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Explore what others have to say about Rhinoplasty Plastic Surgery of the Nose with answers by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.

  • Why did you choose to have the surgery?
  • How did you choose your doctor?
  • How much did it cost?
  • Was the final cost the same as what you were told before the surgery?
  • How was the recovery?
  • Were there any complications? How were they resolved?
  • How do you feel about the results?
  • Did it have any effect on your life
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  • How did others react to your surgery?
  • Did you learn any lessons?
  • What would you advise others?
Information posted in this section does not necessarily reflect the opinion of Dr. Bermant.

E-mail to Dr. Bermant

Rhinoplasty Nasal Surgery Important Information

Question: Re: Rhino after trauma

Dr. Bermant,

Hello. How are you? Let me start by saying that I am a fifteen year old girl and I have a couple of questions about rhinoplasty. See, my nose is not obstructed, and I don't have trouble breathing, but there is a hump in it. There is also a lot of space between my face and the top of my nose. Now, I accidentally had a window closed on me when I was four, I ran into a wall when I was five, I slammed into a screen door when I was eight, and I just recently got hit in the nose with a surf-board. However, two doctors, a pediatrician and a doctor of the nose and throat, looked at my nose and said I had a very straight septum. They also said I have thin skin and I would be a good candidate for surgery if I choose to go through with it. They said the hump would be gone and my nose would be my greatest feature. Well, can you explain exactly what they do? I mean, how do they take the extra bone and cartilage away? I so don't get it. Also, I'm wodering, although this question may seem a little odd, if there is any way I could donate that extra bone and cartilage. I mean, maybe God made people with too much bone so they could give it to people who need more. :) Well, I thank you very much for your time and would really appreciate your response. Thanks again.

M T

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

The nose can be one of the most noticed parts of our faces. As you have found out it also is the most prominent and therefore can get hit first with trauma. Nasal trauma can result in many possible deformities. Sometimes the bones and cartilages heal with a "bump". When this bump is above the natural shape of the nose, corrective maneuvers center on removing the bump. This can be done with sharp chisels or rasps shaving off the extra material. This removed material is rarely very much at all. Although your goals of donation are admirable, we do not have the ability to use it at this time.

Sometimes the nasal deformity "hump" is not really a hump but the edge of a depression deformity. Parts of the nose can be collapsed or have grown poorly after trauma. Removing this type of "hump" can lead to a disastrously small nose. Other options may include rebuilding the depression with graft material from the patients own body.

Without examination and evaluation, I cannot guess what type of surgery any patient would need. I then use a computer to help the patient understand the difference between realistic and unrealistic options. A computer unfortunately can do things to an image that we cannot reliably reproduce in the operating room. You and your parents should continue with your education process until both your and their questions are answered.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Hello again. I just wanted to thank you very much for your response. It has helped me a great deal in understanding surgery of the nose and the possible side effects of it. If I have any other questions or concerns I'll let you know. Thanks again!!

M T :)

Good luck on your surgical education and procedure.

Michael Bermant, MD


Question: Re: nose surgery

Sir,

I have a slightly upturned nose. As a result my nostrils fall beneath the tip of my nose. I also have a very slight bump positioned at the tip of my nose. I suppose comparatively speaking my nose is not that bad but I'm just unhappy with it as it doesn't suit my sort of face.

I would therefore like to know if surgery could do the following: Raise my nostrils so they are in-line with the tip of my nose and eliminate the small bump on the tip of my nose so the dorsum is smooth and even?

A quick reply would be appreciated.

Yours etc,

R N.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

It is impossible to comment on what is possible and what is not without an examination and evaluation. Realistic expectations are the key to a happy patient. The room for misunderstanding by typed words alone is too great.

Adjusting columellar exposure is a common maneuver when indicated. Nostril movement is more difficult and it depends on what "raise" them means. Removal of dorsal humps is also a common part of nasal surgery.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: rhino/septo on asians?

Hi,

Have you performed any rhinoplasty and/or septoplasty on Asians in the past? If you have, please E-mail some photos that you'd been given the permission to release. I'm considering getting the surgery in the next 6 months, can you please give me a list of 'range' of costs (including operating room, anesthesia, consultation)

Thanks

Dr. Bermant responds

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

I have participated in many Asian rhinoplasties and septoplasties during my time in mainland China. Here in the US I have performed many Asian nasal fractures and nasal reconstructions. Here is an example of my cosmetic work:

Ethnic Rhinoplasty the Asian Nose

My chages and fees for rhinoplasty surgery can be found here. Rhinoplasty and septoplasty have so many possible operations, assigning a price without knowing what needs to be done is very difficult. I do not E-mail photos of my patients.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Rhinoplasty

Hello, I had a nose job to eliminate a hump.It did, but after 5 days the splint was loose so I removed it and there was a deep red sore.Infection I'll call it.It healed but left a bad scar on the bridge of my nose.The end of my nose looks bulbus.The doctor wants reopen the scared area,pull new skin down and laser(co2)layers of skin down on the tip to make it smaller.Does this make sense? I'm worried.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

No, what you say does not make sense. But then I have not examined you nor fully understand what your surgeon proposes. Infections and scars CAN happen after rhinoplasty. Scars can sometimes be improved by a revision or reconstruction process. Bulbous tips can be from many different causes. If the large tip is from something like acne rosacea (see my website) then dermabrasion and possibly laser could be a reasonable surgery to offer. Otherwise you would need an evaluation and examination to hear another opinion. Your doctor has had that opportunity and therefore has a much better perspective than someone writing back on the Internet.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: nose surgery

HI, yes i just wanted to ask a few questions. I recently had rhinoplasty and septal about a week ago because my nose had hit and broken. I underwent surgery and realized my nose appeared to be shorter in length and the bump is nolonger there. AS i kept loking at my nose i started to realize im not happy with the shape at all, the tip seemed as if it is turned up and pudgy while the bridge of my nose seemed as if it was shaved too much and the nose looks too short for my face. I was just wondering if this is what the shape of my nose will look like or if it will fill in and out as time passes ( BEING IT IS ONLY 1 WEEK) ? Also if this is normal where the nose can look awful in the beginning and get better? I feel more insecure now than i ever have been!!!! I would really appreciate to hear from you quickly and thankyou for your time!!!!

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

These are all good questions for your surgeon. The surgical process is not just operating and collecting the fee but also the patient education . If you have questions like this, you have not gotten what you have paid for. My patients have, as part of my office's education commitment, a basic understanding of what they are getting into.

It is impossible to predict exactly how surgery will turn out. Even computer demonstrations of what we would like to achieve are not necessarily what will happen with the nose as it heals. Flesh can be a fickle material and does not just stay put as a lump of clay. It heals and has living dynamic forces that bend and twists over time.

Most rhinoplasty operations cause some nasal swelling that can take several months to resolve. Some rhinoplasty surgery takes years for the nose to evolve into its final shape. If you cannot get the answers from your own surgeon, your choices are to get another consultation or patiently wait a little while and see if your nose evolves to what you can be happy with. If not secondary rhinoplasty may be a consideration.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD


Question: Re: Secondary rhinoplasty

Dear Dr. Bermant:

I had a cosmetic rhinoplasty about 14 years ago and was pleased with the results. Gradually it appears that the bones have shifted and I am considering a second operation to re-align things and to improve the tip which is dropping, probably just due to the passage of time. My doctor said the second surgery would probably not be successful. He also mentioned having to put in some type of human-derived material and said that there could be a risk of AIDs infection with this. I have never heard of this before. Do you have any comments on this?

Thank you.

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Skin ages and gravity pulls. Just as the rest of the face helps you show the years of experience age brings, the nose evolves with time. Thinning of the skin showing underlying detail and drooping of the tip are two common signs of nasal aging. Secondary rhinoplasty can be a challenge. Your doctor who has had the opportunity for an evaluation and examination has a much better chance of giving you advice.

Grafts and other "osteoplastic" material can assist the surgeon in the design of the intervention. Grafts are taken from the patients own body. Osteoplastic material provides a matrix for the body to regrow bone. There are risks and benefits from each method and source of material. I do not use human derived matrix but new materials keep being developed. To come up with a better idea of what to recommend, you would need a consultation in my office. Sometimes secondary surgery is not a good option. As long as your expectations do not exceed what surgery could offer, you may be a candidate for further reconstruction.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD.


Question: Re: Laser surgery rhino

Dear Doctor Bermant,

I am scheduled for surgery on Monday for a deviated septum on the right side. It all sounded so easy in the doctor's office, but now I am getting cold feet. A friend of mine told me her doctor told her to wait until they have laser surgery because it is so uncomfortable....My question is: Is laser surgery a possibility for the future? If so, how soon?

My problem is annoying but bearable. I have little airflow through the right side of my nose, spring allergies which usually turn into sinus infections, constant nasal drip, and of course colds that last forever and usually turn into infections.

I should also metion that I have platelet counts of 64 to 70,000 and WBC counts of 2.6 to 3.0 and had a cleft palate (soft) as a child. I told the doctor about the low blood counts but forgot the cleft palate. I have had two bone marrow taps which state the platelets and WBC's are being made but are destroyed in the blood from unknown reasons. Also, I bruise easily but don't seem to bleed excessively although cuts are slow to heal.

I am to go in for the blood workup today at 3 but am considering backing out until I know more about the possibility of laser surgery.

Thanks for you time and any information you might have.

Respectfully,

LL

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

These are reasonable questions for your doctor and yes, if I were the surgeon, I would want to know about the prior cleft palate surgery. Many cleft palate repairs are fairly obvious and your doctor may already know. From the information you give, you may indeed be at risk for bleeding and bruising after surgery. No I cannot think how a laser could be of use during a standard rhinoplasty. We can use the laser for cases like the rhinophyma problem on my website (not used in that case). I generally do not recommend laser for such problems either.

Go talk to your doctor. I want my patients to ask me if they have questions. Good luck on your operation.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

Dear Doctor Bermant,

Thanks so much for your quick reply. I guess if laser isn't in the picture I will go ahead and get this overwith. I did call the Dr. and let him know about the cleft palate and asked him to call me. I also found out that it was a high moderately severe deviated septum.

Thanks again for your time and concern.

Respectfully,

L


Question: Re: college student rhino

I am a freshman at ... College in ...., PA. I have discussed the issue with my parents and I have decided to undergo surgery for a rhinoplasty. I have had virtually all of my questions answered through either friends that have had the surgery or through a family friend who is a plastic surgeon. But, I'd just like to know the approximate cost of the operation. Also, do you know where I can get a listing of the most reputable cosmetic surgeons in the Philadelphia area? Thank you very much.

Sincerely,

CM

Dr. Bermant answers:

This should not be construed as medical advice. I am a Board Certified Plastic Surgeon.

Good exploration and education are very important before proceeding with surgery. Reasonable expectations are essential to a happy outcome. However rhinoplasty is a family of operations each having a slightly different cost. It depends on what type surgery you will need as to what the cost will be. Other factors determining cost will be the type of anesthesia, operating rooms fees, and what part of the country you have this done. We have very reasonable fees here in Richmond Virginia. My surgeon's fees can be found here. You will need an evaluation and examination for a better estimate. I am sorry, my website is a demonstration of the commitment to the education of my patients and their care. We cannot act as a general referral service to other parts of the country, but do we see patients from far away.

I hope this information proves of some use. If my office can be of further assistance, please let us know. We can be reached at: (804) 748-7737. My staff and I try to ensure the comfort of our out of town guests during their consultations and procedures.

Michael Bermant, MD

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