should I have rhinoplasty?

[Zepora]

I have had previous surgery, approximately 6 years ago, for infections caused by allergic rhinitis and the overuse of Otrivin Nasal Spray. I also have a deviated septum, but chose not to have this fixed at the same time, as it was too costly. It has been over 30 years since my nose has been broken, but it has just been withing the last year that I am constantly aware of pain, swelling, the weight of my glasses, my hearing aids and my nose feels like it's not only sliding to one side, but down my face, as well. I had a very traumatic anesthetic and a very long and painful recovery. I have an appointment to see the same Surgeon in July, and I would like to have my nose fixed, but can I be sure that having this surgery will put an end to these problems that I am forced to live with and are taking away from my quality of life? I can't wear contact lenses as I have Blepharitis and I am a carrier of Hepatitis C for over 30 years. Should I have this surgery and will it solve my problems as far as the facial pain and swelling?

[Paul S Nassif, MD]

Dear Zepora,

Thank you for the question.  It is very hard for me to give you advice on whether or not to have the surgery.  Usually, facial pain and swelling may be due to a medical issue such as sinusitis. My best recommendation is for you to see an Ears Nose and Throat doctor and have this evaluated.  Elective surgery in patients with Hepatitis C can cause inflammation of the liver.  

In regards to Blepharitis, I do recommend you see an Opthomologist.  

I hope this helps and please understand that I can only answer these questins generally since I can't give complete medical advice to patients that aren't my documented patients.  However, I hope this little bit of information helps.  

Thank you very much.

Dr. Nassif

Dr. Paul Nassif
Spalding Drive Cosmetic Surgery and Dermatology
Beverly Hills, California

[Zepora]

Thank you for your reply. I definitely don't want to have surgery unless I absolutely have to, so will see if maybe it's just another bout of sinusitis. I irrigate daily using a saline rinse, it would be nice if I didn't require surgery at all, you are right, as the risks are high with my medical history. I thank you for your honesty.
zepora

[Paul S Nassif, MD]

Dear Zepora,

You're welcome and let me know how you do.

Keep in touch.

Dr. Nassif

Paul Nassif, M.D.
Spalding Drive Cosmetic Surgery and Dermatology
Beverly Hills, California

[Zepora]

Dear Dr. Nassif,
As promised, I am following up with you to inform you of the outcome of my appointment with the ENT Specialist last week. After scoping my sinuses, taking several pictures and comparing those with my previous charts, as well as conferring with his associates, they came to the conclusion that the problem is still "Sinusitis, as you had suggested, but because I've not had any sinus infections since he performed the last surgery, and although there is some narrowing of both sinus passages, more so on the right side, he does not feel that surgery will do me any good, at this time. Should I start to get sinus infections again, I should go back to see him, but as long as I am able to breath well through my nose, there is no need to do surgery. As far as repairing the deviated septum via Rhinoplasty, he feels that this will not solve any of my problems, as far as the pain and swelling. The pain will be chronic, as I have Chronic Pain Syndrome, anyways. He was kind enough to ask me if I wanted a referral to the Pain Clinic, but as I have already gone that route several times, I declined. I was very relieved to hear that I don't require surgery, but a little sad that this is one more "little" thing that I will just have to learn to live with for the rest of my life. I thank you for taking an interest in my question and replying to it. You were right about everything........you must be an excellent doctor to be able to make a "bang on" diagnosis without even ever seeing me.
My thanks, again, for all your help.
Zepora