Introduction and objectives
During recent years along with the fast growth of Internet services, most surgeons have been interested in creating a personal website or page. Most of this was for advertisements or prestige. This is, however, the reality; because plastic surgery is current between younger people and middle-aged adults, its publicity use is much restricted, while its informative use is more effective. The first day I thought I would set up a website, it was a period in which many referred to me for pre-surgery consultation each day. It’s interesting to know though I try to give a half an hour consultation, I can’t even solve half of the problems. It’s rather a speech than a consultation; and this repeats again and again. That’s why I decided to give consultation in two phases: first by website, and second in my office. In fact, my aim of setting up a website is to improve consultation quality rather than to attract more clients, as a good consultation is undoubtedly effective both for client and surgeon.
I ask all who chose me for surgery to read carefully and thoroughly all chapters of the site, because it helps them, while in the office to get personal consultation, to have a better understanding of requirements, possibilities and results of the surgery. In addition to this, the first topic of the site relates to nose plastic surgery for its higher number of referrals; we will soon provide information about head & neck plastic surgeries and other surgical procedures.
Referrals who want a nose plastic surgery are first faced with some questions, the most important of which is that if they heal. They should refer to a surgeon to answer this question. Now, hardest question that arises for them is how to choose a surgeon. Choosing a plastic surgeon is a very imperative process and I wish to advise my friends to study the chart below to help them to make a decision.
A- Academic degree related to nose plastic surgery
Today that advertisement surrounds patients from every where such as satellites, newspapers, and messages in which every body introduces him as nose plastic surgeon, determining the academic degree is a must.
Four groups of expert perform nose plastic surgery
- Plastic surgeons; these physicians are general surgeons who study for 2 or 3 years complementary curricula to learn scientifically and practically plastic and aesthetic surgeries of all body organs.
- ENT surgeons; the focus of this group is on nose, head and neck who have academic studies in aesthetic and remedial surgeries of nose and sinus.
- Chin and face surgeons; this group is graduated in dentistry and has completed chin and facial surgery curricula.
- General surgeons; this group of surgeons have not studies academically but experimentally aesthetic & plastic surgery, and introduce themselves simply as aesthetic and plastic surgeons.
Among these 4 groups, the 2 first are most related with nose aesthetic surgeries. Each discipline has its weak and strong points about which I don’t want to express my opinions because of the plenty of disputes in this regard.
B- The educational institution where surgeons obtained their certification is very important. A referral should consider the university of his/her surgeon before choosing.
With the increase of university umbers and complementary studies, first grade universities especially in the capital city have certainly higher scientific and practical quality. Note that without exaggeration, Iranian medicine is the most advanced in the world after US. It’s even better than that in Europe. Recent years during which complementary studies in the universities of neighbor countries, and in Eastern & Western Europe, have become current, Universities in Tehran have indeed many advantages compared with the said universities.
C- Surgeon skill
When you choose a surgeon with his/her relevant specialty and academic authenticity, it becomes more difficult. Even academic education passed in the best universities does not provide guarantees of surgeon’s skill. In fact, A and B points are necessary conditions but not sufficient. In our country, little attention is paid to scientific know-how of students before selection, and this results in the graduation of surgeons with higher scientific level but lower surgery skill and art. Now, how can we access to this information?!
Referrals get to know their surgeon via advertisements or from each other. Usually, those who become familiar with a clinic through ads are very few and are the most troublesome referrals in the opinion of surgeons: they come with distrust and suspicion and, therefore, they are less tolerant. They cause many difficulties and troubles.
Today, however, with the growth of nose aesthetic surgeries, the majority of patients choose their favorite surgeons by word-of-mouth referrals from other patients, and so, they have more confidence in their surgeon. This creates an appropriate correlation between patient and practitioner. It is impossible, as a matter of fact, to determine exactly the skill and competence of a surgeon via ads. The best way is to see and ask other referrals who had an operation before.
I have to mention some points to help you with this subject.
First point is that you should be realist and pragmatic. In all scientific books involving plastic surgery, only 10% is mentioned for the possibility of restoration (second surgical operation that is more limited). That means even in most advanced centers, 5 or 10 out of 100 applicants have the possibility of restoration; so, even if a famous surgeon pretends that he has no restoration, you have to suspect him/her; on the contrary, if the number of restoration procedures performed by him is more than 15%, you should also be suspected of his/her skill. Now that we speak of statistic, you know that if you see just one nose which you like or, on the contrary, if you see a nose which needs restoration when you come to a colleague clinic, none of these statistics can help you. Therefore, above-said percentages are important.
Next point is to determine a surgeon’s skill which depends on the form of the nose of a person before operation. There is a general rule about a nose surgical operation that you should bear in mind: “The less problematic is a nose, the better will be the result; and the more problematic is a nose, the weaker will be the result”.
I have seen so often a very problematic nose but an excellent operation result. I also have seen a nose with fewer difficulties but when referrals sit in the surgeon office for consultation, the surgeon prefers those with fewer difficulties. However, in the view of the surgeon, first referrals are better than second ones. Here is an example. If I give a note of 20% or 30% to the first referral before operation, this note will increase after operation to 75% or 80%. But the second referral whose note was 60% to 70% before operation, he/she will get a post-operation note of 95%. It is clear that the first referral has gained
more benefits, but the second just looks for the final form to make a decision. This is why many surgeons do not accept hard cases, because it’ll be finally rare to have a note more than 80%, and this will compromise his/her popularity despite of the troubles he/she had for doing the operation. Nevertheless, this is not my opinion; I think honesty is the best conduct.
Another major point in determining your surgeon’s skill is his taste. You have seen several times that even a post-operation nose has no problem, but you don’t seem to like it. In most of the cases, a photo that I show to referrals is very acceptable by many, but on the contrary, it is not interesting to other referrals. In fact, there must be an overlap between referral and surgeon tastes.
I have to give an explanation about surgeon’s taste. In the first step of the procedure, when I finish the operation of a referral’s nose, I told them that I would do it according to my own taste like all human beings. After a while, I found out that the nose of all referrals looked like each other. I saw some referrals satisfied while some others unsatisfied even though they had no problem.
For a better understanding, I have to say the surgery also becomes a habit like every scientific or practical skill, and after a while, a surgeon is accustomed to a series of special techniques. Consequently, if he/she uses only certain techniques for several years, the result would be the similarity of post-operation noses. This similarity, however, is not a defect in itself, but it will lead to dissatisfaction where referral and surgeon do not share the same taste. That’s why I decided, after a certain time, to avoid applying my own taste. I just expressed my opinion as an advice during preoperative consultation but left the choice with the referral.
It is to be noted that a nose has its own elements, in aesthetic point of view, which can be performed to some extent. For example, we can create a nose totally flat or medium arched, all of which is acceptable aesthetically but its limit should be conformed to referral’s taste. I had a referral who insisted to have a fantasy nose, so, I had to bend his/her nose to the maximum admissible; another one insisted to have a natural nose due to professional and age conditions, so, his/her nose had to be without any bending. Now to satisfy all referrals, everyone has his/her own conception, and the major difficulty is that a surgeon cannot anymore use similar techniques and has to master all techniques thereof; this is, however, most troublesome for him, therefore, I decided to select a variety of before and after photos. I shouldn’t just show excellent photos in order that everybody takes their view on the level. It is then that you get to know a referral’s taste. I give also some pieces of advice to my referrals. The interesting point is that I faced with many different tastes among referrals; that’s-to-say certain photos were liked by some and certain by others. I will give you in-depth information about your taste and choice in the site’s gallery; I will also give you consultation before any operation in my office.
Now that you have chosen your surgeon considering his/her specialty and graduation place and skill, it is time for you to begin consultation with your favorite surgeon.
Each referral has his/her own questions that he/she has heard from their entourage. Here, I mention the very questions that I’ve explained so often in my office hoping that the time of your consultation will be spent for more important subjects.
What is a fat nose and what is its operation outcome? Does it retake its first shape?
A nose is made of different parts the bigger of which is the cartilage with skin and its annexes.
A fat nose is referred to as a thick skin in science books. What are the features of this thick skin? Usually, it is extremely greasy with big holes on the surface. The grease will be evacuated if you press it. Of course, the nose skin may be thick and greasy in a part but thin in another part. I have experienced many cases in which the thick skin on the nose tip was replaced with a medium skin behind the nose. It arrives sometimes that a nose with thin skin and big cartilages is considered mistakenly as a fat nose.
What difficulty can create a fat nose? Nose’s thick skin covers like a layer the structure of cartilage and bone. If this layer is thin, structure thinness of the nose will be better reflected. The less it’s thick, the less will be the thinness. That’s why men are born with thicker skin, but totally, it will never be as thin as the nose of women.
Another difficulty is the higher blister of a thick skin. Thin skins lose their nasal edema after 2 or 3 months maximum. Thick skins last almost 6 months, and then the remaining nasal edema will last 1 and even 2 years. This is the reason why referrals should receive a complete consultation, in order to exercise more patience to convalesce.
Is there a way to thin a tick skin?
Unfortunately, only a small part of the nose during operation has a tick skin, which the surgeon cannot control: any alteration will have critical consequences. Some surgeons try to shave a skin from inside to make it thin. But except from loose tissues like grease, they are not allowed to damage the skin, because this will injure and remove the quality of skin.
The most critical point maybe to mitigate the difficulty of these people is to stick conveniently at least for 2 months. Sticking causes the skin under pressure to stick to the cartilage and bone tissues underneath and the nose to take a more suitable shape.
Finally, another question concerning fat noses is that if they will fall down or shrink after a while.
The answer of this question relates again to the recognition of nose anatomy. A thick skin and soft tissues put, under gravity, a downward pressure to make the nose fall; at the same time, fat noses have naturally weak tissues, and this lessens the nose solidity. Although fat noses are operated via current techniques, nose fall is inevitable; as a result, we avoid this event by applying special techniques to strengthen nose structure.
What is the use of laser in nose surgery?
Undoubtedly, laser plays no role in nose surgery and it seems that some practitioners use laser as a publicity tool to have more patients in their office.
Is the incision of nose edges necessary?
Technically, there is no need to incise nose edges for operation. However, when a surgical operation is finished, nose becomes usually wider at the level of septum. To reduce this width, surgeons incise nose edges to make the septum smaller. How big the incision of nose edges, it depends upon surgeon and patient’s preferences: small or big incisions do have consequences that will be discussed later.
There are also other questions that I hope you will ask me by e-mail: firstname.lastname@example.org in order to enrich the list of questions/responses in the website.
Don’t eat or drink anything before operation.
Men need to cut their mustache and beard.
Avoid bringing precious objects.
If you use false teeth or tooth veneer and/or contact lens, please take them away before entering surgery suite.
Be sure to bring with you following documents:
Birth certificate plus a copy of the first page.
Valid insurance policy, if any, issued for the patient.
Refer to relevant centers only at the date fixed.
Don’t eat or drink six hours before surgery operation.
In case of any disease and/or use of a medication (Aspirin for example), be sure to discuss this with your surgeon beforehand.
After operation, avoid walking or going alone to the toilet or to your home.
Your surgical operation would not be immediately after you are bedridden, and it may last several years (because of previous operations and/or because operation tools are not ready or other medical considerations).
Please read these prescriptions before surgery. Following them will lead to the best surgery result. In case of any ambiguity regarding the surgery, do not hesitate to ask questions. Take this form with you to the hospital and follow them from the day of operation.
- Do not blow out your nose before you are allowed. Clean your nose, if need be, with a piece of soft cloth.
- You can replace the nasal dressing in front of your nose, if any.
- Nose plaster will last between five and seven days and will be removed later in the office. Please do not touch it and keep it dry.
- Brush your teeth with a soft toothbrush and avoid touching upper lip.
- Avoid doing intensive bodily activities and champion sports and spend more time to rest.
- Avoid eating foods that need more time to chew; otherwise, there will be no special diet.
- You can wash your face but avoid your nasal dressing to get wet.
- Avoid speaking longtime (on phone …) for 10 or 14 days.
- Avoid laughing intensively or working out your face muscles for a week.
- Do not wash your hairs for a week, although you can take a shower one hour before coming to the office to remove the nasal dressing on your nose.
- During the first week, wear cloths with buttons. Avoid wearing tee-shirts or clothes exerting pressure.
- Keep away from direct sunlight for six weeks after the operation. Heat causes your nose to swell.
- Do take medications prescribed only by your doctor.
- After removal of the nose dressing, don’t worry if there is nasal edema or ecchymosis on your nose or below your eyes or if your nose tip is upwards. Such changes will disappear usually after two or three weeks. In some patients, the nasal edema will be recovered after six months or one year.
- Do not go swimming for one month after operation.
- Do not use eyeglasses or sunglasses for one or two months. If necessary, you can fasten the eyeglasses on your forehead by adhesive tape to avoid any pressure on the nose.
- You can use eye lenses two or three days after the operation.
- After removal of nose plaster, you can clean the nose skin by soft cleaners. After applying nose tape, you can also make up if you would like.
- Please do not take aspirin, ibuprophen, and vitamin E and don’t smoke cigarette for ten days before and after operation.
- Before removing intranasal sutures, use tetracycline ointment and ten days after their removal, use gel on the injured area.
- After removing intranasal tampon, help to remove intranasal clots by spraying physiologic serum.
Why rhinoplasty in iran?
Why Dr Amir Sajadian?
Iran is the capital of nose job in the world because its seven times more rhinoplasty is being carried out than in USA.
You can find whoever nose style surgeon you like. fantasy, dolly ,semi fantasy natural and etc.
Dr Amir Sajadian is well known international surgeon who is more interested in natural and semi fantasy nose and revision rhinoplasty. he has done thousands of surgeries in Iran and abroad. if you are not comfortable to come Iran you can visit and do surgery in Muscat, Oman.
Gulf Specialized Hospital,
Ground Floor, Maktabi Building, Car Showroom Road, Al Wattayah, Muscat, Sultanate of Oman.
For direct consultation you contact Dr Amir through this number +989300157740 on WhatsApp.
If you are interested in visiting Oman contact this number on WhatsApp.
Contact for inquiry/booking:
Photos of rhinoplasty
In order to watch more photos, please go to gallery.