Nirav Patel

I tell patients to hold off rubbing or putting pressure on their noses after rhinoplasty for up to six (6) weeks' postop. However, if you wear reading glasses or need glasses to see adequately, one trick you can do is to TAPE your glasses up against your forehead to avoid direct contact of the glasses with your nose. If this is not possible or your glasses are too heavy, then unfortunately you will have to "make do" until your surgeon clears you to resume safe glasses wear. That, or consider wearing contact lenses to obviate the issue (if you wear contacts). I hope this information helps and you have a good recovery from your rhinoplasty!

Talk to your Board-Certified Plastic Surgeon or Facial Plastic Surgeon for specifics, but: You do NOT want to be applying pressure to your nose whatsoever for several weeks after rhinoplasty, especially if the nasal bones were broken (with osteotomies). I generally tell my patients, whether healing from trauma or cosmetic rhinoplasty, to avoid direct pressure to the nose for at least six (6) weeks to allow for adequate healing of the bones and cartilage. For open rhinoplasty (where the nasal skin is elevated to allow the surgeon to work on your internal nasal cartilage and bone), there is usually an incision along the strip of tissue between the tip of your nose and your upper lip called the columella. You definitely want to avoid makeup particles getting into a healing columellar incision! That said, applying makeup elsewhere? is generally 'ok', assuming no other procedures were done (i.e., you did not get an eyelid lift or facelift or receive injections such as Botox or fillers while you were under the knife). For facial surgeries, I typically tell my patients that it's 'ok' to apply concealer makeup, particularly to areas of resolving bruises, at approximately three (3) weeks postop. After rhinoplasty, it's common to have the 'raccoon eyes' look, where you exhibit bruising along the corners of your eyes or along the lower eyelid and cheek regions, and sometimes involving your upper eyelids. So long as there are no actual incisions or broken bones requiring avoidance of pressure, makeup in those areas should not harm your surgical result.

First of all-ask your surgeon for his or her protocol! Necklift patients typically wear the chin strap day and night for several days up to a couple weeks. Depending on surgeon preference and your overall healing, you may then switch to daytime use only before ridding of the strap altogether. Again, if you do not already know the answer to your own question...ask your plastic surgeon, especially if you're having surgery in a week! Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

If by "cast" you mean "splint", then the answer is yes, typically, at least in my current plastic surgery practice. I routinely place both internal nasal splints called "Doyle" splints-one through each nostril, secured to one another with a temporary silk stitch-as well as an external splint called a "Denver" splint, which is a combination molded piece of aluminum attached by Velcro to another molded piece of material with adhesive that sticks to your nose, secured along with SteriStrips placed on your nasal skin. I use a Denver external nasal splint and Doyle internal nasal splints for those who have broken noses requiring resetting, as well as for those undergoing a full cosmetic rhinoplasty, including work on the nasal septum (the wall separating your nasal passages) and the nasal bones (the hard upper 1/3 of your nose), which are not infrequently and intentionally broken by techniques called osteotomies, usually to help narrow a wide nose. I typically remove Doyles at one week postoperatively, while having patients continue to protect the external nose with the Denver until the 2nd postoperative week. For another month thereafter, patients still have to protect the nose against inadvertent injury, as it usually takes six (6) full weeks for bones to heal (if they were broken by traumatic injury or by planned osteotomies). For less extensive rhinoplasty, for example, for minor revisions, tip work, or procedures to reduce the size of the nostrils (called 'alar base' or 'Weir' excision), a splint may not be necessary. Seek a Board-Certified Plastic Surgeon or Facial Plastic Surgeon (for the latter, one trained in Otolaryngology, or 'ENT') to discuss your rhinoplasty goals and which techniques would be best to address them. Depending on the operative plan, the extent of 'casting' or splinting becomes apparent. Good luck to you! Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

It depends on what kind of necklace you are having and in combination with what other procedures! A face and necklift can take several hours when done together. An isolated necklift is shorter, but of course, then, there are different necklift techniques. Directly removing excess neck skin can be potentially quite short, like a 1 1/2 hour procedure depending on the surgeon's speed. A more extensive necklift combined with a facelift and an incision under the chin to remove fat and tighten the neck muscle called the platysma, combined with fat injections to the face, could take in excess of 6 hours. We strive to keep surgeries to 6 hours max to avoid dangerous complications such as venous thromboembolism (VTE), which can lead to life threatening complications such as pulmonary embolism (PE) and stroke (cerebrovascular accident, CVA). It all also depends on whether there is a surgical first assistant, physician assistant, or surgical resident/fellow assisting the attending surgeon, which can help reduce the total operative time. Go see a Board-Certified Plastic Surgeon who can assess your facial anatomy, discuss your neck rejuvenation goals, and come up with a reasonable, safe surgical plan that fits your budget and risk tolerance.

There are three primary pathways for scar management, which I ordered from non-invasive (medicine) to invasive (surgery): 1. Medical management. This includes scar therapy, particularly using products that contain silicone, whether silicone gel or silicone strips. I have all of my patients use a silicone/SPF combination gel called Biocorneum, which they start anywhere from 1-3 weeks postop and finish out their courses before transitioning to moisturizer and sunscreen. Scar therapy should be done at least twice a day, if not more frequently, with rubbing done along the grain of the incision or scar. Scar therapy is only effective at modulating and softening scars that are less than 12 months (1 year) old. So, if it's been over a year since your surgery or injury, you will need to look into surgical correction (option #3 below). 2. Steroid injections. This is typically done with triamcinolone, also called Kenalog. Your plastic surgeon or a dermatologist can administer Kenalog injections in the office. You cannot have steroid injections more frequently than every 4-6 weeks as you can risk atrophy (weakness) of the skin or scar, which can even lead to wounding or infection. This option is a step up from silicone scar therapy. Steroid injections will not work on scars that have reached maturity, meaning scars that are 12 months (1 year) or older. 3. Surgical scar revision. I do not offer this until someone has healed 9-12 months typically. This requires complete surgical removal of the scar tissue and re-suturing the remaining, good skin. Depending on the extent of the scarring, this can be done in the office under local anesthesia. For more extensive scarring, you may have to go back to surgery. I hope this helps, and I hope you're at the phase of healing where medical management (choice #1) is still the best pathway. Discuss your concerns in person with a Board-Certified Plastic Surgeon so that you can ensure you're on the right treatment protocol for your facial scarring. Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

First of all, as you are proceeding with a necklift, make sure to ask your own surgeon! No surgery is pain free, but a necklift should have tolerable (functional) discomfort by two weeks postop, and at least for my patients, they are down to using only Tylenol and perhaps supplementing as needed with NSAIDs intermittently (Aleve, Advil, Ibuprofen, etc). Everyones pain tolerance and recovery is different, but do not expect zero pain for at least several days, if not a couple weeks or longer. Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

No surgery is pain free postoperatively! Yes, there will be discomfort postop, but with a good overall anesthetic plan-both from your surgeon as well as from your anesthesia team-it should be manageable. The extent of discomfort also depends on how extensive your rhinoplasty is. Minor tip work, for example, is far better tolerated than a complete open rhinoplasty with osteotomies (rebreaking the nasal bones). Discuss your concerns with a Board-Certified Plastic Surgeon or Facial Plastic Surgeon to determine the best course of action based off your medical history, medications, and general tolerance to pain (if you've had surgery in the past). Best wishes to you as you decide on your rhinoplasty journey! Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

The safe answer I give my own patients is to wait until you're at least six (6) weeks out from surgery. However, ALWAYS ask your own surgeon first! He or she may be more liberal or strict than what I outlined. I hope you've had a good surgery and recovery thus far! Take care. Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

Great question! Every plastic surgeon is going to give a different response, but this is my approach: Regarding physical restrictions, I am quite strict and do not like my patients overdoing it with their arms for at least four (4) weeks, often six (6) weeks for those having implants for breast cancer reconstruction purposes. I have seen far too many complications in training and some in practice where patients were non-compliant (not following) postoperative instructions when it comes to physical activity. Regarding sleeping, you definitely should NOT be sleeping prone-on your abdomen-as the pressure risks ripping open your incision and having the implants "pop out" (or extrude) and causing distortion to the shape of your augmented breasts. I like having my patients sleep flat on their backs (supine) for at least the first two (2) weeks' postop, before allowing them to gradually transition to side sleeping. When giving the green light to side sleep, I do not allow my patients to completely turn on their sides in bed. I generally advise them to be partially on their side and bracing their back with pillows or a foam wedge. The reason I worry about completely side sleeping is that the breast that is down (closest to the bed) can get swollen due to retained fluid (edema) settling with gravity, which will only prolong the recovery and healing. I also counsel patients to alternate sides when transitioning to side sleeping, so that one breast does not get unduly swollen compared to the other. [I give the analogy of having to turn one's baby in the crib to avoid the baby's head getting a flattened shape on one side.] If side sleeping is successful as described above, then I start to liberalize the restrictions and let my patients start to sleep the way they want. HOWEVER, regarding sleeping prone (on one's tummy), I-as a plastic surgeon-feel WAY better if my patients refrain from doing so for at least three (3) months (that is, 12 weeks' postop). Again, doing so prematurely can put excess pressure on the augmented breasts, flatten the rounded shape that was carefully established during surgery, and even push the implants down toward the breast incision, risking bottoming out, or worse, straight up implant exposure, which would be an emergency, requiring further surgery to swap out the implants and re-close the wound. It's YOUR money and YOUR investment in your body! Use common sense, listen to your Board-Certified Plastic Surgeon, and follow his or her instructions to a tee. Don't let your desire to get the most comfortable sleep possible soon after surgery ruin your results, as opposed to a few weeks of less ideal sleep, but in a position that's much safer for your breast augmentation recovery. Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

Hi there, Your question is a bit loaded as the answer depends not only on what technique of browlift is done but other factors such as setup and anesthesia time. I always say there's up to an hour of "farting around anesthesia time", such as going to sleep for general anesthesia, and for longer surgeries, having a Foley urine catheter placed. If it's an isolated browlift, some of the things may not apply, and it may be possible to get done under local anesthesia with IV sedation (local/MAC, or monitored anesthesia care), which greatly reduces the induction and recovery times. As far as the surgery itself, the time varies depending on the technique. Browlifts usually involve both sides but in certain situations may only involve one side, which usually means less operative time. A bilateral, subcutaneous browlift can take as little as one (1) hour and as long as 2 (1/2) hours for a bilateral endoscopic browlift (Endo Brow). Hopefully, that gives you a ballpark, at least as far as what time the surgeon needs to get the browlift done.

I generally tell patients to avoid straining or nose blowing for six (6) weeks after rhinoplasty. Regarding sneezing, (1) it's hard to avoid, and (2) it's very hard to do this suggestion consciously-and it's not very friendly in terms of minimizing risk of spreading viral illnesses (including COVID!)-but it is better to sneeze with an open mouth to reduce any potential pressure to your head and neck area, which can be painful with a vigorous cough or sneeze. Especially if bones were rebroken during the rhinoplasty, they are delicate and need time to heal properly by sitting still, and avoiding exertion or pressure to the head helps with that process.

You are too early postop. I would wait until you are at least 3-6 months postop until you and your surgeon review your results, usually with formal clinical photography. Revisions are not uncommon with otoplasty but I hope that will not be the case with you!

There is no simple answer to your question, unfortunately. For starters, I'm not even sure that laser is the best treatment modality to help you rid yourself of stretch marks. A tummy tuck, or abdominoplasty, is a great way to remove many (but not all) stretch marks, which involves significant surgery. Even assuming lasers would be effective at reducing the severity or visibility of your stretch marks, without the benefit of a physical examination or even photographs to see how extensive those stretch marks are, no one will be able to give you an accurate answer. For anything involving lasers, I generally counsel patients that they would need at least three (3) treatments, perhaps many more, spaced out 4-6 weeks apart, to really start seeing a difference in resurfaced skin. However, this is a very general rule of thumb that may or may apply in your situation. See a Board-Certified Plastic Surgeon in your area if you want a more accurate or honest answer that I could possibly give you with the extremely limited information you've provided! Apologies in advance for not being able to give you a clearer answer.

It's a bit premature to be asking about postoperative pain so soon after plastic surgery, especially otoplasty! The ear has rich innervation around it, and those nerves "wake up" after surgery, when the general and local anesthesia wears off. Don't expect to have zero pain after any surgery, but your pain should be controlled enough for you to engage in light activity such as getting out of bed and walking around the house. If you have concerns, contact your surgeon and see if anything needs adjusting with your medications!

Yes, there are several skin resurfacing options to help reduce or eliminate acne scars. One option I will describe is micro needling, which has been specifically FDA-approved to treat acne scars. For example, our practice carries a device called SkinPen, which is a microneedling instrument that rapidly injects tiny needles into the skin, which causes a controlled injury that then heals rapidly with a brand-new skin. Generally, like many skin resurfacing treatments, microneedling requires several sessions separated by 4-6 weeks, so that the entire surface area of the skin can be addressed thoroughly.

Without having further information, photographs to review of your "turkey neck", and a better understanding of your goals and willingness to undergo procedures with downtime, it is hard to answer your question fully. The most predictable result to handle neck contour as severe as what you are implying would be a formal neck lift. Depending on the severity of the neck sagging, the neck lift could be combined with a lift of the lower face through incisions around the ear, or it could be combined with a separate incision underneath the chin to help thin out fat in the submental (under the chin region) while also surgically tightening the superficial muscle in the neck, called the platysma (when this is done it is called a platysmaplasty). Sometimes a direct excision necklift, done with an incision that breaks up the final scar (called a Z-plasty, S-plasty, or "waveplasty"), can be done if you truly have an isolated "turkey wattle". This last choice can be good for a very isolated area of neck skin excess, if a patient has serious medical conditions that make him or her unsafe for a full face and necklift, and if a patient is willing to tolerate and manage to scar with scar therapy (using topical silicone gel, with or without sunscreen). However, there are procedures short of surgery that could potentially help you, for less severe neck sagging or laxity. Many offer neck tightening procedures using energy-based devices, such as radiofrequency. Laser is very much inadvisable to the neck given the risk for scar contractures. Using off-the-shelf fillers or even your own fat can help address some wrinkles, scarring, or contour issues to the neck skin. A series of chemical peels might help improve the quality of the neck skin and give a subtle tightening without surgery. See a Board-Certified Plastic Surgeon to give you a full, in-person assessment and provide you with a tailored plan that meets your individual goals in accordance with your current health condition, budget, and schedule. Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

The answer depends on whether your rhinoplasty is done with an "open" or "closed" approach. The major advantage of open rhinoplasty is that it gives the surgeon full view of your nasal anatomy under the skin, including all of the nasal cartilages and septum (the wall dividing your nostrils). The small downside is a scar that is along the strip of skin connecting your nose to your upper lip, called the columella. When the skin incision is done well and sutured together precisely, the scar is generally imperceptible to the casual observer, unless you look up and someone else looks directly at your columella. Most surgeons make an incision that looks like a stairstep or an inverted-V to make the scarring imperceptible. Closed rhinoplasty involves no visible scars, as the incisions are made near the inside of your nostril rim or along the sidewall of mucosal (soft) tissue covering your septum. There are a variety of approaches in closed rhinoplasty, which overall is more challenging and requires more experience with the surgeon, as much of the closed techniques are "blind" and require more feel of the tissues and knowledge of the underlying anatomy in "your mind's eye". Bottom line is that both open and closed rhinoplasty techniques are perfectly acceptable, and I would say that the surgeon should use the techniques that he or she is most comfortable with, as rhinoplasty is a challenging type of surgery no matter which way you cut it, pun intended! Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/

Liposuction is the permanent removal of fat from the body. So by undergoing cheek liposuction, what fat is removed is gone permanently. Sounds great, right? Not so fast! Keep in mind that without adhering to a solid diet and exercise plan, what fat remains can grow (or hypertrophy) as it stores unused calories, so you still risk your result not being permanent if you get complacent and don't protect your postoperative result with good, healthy behaviors. This principle applies to any part of the body undergoing liposuction. Caveat emptor, or, let the buyer beware!

While any surgery has post-operative discomfort, your necklift should not hurt during the procedure itself. If done under general anesthesia, you are fully asleep, and you should feel nothing during your necklift as you would be unconscious. Many will perform facelifts and necklifts under conscious sedation combined with local anesthesia, but even then, when appropriately anesthetized, you should not feel sharp or burning pain. While done under local with monitored anesthesia care (MAC), you might sense movement of your head side-to-side as your surgeon adjusts you during the procedure, and you might feel pressure or pulling of instrumentation or sutures, but it should not hurt. Postoperatively from ANY surgery, you should not expect zero pain. However, your pain is usually very well-managed after necklift surgery with over-the-counter medications such as Tylenol (acetaminophen) in combination with non-steroidal anti-inflammatory drugs (NSAIDs, such as Ibuprofen, Motrin, Aleve, or Advil). It is not my practice to prescribe oral narcotic pain medication, as I do not find it necessary, but many surgeons may prescribe you a short course of a mild narcotic such as Norco (hydrocodone-acetaminophen) or Percocet (oxycodone-acetaminophen). However your postop pain is managed, you generally do not require much more than over-the-counter agents after the first 1-2 weeks following your necklift. Hopefully this information reassures you regarding procedural pain (it should be none!) and postoperative pain (typically very well managed, even without use of narcotics, which can be addictive and constipating). Nirav B. Patel, MD, JD, FACS, FCLM Board-Certified Plastic Surgeon Plastic, Reconstructive, Aesthetic, & Oculoplastic Surgery Patel Plastic Surgery, LLC 1519 Johnson Ferry Road Suite 250 East Cobb, GA 30062 Office 470-395-6932 Fax 470-395-6951 https://www.drpatelplasticsurgery.com/