Oftentimes my interactions with my patients can be funny and sweet. I would like to share one of these with you. A few months ago a woman came in to see me for hearing loss. She was about 60 years old and during the exam I noticed that she had a pinched appearance to her nose on her left side. She related to me that she had a rhinoplasty (nose job) forty years ago and ever since she had trouble breathing. Over the years she had talked to doctors but was told there was nothing that could be done.
In my experience this is not an unheard of problem. A surgeon that is trying to make a dramatic change in the appearance of someone's nose will resect a good deal of cartilage. Sometimes this results in the nose losing its structural support. Essentially the nose collapses just like a building would if you weakened the supporting beams. Correcting this can be tricky. One has to open the nasal skeleton and place cartilage support in the areas of weakness. The surgery doesn't always work and I believe that is why this was never offered.
We discussed the procedure in detail and we scheduled a surgery date. In the operating room I could see that there were very specific areas that had weakened and I harvested cartilage from a hidden incision behind the ear. This was then trimmed and placed in key areas around the sites of collapse. She was sent home with a plastic implant in her nasal cavity for support for one week.
At the one week recheck I removed the plastic in her nostril and it looked like the nose had healed correctly with good support. She took in a deep breath gave me a big smile and said "You're a Genius!" I laughed and said she better wait a little bit longer before being convinced of our success. I told her I wouldn't brag to my mother about her until I was sure she had at least one month of healing. This is because scarring can contract and shift the cartilage implants out of position.
One month went by and she came in for her recheck. I opened the door and with a big smile she said, "Ok, now you can tell your mother you're a genius!" Well, I don't think I'm a genius but I am glad that I could help this patient. And Mom, if you're reading this, I hope you get a smile from this story.
