How much time do you think is necessary to take off from work to recover from a rhinoplasty?
Not all rhinoplasty procedures are created equal, and the requirements of jobs are also quite different. So the answer to this question is, "it depends." If you work as an IT consultant, and you undergo a little tip rhinoplasty without any fracturing of the bone, you may be able to work from home the day after surgery and be seen in public within a couple of days, depending on how much swelling you have and how concerned you are with your appearance. Alternatively, if you do construction work, and you are transformed from Cyrano de Bergerac to Brad Pitt, which would certainly involve major cartilage work and infracture of the bone, then you will need a little more time. You need to avoid activities that could displace the bony elements of the nose, and often, you are kept in a splint for a couple of weeks, followed by taping. Additionally, activities that could increase the pressure in your head and neck can increase swelling in the area, and also put you at some risk of bleeding, particularly in the early post-operative period. The best person to help you plan your recovery is the surgeon who is doing the procedure, since he or she will know exactly what was done and how any activity-job-related or otherwise-will impact your results.
Have you ever performed areola donut pexy or do you not like this practice? If you do perform it, is the scarring always permanent or can it heal???
This inquiry relates specifically to male breast reduction or gynecomastia surgery, where there is an excess of skin, frequently in combination with a large areola. And the answer is, yes, I do perform skin resection when necessary as a "donut pexy." I have a number of patient examples of this procedure, but one that is particularly appropriate to accompany a reply on this website can be found on my site at:
http://www.ricksilverman.com/component/joomgallery/?func=viewcategory&catid=100
This young bodybuilder had significant skin excess and large areolas since puberty. I had seen him when he was 17 originally. He never had the surgery then, but later came back with the same problem, worsened a little after a cycle or two of steroids. In his case, I did the procedure in a single stage, removing the underlying gynecomastia tissue while removing the donut of skin to tighten the chest.
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| BEFORE | AFTER |
There are some important considerations with this operation. First off, it is riskier than routine gynecomastia surgery without skin resection, since the potential for compromise to the blood supply of the nipple is far greater than in a simple removal. There are many plastic surgeons who will stage the procedure, and indeed, I have also staged it in patient who were borderline in terms of a need for skin removal. Frequently, removal of the underlying gynecomastia tissue in conjunction with some aggressive liposuction will result in enough skin retraction that no skin removal is required. If, after six months to a year, it's obvious that skin removal is still necessary, I can do that under local anesthesia in my office, and the risk of a problem is much less. One contraindication to doing this procedure in a single stage is in smokers, since the risk to the blood supply of the nipple is so significant. So if you need this procedure and you smoke, you should either quit well in advance, or plan to do it in two stages.
To address the second part of the question, scarring is always permanent with any operation. That is a fact that cannot be altered. It is the nature of the scar, which is less clear, and in most patients these scars fade over time and are difficult to detect. But they are still there. Scar management is an important part of any surgical procedure, and there are things we can do to encourage the best scarring possible.
Dr. Rick Silverman is a Boston-based plastic surgeon, whose practice is rooted in bodybuilding. One of his first patients in 1992 was a bodybuilder with gynecomastia, and his involvement with these patients eventually led him to the competitive stage, where he competed from 1996 to 2005, achieving professional status in the WNBF and competing in the masters level in the NPC. His practice focuses on providing optimal care for gynecomastia, breast enhancement, liposuction and other body contouring procedures, with a minimal interruption in your work-out regimen. He can answer your questions about bodybuilding and plastic surgery in the forum at http://forums.rxmuscle.com/showthread.php?t=34335
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