When comparing surgeons, consider seeing a facial plastic surgery specialist, ideally focusing solely or mostly on noses. Too often, patients have had surgery on their nose where their breathing problems either don’t improve after surgery or worse off become even more problematic. This is the main importance of having an Otolaryngology (ENT) background, where a vast experience working inside the nose and correcting non-cosmetic breathing issues is gained. Even a good looking result will be unsatisfactory without being able to properly breath through the nose. Thus at the same time as changing the shape of the nose, the internal structure of the nose can also be maximized for optimal nasal breathing.
Preoperative consultations are broken into two parts. If you have breathing problems and health insurance, we will process any potential procedures through your insurance, so this part is handled separately. This is the first step so Dr. Murray can look in your nose, evaluate your anatomy and document any potential structural issues. If you don’t currently have health insurance, there will be a fee for this medical evaluation.
The cosmetic consultation is done free of charge. Dr. Murray will take pictures of your face from many different angles and he uses a special Photoshop type of program to provide you some estimation of the potential results. It is during this visit where Dr. Murray will listen to all of your cosmetic concerns, likes / dislikes, and show you a few of the different possible outcomes. He will also perform a detailed aesthetic evaluation of your face and nose, providing you with his recommendations based on his vast experience and study of aesthetic principles.
At the end of the day, the goals are to give you a safe, stable nose which you will be able to breath through for your lifetime and to make you happy with the cosmetic result. Dr. Murray customizes each surgical plan and aesthetic goals for every patient individually. His personal mission is to give you the nose you’ve always dreamed of, within the limits of what can safely be accomplished surgically.
All of Dr. Murray’s rhinoplasty surgeries are performed in a fully accredited Ambulatory Surgery Center. The procedures are done strictly under general anesthesia with full time, licensed MD Anesthesiologists. This is because of his belief that a secure airway is the absolute safest way to perform this procedure. Surgery time can vary anywhere from 3-6 hours. The time of the surgery is not indicative of anything necessarily and Dr. Murray is a perfectionist. He will take as long as time as is needed until he is happy with the result.
Patients will go home the same day and should ideally have someone around the first night to assist them if needed. Dr. Murray typically performs open rhinoplasty, so you will have sutures on the underside of the nose on the columella and a cast on the bridge. He does NOT pack the nose, but instead uses soft plastic splints with holes in them to allow for as much nasal breathing as possible during the early recovery stages.
My goal 100% of the time is to make the patient happy with their nose, so I try to customize the result based on their desires. During the cosmetic evaluation, I use photoshop morphing software to be able to show a reasonable simulation of the predicted outcome. Patients often bring photos of other noses they like, which can be helpful for me to learn what type of aesthetic you find most attractive. I will, of course, explain what can / cannot be achieved as well as offer my suggestions based on years of analysis of facial beauty and harmony. Rhinoplasty is a somewhat unpredictable process which I attempt to make as predictable as possible. While no one can guarantee a specific result, if a patient has specific concerns about their nose, I can focus on those primarily and usually we can find a shared vision that can be accomplished with surgery.
Most patients are very nervous about this part but will ultimately end up saying that the process overall was much less painful / stressful / difficult than they expected. The first few days are the probably the worst and the feeling can be described more as like having a head cold than anything else. Most patients do NOT have much pain, but the nose will be somewhat tender to the touch obviously, and you will get pain medication in case you need it.
The columellar sutures are removed from the front of the nose on the first post op visit. Most would describe this sensation akin to having nose hairs pulled out. The second post op visit is at one week and this is when the splints and cast are removed. This is usually even easier than the first visit.
The nose will look very swollen initially, but you will notice the basic framework and changes to the nose immediately. At one week, there still is a very significant amount of facial swelling as well. Most of this will settle out over the next few weeks, but the nose will continue to undergo minute changes over the entire first year.
This depends on which aspect of the recovery you consider. Dr. Murray requires at least one week of from school / work. You will be able to eat whatever you want and walk around, but you need to take it easy. There is also a 3 week limit on heavy lifting or strenuous exercise to limit the risk of any bleeding that could arise. Most people are ready to return to their normal activities at the one week point, however you may still be bruised and quite swollen at this point. If this appearance is not important or critical for you, then you should be fine at one week. However, anyone who doesn’t want the potential for under eye bruising or anything noticeable should probably plan on missing 10-14 days just in case.
Please see our Gallery page for all photos. This page is updated frequently so check back periodically to see new patients’ results.