Ahmad who joined The Plastic Surgery Clinic in 2010 and serves as the Director of Research and Education. Dr. Ahmad is a highly respected plastic surgeon who performs a wide range of facial and body procedures and he specializes in rhinoplasty surgery in particular. He is one of the editors of the prestigious Dallas Rhinoplasty: Nasal Surgery by the Masters, 3rd Edition medical textbook, a renowned reference used by surgeons performing rhinoplasty around the world. Dr. Ahmad is also one only a very few number of surgeons in Canada to be inducted as a member of the international Rhinoplasty Society.
The majority of our rhinoplasty patients choose to have surgery on site at The Plastic Surgery Clinic. Because our clinic was custom designed to provide the best patient experience possible, many of our patients prefer to have their procedures performed here since the facility meets and exceeds hospital standards while providing a higher level of privacy, luxury, and comfort. We are a fully accredited Independent Health Facility. To attain this license, we are frequently inspected and reviewed by the Ministry of Health of the Province of Ontario. The Canadian Association for the Accreditation of Ambulatory Care Facilities similarly certifies The Plastic Surgery Clinic and conducts regular inspection so that we can maintain our license. We’re so pleased to be one of the few plastic surgery facilities in Ontario that can attain these accreditations to offer our patients the highest possible safety standards.
Dr. Lista serves as Past Chief of Plastic Surgery at Mississauga’s main hospital, the Trillium Health Center. This means he continues to enjoy hospital privileges at the facility, which is only a 3-minute drive from The Plastic Surgery Clinic. So if you would feel more comfortable having your rhinoplasty performed in a hospital setting, it’s our pleasure to accommodate your request.
Whether you choose to have your operation at our clinic or at the hospital, you will always have anesthetic administered by a board certified and highly trained anesthesiologist. This specialized doctor will stay with you during your entire operation and will remain with you as you wake up to closely monitor your vital signs. The anesthesiologist will always be there to make sure that you are comfortably and safely asleep every step of the way and will ensure a smooth and healthy transition from your operation to your recovery period. In the hours and days that immediately follow your operation, a surgeon will always be on call 24 hours a day and our staff will always be available to help address any questions or concerns you might have.
Preparing for Your Surgery
During your consultation, you will receive special instructions from Dr. Lista about what you can do to best prepare for your surgery. These recommendations will include guidelines on eating, drinking, and smoking, as well as taking or avoiding certain medications and vitamins. If you are a smoker, it’s very important to quit for at least two weeks leading up to the operation. While the best advice is to stop smoking permanently, if you feel that is not yet a viable option, it’s important not to start smoking again for at least two weeks after surgery as well. We understand this can be a difficult task, but smoking interferes with blood flow to the skin and can therefore adversely affect the healing process. If you are a smoker, you may wish to ask Dr. Lista which strategies and tools are available to you that can help you make the transition away from cigarettes.
It’s important to follow your surgeon’s instructions carefully. They will not only help your rhinoplasty procedure go more smoothly, but they will also tend to lead to an easier recovery period.
The Rhinoplasty Operation
This procedure usually takes somewhere between one and two hours, though in more complex cases where a more complicated approach is required, more time may be necessary. During the operation the skin is separated so that the underlying framework of bone and cartilage can be reshaped to better match the patient’s desired outcome. Dr. Lista will choose a technique and an approach to reshaping the nose that is totally customized to the result you want to achieve. When the nose reshaping is completed, the skin is draped again over this new framework.
Rhinoplasty is typically performed by making an incision inside the nostrils, meaning that any scars or marks from incisions are hidden within the nose. In some rare cases where the corrective surgery is more complicated, a different technique known as open rhinoplasty is required instead. In these instances the incision is placed on the outside, though it’s small and it runs across the vertical strip of tissue that separates the nostrils (known as the columella).
With both of these approaches, Dr. Lista is able to make all kinds of necessary structural changes to the nose depending on your particular concerns. He can improve the appearance of a hump, narrow the bridge by bringing nasal bones together, trim cartilage to reshape the nose tip, and adjust the angle between the nose and upper lip to change the width of the nostrils.
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After your surgery, you may experience some discomfort or pain, particularly in the 24 hours that follow your operation. Your face will likely feel puffy, and it’s not uncommon for the nose to ache or to experience an overall dull headache. Usually this pain and discomfort can be managed by taking the prescription pain medication that Dr. Lista will provide you. It’s important that during this first day you stay in bed with your head elevated, and that you only really get up and move around to go to the bathroom.
You’ll probably also notice some swelling and bruising around your eyes. For about two or three days after your surgery, the swelling and bruising will likely increase and become more apparent. This is completely normal and you can help manage them by using a cold compress, which can help you feel a bit better too. As Dr. Lista says, during this time you’re going to feel a lot better than you look. Within about two weeks the swelling and bruising should dissipate on its own. You will still see some subtle swelling around the nose for several months, but it will be so minor it will only seem noticeable to you and your surgeon.
It’s also not uncommon to experience some minor bleeding around the first few days after your rhinoplasty. Because of this, and because of swelling in the nose, you will find that you’ll feel some stuffiness for a few weeks. For the first week, it’s important not to blow your nose. Dr. Lista will explain this recommendation in greater detail during your consultation, but the main reason to avoid this is to give your tissues a chance to heal - blowing your nose can put unnecessary force on your incision sites.
A few days after your nose surgery your nasal packing will be removed. Most of our patients find this helps them to feel much more comfortable. You will also have an external splint or cast to wear for somewhere between 10 and 14 days, though most people find that this is not too uncomfortable.
Long Term Recovery: Getting Back to Normal
A lot of rhinoplasty patients want to know: how soon can I go back to work or to school after surgery? Most people find that they are able to be up and about within 2 days or so. A lot of our patients choose to take a week off to give themselves the best recovery possible before returning to sedentary work. It’s also important to recognize that you won’t be completely up to speed for a few weeks and that you need to treat your body accordingly.
One of the best things you can do for your own recovery process is to listen to Dr. Lista’s guidelines carefully and follow them closely. Some of the things he’ll discuss with you are suggestions about physical activity and taking care of your nose. Usually his recommendations are to avoid strenuous physical activity, including things like jogging, swimming, bending, and sexual activity, for two to three weeks. A good general rule is, if it increases your blood pressure, you’re going to need to take a rain check. Take care to avoid rubbing or hitting your nose and avoid too much sun exposure, if possible, for eight weeks. The main concern here is to avoid getting a sunburn, so it’s important to stay in the shade, wear a big hat, and use SPF protection. At the same time, be gentle while washing your face or hair and while using cosmetics.
If you require contact lenses for vision correction, you can start wearing them again as soon after surgery as you feel like. If you are a glasses wearer, however, you’ll need to follow a different set of guidelines. If you wish to wear glasses after your splint has been removed, you need to arrange them in such a way that they will not sit on or apply pressure to your nose for another six or seven weeks—as long as it takes for your nose to heal completely. Some ways to accomplish this are by taping them to the forehead or by propping them up on the cheeks.
Dr. Lista likes to schedule a number of follow up appointments with all of his patients in the months that follow a rhinoplasty surgery. During this time he can check on the progress of your healing and address any questions that you have. If you develop any symptoms between these appointments that seem unusual or cause concern for you, or if you have any questions about your recommendations throughout your recovery, we’re always available and more than happy to discuss it further with you. Don’t hesitate to get in touch with us even if it seems small or silly. In the over 25 years that The Plastic Surgery Clinic has been open, we’ve heard just about every question you could possibly think of. We’re here to help!
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Rhinoplasty Risks & Complications
Whether it’s an elective cosmetic operation, or a necessary medical procedure, all types of surgery are associated with some risk and some uncertainty. That’s why it’s so essential to chose a qualified and highly experienced plastic surgeon to perform your rhinoplasty. When a qualified surgeon does the job, complications are quite rare and tend to be minor and easily remedied. All the same, the risk is always present for a complication like infection, nosebleed, or a reaction to anesthetic to develop. One effective way to reduce these risks is to carefully stick to Dr. Lista’s recommendations for before and after your surgery.
Sometimes after rhinoplasty small red spots may appear on the skin’s surface as a result of burst blood vessels, and these are more often than not quite minor, but in some cases they can be permanent. If yours is a closed rhinoplasty, the incisions will be placed within the nose and you’ll be left with no visible scarring. However, if Dr. Lista is required to use an open rhinoplasty technique, or if your particular procedure involves a narrowing of flared nostrils, small scars will be present at the base of the nose, but these tend not to be visible.
In around 10% of all cases, or 1 in 10 rhinoplasty procedures, a secondary procedure might be required. This type of secondary procedure would generally be used to correct a small deformity, which is an unpredictable outcome that happens even to patients of the most skilled plastic surgeons. All the same, the corrective surgery is usually minor and the patient can still achieve a completely satisfactory result.
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