Rhinonplasty Houston

Ther are a number of things you should know before you have surgery on your nose.

Typically, the nose isn’t anyone’s favorite feature. Songs are written about beautiful hair and lovely eyes--but you don’t hear musicians trying to immortalize "gorgeous" noses. The truth is, many people don’t like their noses and wish that they could have them made smaller, less bumpy, or just less conspicuous.

Patient before and after Rhinoplasty and Septoplasty by Dr Kridel (6 months post-op)

Thousands more simply hate their noses because they don’t work well. This may be due to a past injury or simple genetics, but the bottom line is the same - their noses don't allow efficient breathing.

It's common knowledge, of course, that you can see a plastic surgeon and have your nasal appearance improved. A good facial plastic surgeon can make your nose function better as well as look better. The "nose job" has been around for decades. But, you shouldn't mistake nose surgery for a simple matter just because it's commonplace. A good nose surgery is a work of mastery, and that's why you, the prospective patient, need to acquaint yourself with the different kinds of nose surgery, what such surgery entails, what an improved nose can mean to you, and how you can find the best surgeon to perform your procedure.

Typically, you go through these steps:

1. You provide information on your medical history. On the form that you complete in Dr. Kridel’s office, you answer the following questions (as well as others):
   
   • Have you ever had aa adverse reaction to a drug?
   • Have you ever experienced an episode of uncontrolled bleeding?
   • Do you have seasonal allergies?
   • Do you smoke? Do you take medications or use "recreational" drugs or alcohol?
   • Do you take vitamin supplements or herbal supplements?
   Dr. Kridel relies on this information to have a complete picture of your current health status.
   
2. You watch a video that explains the surgical options for noses.
   
3. You discuss your concerns with Dr. Kridel. Explain what bothers you about your nose and what you would like to have changed. Some of the things you might mention are the following:
   
   • You're having trouble breathing.
   • You dislike a hump on your nose.
   • You think that your nose is too big for your face.
   • You want your nose to be narrower, wider, or smaller.
   • You want a crooked nose made straighter.
     

4. Patient before and after Rhinoplasty and Septoplasty by Dr Kridel (9 months post-op)

   During the physical exam phase of your consultation, Dr. Kridel will evaluate your nose (externally and internally) in order to determine if there are abnormalities that require surgical correction.
   
   Elements that Dr. Kridel must consider before recommending nose surgery are your age, general health, skin tone and texture, bone structure, and healing capacity. All of these factors come into play when a doctor performs nose surgery.
   
5. A medical assistant shoots photos of your face from different angles. These photos become part of your medical record, and Dr. Kridel refers to them when planning your surgery. During postoperative visits (following your nose surgery), more photos of you are taken to give you a way to compare your "before" nose with your "after."
   
6. Dr. Kridel does digital photo-imaging, which is an exciting part of your visit. He uses the photos that have just been taken to project your face on a screen and draw in changes to show the visual goals of your surgery. Of course, these are only estimations because it is impossible to predict individual healing patterns. Digital photo-imaging is, however, an excellent tool for getting you and Dr. Kridel on the same page from the start. If you want to show Dr. Kridel a picture of a movie-star’s nose that you especially like, that's just fine - but bear in mind that he can't "give" you just any nose you find attractive. Your nose isn't like clay; the surgeon is working with a set of givens, including the following:
   
   • the contour and shape of your nose
   • the texture and thickness oy your skin
   • the inclination of your chin, lips, and forhead
   • the depth of angle between your forehead and your nose
   • your height
   • your individual pattern of skin healing
     
   Digital photo-imaging is valuable because it provides a chance for you and Dr. Kridel to "get real" and talk about goals for surgery. You share ideas on changes you want to see, communicate your preferences, and Dr. Kridel explains whether he thinks your goals are realistic and do-able.
   
   Do keep in mind, though, that it’s impossible for any doctor anywhere to give you a perfectly accurate prediction of your final result because every person heals differently. You’ll see an immediate change when the bandage or splint is removed but there will be some swelling. Full healing takes time, and you don't actually see the final result--what your nose will look like for the rest of your life--until about a year when your nose has had time to "settle down." This is major surgery, and some people have minor swelling for several weeks. Dr. Kridel tends to give a patient a very conservative estimate of what he can accomplish, and in most cases, his patients are pleasantly surprised to find that their results surpass

   Patient before and after Rhinoplasty and Septoplasty by Dr Kridel (5 months post-op)

   even what they had hoped for.
   
7. Looking at before/after photos is a very important part of your first consultation. A nurse will show you before/after photos of patients on whom Dr. Kridel has operated (who have given permission for their photographs to be shared with other patients). Focus on these because before/after photos can help you decide if you and Dr. Kridel agree on what makes a nose attractive.
   
8. The patient coordinator provides information on the surgeon’s fee, operating-room charges, and cost of anesthesiology.

Nose surgery breaks down into two main areas - the operation intended to make your nose more pleasing to look at - the rhinoplasty; and operations that take care of defects or problems in the nasal airway, referred to by the umbrella term "nasal airway surgery." But, it's not your job to figure out what you need. You can leave that up to Dr. Kridel, who can assess your candidacy for nose surgery. Most people who want nose surgery can benefit--but not everyone.

Rhinoplasty: For a Better Look

Are you considering nose surgery because you have a large nose or a prominent hump? If so, Dr. Kridel will explain to you how he assesses your nose in relation to your other features. To do this, he uses some well-established hallmarks of proportion. You look at a photograph of yourself and draw horizontal lines through your hairline, brow, and the base of your nose. The three segments should be close to equal, and your nose should fall inside the middle third.

Of course, what is ideal in a nose varies greatly by ethnicity. If you’re Caucasian, for example, a well-proportioned nose will lie within a triangle created by connecting the center of the brow with the corners of your mouth.

Your profile is another factor. In a photo, if your nose is well-proportioned, it should lie within the right triangle formed by the bridge, base, and nasal tip. If parts of your nose extend beyond this triangle, you may be able to benefit from cosmetic nasal surgery, which would bring your proportions closer to
classical standards of what society views as attractive.

The goal of rhinoplasty (aesthetic nose surgery) is to refine the shape of your nose and bring it into balance with your other facial features. This alone won’t make you a movie star look-alike - or ensure that you'll attract a lifelong mate or a new job. It will make you feel better about yourself and help you relate to others in a more confident manner, which is always a plus.

If you want your nose to look and/or function better, Dr. Kridel can deliver these goals via a rhinoplasty - if you are a candidate for this surgery. He can fix deformities inside your nose that impair breathing and cause headaches or sinus trouble, which may mean removing excess bone or cartilage, or augmenting areas of the nose that don't have sufficient bone or cartilage. Af terward, he reshapes and rearranges the remaining tissue and cartilage, thus correcting nasal deformities both internally and externally.

In most rhinoplasties, a small incision is made between the two nostrils and the rest of the work is done on the inside. The skin over the nose is elevated and necessary corrections are made.

For a large nose or one with a prominent hump, a portion of the cartilage is trimmed from the middle of the nose. Removing small pieces of cartilage from each side of the nose helps to refine the shape of the tip. Dr. Kridel elevates the nose tip by various methods. Excess bone in the upper third of the nose is shaved away, and the bones are mobilized at the base and brought together to refine-and narrow the bridge.

Patient before and after Rhinoplasty & Chin Augmentation by Dr Kridel

To narrow the base of your nose, Dr. Kridel may need to remove two small wedges of skin from the side of each nostril, close to where it joins the face, then the edges of the skin are brought together and sutured. Incisions are hidden in the creases at the base of the nostrils. Techniques for improving the function of the nose are very similar to the ones involved in improving aesthetics.

If you want to have your nose improved functionally (so you can breathe bet ter) and have Dr. Kridel make it look better too, he can perform both procedures at the same time, and usually that is the way to go. You can, on the other hand, have functional surgery alone, with no changes made in the appearance of the external nose. Sometimes, Dr. Kridel suggests correcting a receding chin (with a chin augmentation) at the time of nose surgery to provide greater facial harmony. A recessive chin tends to make your nose look bigger.

Septoplasty (for the deviated septum) and turbinate surgery are types of functional nose surgery that can correct chronic breathing problems caused by structural abnormalities inside the nose and can be performed at the same time as a rhinoplasty.

The Deviated Septum
People often also come to Dr. Kridel to have him correct a crooked (or deviated) septum, which can interfere with breathing and sinus drainage. The septum is the dividing wall between both nostrils and is cartilage and bone covered by a mucosal lining on both sides.

In an operation called septoplasty, incisions are made inside the nose, and the delicate mucosal lining is elevated. Dr. Kridel trims, reshapes, and repositions portions of the septal cartilage and bone. He may insert soft packing to hold the septum in its new position
temporarily.

Enlarged Turbinates
Turbinates are structures way inside the nose on both sides; they warm and humidify the air but can enlarge due to allergies or a deviated septum. Enlarged turbinates can block the passage of air in the nostrils and interfere with sinus drainage. To correct this problem, Dr. Kridel makes incisions through the mucous membrane that lines the lower surface of the turbinate. He peels mucosal tissue back, shaves away excess bone and mucous tissue, and leaves just enough of the turbinate tissue to allow adequate function. He can then cauterize the margins of the mucosa. A small amount of packing may be placed in the nose to help prevent bleeding, hold the turbinate mucosa in the correct position, and facilitate healing.

Nasal Valve Collapse
Nasal valve collapse occurs when the nose is too narrow in a certain portion and the airway is compromised. In the case of nasal valve collapse that results from aging, trauma, or previous unsuccessful surgery (by another surgeon), Dr. Kridel can put grafts on the inside of your nose--or widen the airway with spreader grafts. (In such cases, your health insurance may defray part or all of the cost of the procedure.)

Revision Surgery
If you have already had nose surgery but the results didn’t please you, you can turn to an expert on revision rhinoplasty for a "redo."

Patient before and after Rhinoplasty and Septoplasty by Dr Kridel (3 months post-op)

Dr. Kridel is one such revision expert; his own revision rate is less than 5 %. But he’s often called on to revise noses previously operated on by other surgeons. Few doctors in the nation do more revisions than he does routinely, and people come from all over the world to have him do "redo" surgery when a previous surgery elsewhere failed to deliver what that patient wanted. As an authority on nasal surgery, Dr. Kridel has often lectured on revision rhinoplasty; he edited two textbooks on this subject and has written several chapters and articles on this topic.

Dr. Kridel points out that when he sees dissatisfied patients, the problem sometimes isn’t that something was technically wrong with the first nose surgery--but that the doctor actually failed to understand what the patient wanted--and the lack of communication resulted in disappointment. That’s why computer imaging is so important as a communication tool.

In most cases, the patient who wants a nose revision surgery is not happy with previous results, or has had a hard time breathing ever since he had nose surgery. Other candidates are people whose noses healed irregularly or were overdone--too much cartilage was removed, leaving a nose that looks "operated on." It's important to choose a veteran of revision surgery for your "redo" because nasal revisions are especially difficult. Dr. Kridel is quick to point out that the goal of such surgery is improvement, not perfection.

"Prior to any surgery, there are layers of tissue planes that have natural separations between the types of nasal tissues, and as a surgeon operates on your nose (the first time), he can easily separate these layers to access different structures. This isn't the case, however, with revision surgery. These planes no longer exist, and that makes surgery harder. It's almost as if someone has put glue in the nose because skin is stuck to cartilage and bone."

It's easier to correct a nose job in which too little was done--in other words, the lump you wanted removed is still there--or the nose is irregular. This means taking more away. But the nose surgery that removed too much is a real challenge; obviously, it's easier to take away than to add.

Other difficult situations are noses previously operated on that are now too small, too short, or too pinched. "In such cases, grafts have to be added, and these must be molded to take on not only the shape but also the function of the previously removed tissue, and that's no small feat," says Dr. Kridel.

Nasal surgery usually lasts about two hours in an outpatient surgical facility, and you wake up a bit groggy from having been under light anesthesia. There’s a small external splint on your nose and a small dressing inside your nose. Your nose feels stuffy, and slightly bloody mucous drainage seeps through the bulky dressing that was applied to your nose. You may also experience swelling and bruising around your eyes if the nasal bones were fractured or repositioned during surgery.

Few patients are bothered by pain related to this surgery, which is interesting considering the fact that the most common question regarding nose surgery is, "how much will it hurt?" The refreshing surprise is that most people who have nose surgery describe any pain associated with rhinoplasty as "mild." You can take mild medication that is prescribed to handle any discomfort. It’s important, however, to avoid aspirin products and other medications that tend to increase bleeding.

After you go home, you rest with your head elevated. Dr. Kridel may suggest that you use a cold compress to minimize swelling. Post-surgery, it’s a good idea to take it easy for a couple of days. To relieve the stuffiness that is inevitable after nose surgery, you can take an oral decongestant - but you shouldn't overuse nasal spray or drops unless Dr. Kridel recommends them. You will go into the doctor's office the day after surgery to have Dr. Kridel or our fellow look at your nose and remove the light packing.

Do expect some swelling and bruising, which are natural consequences of this kind of surgery.

For six weeks, you can't wear eyeglasses without using a special eyeglass support or suspending them with tape. Most people can return to work or school a week after surgery, but you must wait several weeks before resuming exercise. Air travel is allowed a week after having nose surgery.

By the time you return to work or school, your nose will look good. It will continue to improve over the months to come, and you will see your final result "settle in" after about a year.

For a few months following surgery, you will go back in for post-op visits so that Dr. Kridel can continue to monitor your progress.

While you are in Dr. Kridel’s office, a patient coordinator will explain all costs related to nose surgery, including the fee for the surgeon’s work, anesthesia, the surgical facility where the surgery takes place, and the medications required. The surgeon’s fee varies because some nose procedures are more complicated and time-consuming than others. The patient coordinator can answer any questions you have regarding fees. Although most insurance plans don’t cover rhinoplasty that is done strictly for cosmetic reasons, the surgeon’s fee and other costs may be covered partially by insurance if Dr. Kridel is correcting a functional (breathing) problem, too. The patient coordinator can check with your insurance company to find out if part of your surgery is covered by insurance.

Patient before and after Rhinoplasty and Septoplasty by Dr Kridel (3 months post-op)

Why Dr. Kridel Is Your Best Choice for Your Nose Surgery

Ask just about anyone in-the-know about plastic surgeons in Houston, and you will hear that Dr. Kridel is the top choice for nose surgery. Over the years, he has done more cosmetic nose surgeries than any other plastic surgeon in Houston, which:

• gives him vast and varied experience
• attests to his excellent results
• makes him an in-demand speaker and educator of other doctors

In 2003, the Houston Chronicle toasted his skills by listing him as the number one Houston doctor for nose surgery. He performs over 100 nose surgeries per year which is a much larger number then most doctors perform.

For years Dr Kridel has been invited to speak on the topic of nosr surgery, which has taken him to many U.S. cities and to countries abroad to share vital information with medical colleagues who were interested in bettering their skills.

Dr. Kridel writes and edits textbook chapters on nose surgery. He has penned numerous articles on various aspects of refining and performing nose surgery. Hands down, Dr. Kridel is the Houston facial plastic surgeon best known for excellence in performing nose surgery. In fact, he achieves such superior results that he draws plastic surgeons from all over the world to observe him in the operating room and learn from him.

Anyone having rhinoplasty would do well to choose a surgeon who meets the following qualifications (all of which are true about Dr. Kridel):

• knowledgable in both form and function of the nose
• has extensive and specific training in the specialty
• does nose surgery frequently (several times a month, not twice a year)
• is willing to show you photographs of his good results in nose surgeries
• is a strong communicator
• does noses that are natural-looking and suit the individual rather then one-size-fits-al "cookie cutter" noses

Furthermore, Dr. Kridel just happens to be the doctor to whom other doctors come for nose surgery for themselves or members of their families. the fact that he is their choice is revealing. As medical-community insiders, doctors know who is known as the best doctor for what, and many Houston physicians have Dr. Kridel do nose surgery for themselves and their family members when they opt to have this kind of procedure.

Years of experience increase the competence of a doctor and provide comfort to patients in knowing their doctor knows how to handle their specific anatomy. For over 25 years, Dr. Kridel has been a leader in the art of nose surgery and widely acclaimed for his work in refining the art of rhinoplasty. He has spearheaded many innovative cosmetic nasal techniques and has extensive experience with nasal reconstruction following unsuccessful surgeries performed elsewhere. Dr. Kridel currently performs over 100 cosmetic nasal surgeries per year and because of this experience, many patients are referred to him from all over the world. That's why it's important to ask the surgeon you're considering how many he does. If he does one or two per month, you should definitely compare his results with those of a doctor who does nose surgery frequently. Additionally, Dr. Kridel is board certified not only in facial plastic surgery but also in otolaryngology (ENT). So you can breathe easier knowing your surgeon not only understands aesthetics but also the breathing function of your nose.

Dr. Kridel has also written over 35 scientific articles and textbook chapters on cosmetic nasal surgery. For that reason, he has served on the faculty of the world's largest Advanced Rhinoplasty course for over 10 years and is frequently invited to lecture at courses on nasal plastic surgery throughout the United States, as well as in Europe, South America, the Middle and Far East, and Africa.

Many procedures Dr. Kridel has created are taught to residents who are learning facial plastic surgery and his outstanding results and techniques draw doctors from all over the world to study with him (over 22 have done fellowships in Houston under Dr. Kridel).

Elected by his peers, Dr. Kridel was National President of the American Academy of Facial Plastic and Reconstructive Surgery from 2000-2001. He currently serves as Senior Advisor to the Board of Directors of the American Board of Facial Plastic & Reconstructive Surgery (ABFPRS) and has been a Board examiner in Facial Plastic Surgery for both the American Board of Otolaryngology (ABO) and the ABFPRS. Additionally, Dr. Kridel is certified by the American Board of Cosmetic Surgery, giving him a total of three board certifications