Many people are undecided about rhinoplasty because making the decision to have a nose job (rhinoplasty) is a big one and is often associated with significant anxiety or even fear. Of course, these concerns may be understandable because, after all, you are entrusting a surgeon to change the appearance of your face, let alone your nose!  This decision takes a lot of trust and reassurance that the surgeon is going to achieve the look you want, and not make you look worse, unnatural, or just feel sorry you decided to go through it.

For many, there can be additional anxieties about undergoing anesthesia, finding a facial plastic surgeon you can trust, and being satisfied with the aesthetic improvement. After all, you want the best doctor, the perfect experience without complications, and the ideal nose.

We can help you overcome your fears. Make an educated decision and dispel your fears once and for all. Follow this guide to rhinoplasty and schedule your rhinoplasty consultation today.

There are a lot of “plastic/cosmetic/aesthetic” surgeons out there, so how do you choose which one to go to? It can often be a daunting task to find the right surgeon. According to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), you should look for a surgeon who is board-certified in facial plastic and reconstructive surgery, as these are specialists in facial cosmetic and reconstructive surgery. These surgeons have completed a minimum of a 5-year highly competitive residency program that includes 1 year of general surgery and at least 4 years of training specializing only in head-and-neck surgery. Many AAFPRS members have also completed additional fellowship training in facial plastic and reconstructive surgery, including Dr. Colin D. Pero of North Texas Facial Plastic Surgery.

Colin D. Pero, M.D., is double board-certified by The American Board of Facial Plastic and Reconstructive Surgery (ABFPRS) and the American Board of Otolaryngology/Head & Neck Surgery (ABOto). He completed a fellowship specializing in aesthetic and reconstructive surgery of the nose accredited by the American Academy of Facial Plastic and Reconstructive Surgery. Dr. Pero was fortunate to complete his fellowship under the tutelage of Dean Toriumi, M.D., a world-renowned Facial Plastic Surgeon, whose fellowship is regarded as the premier training opportunity in the world for the study of Rhinoplasty and Facial Plastic Surgery.

Dr. Pero has been in practice for over 10 years and is a well-known expert in his field with a record of excellence. He has chosen to focus his training and practice on Facial Plastic Surgery of the Head, Face, and Neck and is pleased to offer his patients surgical and non-surgical treatments that enable individuals to reflect the beauty and youthful energy they feel on the inside. His practice emphasizes health and wellness with an interest in aesthetic and reconstructive surgery of the face and neck. With every case, he puts a strong emphasis on natural-appealing results and avoids the “tell-tale” signs of poorly performed facial plastic surgery.

Dr. Pero’s specialties are Rhinoplasty and Revision Rhinoplasty.

Dr. Pero’s personal philosophy on rhinoplasty is to provide patients with results that make them happy. In doing so, he follows a conservative approach and utilizes techniques that minimize the risk of long-term complications while ensuring excellent long-term cosmetic results. Each patient is unique and requires a similarly unique approach to achieve patient satisfaction. This approach involves careful consideration and conversation with the patient on an individual basis with the aid of clinical photographs and computerized imaging to decide upon a treatment plan together.

Dr. Pero’s training in rhinoplasty emphasizes adequate support of the nasal structure to resist postoperative scarring forces that result in contracture and “pinching” when inadequately supported. This results in durable, long-time results that avoid the typical “operated-on” appearance characteristic of many traditional rhinoplasty techniques.

Dr. Pero’s personal approach to creating a more youthful and rejuvenated you stress the need for a conservative approach. Following a considerate, thorough discussion that often includes the use of computerized imaging to demonstrate proposed outcomes, both Dr. Pero and his patients come to an agreement as to what is considered realistic and appropriate for each patient. This tailored, individualized approach results in changes that reveal the inner, beautiful you while avoiding any of the unnatural, “done” appearances sometimes noted in other patients.

Dr. Pero has trained with some of the elite Facial Plastic surgeons in the world and continues his commitment to excellence by constantly evaluating and integrating the most cutting-edge procedures available in the world of cosmetic surgery. Often, new techniques offer shorter recovery periods and similar results to more traditional approaches. As a patient, you can expect a thorough discussion and evaluation of any proposed procedures to ensure it offers the lasting results you desire while avoiding any undue risk of complications. This sometimes means relying on more traditional, proven procedures to achieve results in order to avoid the temptation of the “hottest” new procedures that have yet to prove their effectiveness and safety.

As part of your comprehensive rhinoplasty consultation, Dr. Pero will

• Review your medical history with you.
• Discuss your surgical goals with regard to both appearance and breathing.
• Examine your nose.
• Take photographs for preoperative analysis
• Examine and analyze your facial features, including aesthetic analysis of the nose.
• Explain the options available to you for nose reshaping.
• Discuss your specific nose surgery options.
• Recommend a course of treatment.
• Discuss likely outcomes of nose surgery and any risk or potential complications.
• Perform computer imaging of proposed changes to the appearance of your nose

Dr. Pero will ask you very specific questions about your general health status and if you have any pre-existing health conditions or risk factors such as

• Do you have any medical conditions or drug allergies?
• Have you had any previous medical treatments?
• What current medications do you take, including vitamins and herbal supplements?
• Do you currently or have you ever smoked?
• Have you or do you currently use drugs, especially in the nose?
• What previous surgeries have you had, if any?

It is very important that Dr. Pero has a clear understanding of your past medical and social history, so please be honest with your answers.

If you are interested in having aesthetic rhinoplasty surgery, Dr. Pero will ask you what you dislike about your nose, the correction you desire, and your motivation for having the surgery.

Dr. Pero will do a thorough exam of your nose, which entails

• Observation (looking at form)
• Inspection
• Palpation  (feeling your nose)
• Evaluating your breathing (function)
• Possible nasal endoscopy to fully evaluate internal nasal anatomy

The aesthetic analysis of your nose is also very important. The goals of the analysis are to define external nasal deformities, predict the underlying anatomic variations, and determine the appropriate surgical intervention. A thorough analysis includes:

Side View Evaluation

With the side view, the lowest third of the nose is examined first and evaluated for two things:

1. Projection. Dr. Pero looks for how the nose projects in or out from the face. That is, how far does the nose stick out from the face.
2. Rotation. This is the angle between the base of the nose (columella) and the upper lip. So if the nose is raised up too much we call it over-rotated, and if it is droopy we call it under-rotated.

Dr. Pero will ask you if you have an issue with the projection in or out or rotation up or down to get an idea of the type of correction that is most important to you.

He will also evaluate the bridge of your nose and evaluate how it affects your side view.  Any irregularities and their relationship to the nasal tip will be fully evaluated and discussed.

Front View Evaluation

When Dr. Pero examines the front view of your face, he initially ignores the nose and pays attention to overall facial symmetry first. This is important to discuss because 90 percent of people have some kind of facial asymmetry. For example, the right eyebrow and right eye may look smaller and lower than on the left side. From a vertical symmetry perspective, this may not be an issue, but from a horizontal symmetry perspective, Dr. Pero has to consider what nasal correction would be the most harmonious with the rest of your facial features.

What this means is that Dr. Pero may need to align your nose to match any pre-existing facial asymmetry, as any overdone nasal correction of this nature may accentuate the asymmetry and be less flattering to your overall appearance.

Ideal Contour Evaluation

Dr. Pero next evaluates the ideal contour for your face. The dorsal contour should start at the inside of the brow and extend along the bridge of the nose and gently curve out to the tip. It should be like an hourglass and those lines should be symmetrical on both sides.

Taking Photos of Your Nose

Dr. Pero will take photographs of your nose from different angles, and will upload them on his computer to use with computer imaging. He will solicit your opinion prior to demonstrating the nasal reshaping he recommends. This is a good visual exercise for patients, as it sets realistic expectations for what can be achieved for them with rhinoplasty surgery. Dr. Pero will provide you with copies to take home and further consider.  He encourages adequate discussion preoperatively to ensure understanding of the goals of surgery and will meet as many times as necessary to make his patients comfortable.

In determining the ideal nose for you, Dr. Pero not only uses lines and measurements as a guideline, but he also evaluates the artistic component to create the most aesthetically pleasing nose for you.

If Dr. Pero determines, after careful analysis, that you are a candidate for rhinoplasty surgery, this is the time to have any of your questions answered. Don’t be afraid to ask questions. Take advantage of this one-on-one consultation to dispel any fears you may have about the surgery, the anesthesia, and the recovery period.

If after your consultation you have additional questions, check out our pages on Rhinoplasty, Revision Rhinoplasty, and Ethnic Rhinoplasty. There is a lot of good information on these pages that may answer any remaining questions you may have.

According to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the modern goal for facial plastic surgery is refreshingly natural with the trend shifting away from patients wanting to look like a celebrity. Patients today are more concerned about looking natural and not having an overly-enhanced cosmetic enhancement that just doesn’t fit their facial profile.

Dr. Pero is glad to see this change in trend, as it reflects his own personal philosophy on rhinoplasty and the importance of giving patients clear and reasonable expectations.

There is a level of patient responsibility involved as patients need to ensure they are healthy enough to undergo any surgery and heal well postoperatively. For example, if you are a smoker, you should refrain from smoking 2 weeks before and after your surgery to promote quicker healing.

Postoperatively, make sure you schedule and show up for your follow-up appointments and strictly adhere to your surgeon’s instructions to experience the best patient outcome for your rhinoplasty surgery.

Dr. Pero typically sees patients back after surgery 8-12 times to ensure a good long-term result. Many patients benefit from conservative therapies (massage, steroid injections, etc.) to maximize their results, and the need for these manipulations changes over the course of the first year of healing.

Rhinoplasty costs vary but often include

• Anesthesia fees
• Hospital or surgical facility costs
• Medical tests
• Prescription for medication
• Surgeon’s fee

A surgeon’s fee is often based on experience, the type of procedure used, and the geographic office location.

If you are interested in financing options available to cover costs, please contact North Texas Facial Plastic Surgery for more information.

Functional rhinoplasty may be covered by health insurance, as the procedure is being performed to improve breathing function due to an obstructed airway. This procedure, whether performed alone or in conjunction with cosmetic rhinoplasty, is considered reconstructive and therefore may be covered by insurance.

For insurance coverage consideration, a detailed examination is done to verify the cause of your breathing impairment and prior authorization from your insurer would be required.

At North Texas Facial Plastic Surgery, we make all of our patients feel welcomed. When you become our patient, you will find yourself greeted by a courteous and attentive staff intent on ensuring that your experience is as comfortable and satisfying as possible. Our focus is on you, the patient, and we aim to deliver earnest, individualized service to all of our patients. We consider ourselves as partners on your journey through the process of evaluation, treatment, recovery, and beyond.

Whether a patient is new to Facial Plastic Surgery or more familiar with the latest procedures and techniques available, we strive to create a unique patient-physician connection that will result in an informed and completely satisfied patient. All questions and inquiries are welcomed as are any concerns or clarifications. This relationship extends from Dr. Pero himself as well as to all of our clinical and office staff.

North Texas Facial Plastic Surgery strives to provide a caring, thoughtful environment that enables you to make an educated decision regarding your facial plastic surgery. As a specialist focusing on cosmetic and reconstructive surgery of the face and neck, Dr. Pero is able to provide you a unique combination of expertise, courtesy, and trustworthiness we think you will enjoy.

Don’t remain undecided about rhinoplasty. Schedule your rhinoplasty consultation today. You may call (214) 382-5100 to schedule your consultation or you may request a consultation online.

We look forward to seeing you soon.

Myth #1: The surgeon will have to break my nose during rhinoplasty.

In most rhinoplasties, the bones are left intact. If a patient has had significant trauma to the nose in the past, the bones may need to be shifted into a more favorable position.

Myth #2: Cosmetic rhinoplasty is covered by insurance.

Cosmetic rhinoplasty is not covered by insurance; however, functional rhinoplasty may be covered for medical reasons (e.g., trouble breathing due to previous trauma, cleft lip deformity, etc.). Double-check this with your insurance provider before scheduling surgery.

Myth #3: Any plastic surgeon can perform a rhinoplasty.

For the best results, you should have a facial plastic surgeon perform your rhinoplasty–someone who specializes and has specific training performing these surgeries–after all you want the best possible outcome. Rhinoplasty is an exceedingly complex and demanding operation–so your surgeon should have a thorough understanding of the aesthetics of the nose and face, as well as the functional components of the nose (e.g., breathing, sense of smell, or sinus issues).

Myth #4: Anesthesia is dangerous.

For rhinoplasty, general anesthesia is used and it is exceedingly safe, especially if you are in generally good health. Risks and long-term complications are quite rare.

Myth #5: Only vain people have a nose job.

There may be a small number of people who are truly vain who have rhinoplasty, but it is not the majority. Many people who decide to have rhinoplasty do so for medical reasons (e.g., trouble breathing) or because they have had trauma to their noses (e.g., car accident, broken nose). For others, they are looking for their nose to be more harmonious with the rest of their facial features. For these patients, it is amazing how this one significant change boosts their self-confidence and they experience a better quality of life.