Rhinoplasty in NYC: Lip Augmentation

5/8/09. Ok, you must be wondering what on this green earth does lip augmentation (aka Restylane injections) have to do with rhinoplasty? Well, my face is asymmetrical, my lips are too thin and my nose is crooked. And for those who have made comments about the way I look bc you're a sad case, read the last sentence again. I'm HUMBLED by the fact that I am dissatisfied by my appearance, so don't attack. I always have been. I'm aware of it, and I'm doing something about it.

Last night, after work, I went to Dr.Eddie Alvarez (a well known dentist in NYC). He has a stellar reputation on DoctorOogle and I saw that he does Restylane injections to plump up the lips. He numbed me, took plenty of time with me, and sculpted my lips to perfection. They were swollen immediately after but already by this morning, they've gone down and look pretty hot I have to say.

PS that image is called Faux.Real by the most incredible artist who I simply adore named CallowLily. You can google her.

Rhinoplasty in NYC: Appt 3 cont.

So, remember in Appt 3 where I said Prissy Barbie was trying to oversell? Well she called me today and got me on the phone saying "You're scheduled for an appointment and I just wanted to confirm"...wait. What you actually told me when I left your office was that if I don't call back to confirm the appointment and pay the downpayment, the spot would be relinquished. I was pissed that this chick got me on the phone. I told her I wasn't ready to make a decision yet, and her response was "Well, what is it that's holding you back? Price? Are you still researching? Your insurance? Do you want me to put you into contact with other patients that have seen Dr.Miller?" UGH. STOP IT. I told her his price was too high, she said "Well, the lowest I could possibly go is 20% off the quote...that's $8,320. And that's what I'll do, put you in touch with some of his past patients. Dr.Miller has never had a law-suit against him, Thank Gowd" (Yeah, lady, how many times can you say that? I GET it). Notice how the bird sings a different song now? Because the possibility of me walking away as a patient exists. I'm starting to realize that maybe the reason this doc gets all these patients is because he has vulture sales-women in the office. PS I'm not chosing him, bc I think his pics are crap. Please don't call me again.

Rhinoplasty in NYC: Appt 5 cont.

Yeah, so last night, at 9:52pm, I got an email from Dr.Westreich. "My office staff says we need a copy of your CT report for submission if we are going to move forward with it."

Ya think? Didn't I tell YOU that in your office? And aren't YOU the surgeon, and I'm the patient? Have you ever done this before? Sheewhiz, just when I was really confident in him. I don't really understand the disconnect. Even if you're not the one who handles insurance claims, etc. don't you know, as an experienced plastic surgeon, that if a patient has a deviated septum, in order to get coverage from insurance, you NEED a CT Scan report as proof? WEIRD.

Rhinoplasty in NYC: Appt 5

5/4/09. I like the few before and after photos on Dr. Richard Westreich's website. I also like the way he approaches rhinoplasty. Above all else, function, then appearance. Clearly after reading some of those online blogs, I'm utterly terrified that my nostrils can collapse or something can go horribly wrong. More than being better looking, I'd like my nose to work properly and not cause me problems in my life. Westreich's assistant is a peach. The woman's lovely. Period.
Dr.Westreich was great too. His facility is clean, comfortable, and his educational background (you can download his CV) puts me at ease. He took out (clean) specs and checked around inside my nose (and sprayed me w/ a decongestant, since I was stuffed up, but what else is new). Then he took out paper and drew for me what was going on inside. He explained that my septum deviates to the right, and in order for my left nostril to compensate for the larger airway, the turbinate is enlarged - he also explained my nasal cycle and the corrections that he'd make inside to completely correct my breathing. Great! He then took pics, that he told me he'd make the adjustments we discusssed later in the day and email them to me. When he took the pics, the photo he took with me leaning my head back, he said "see this pic, this is what we submit to the insurance company. You can see that your septum is deviated." Uh...why did everyone else tell me I need a CT scan, if this guy can just submit pics to Cigna and they'll take care of everything?! Well, Dr.Miracle, that's awesome. I got the CT scan anyway this past weekend incase I don't use you as my surgeon.
Then comes the quote. He says, "If your insurance covers the facility fee, anesthesia, and septoplasty, you'll be responsible for $4,000. Because the facility is 'out of network' you may be partially responsible for that fee as well"...
Great price for me. And I'll say, that the photos he emailed me tonight were good, but not exactly what I want, so I decided to make some further adjustments with photoshop (ha! Yes, I'm great with photoshop) and sent them back to him. He told me they were subtle, reasonable, and certainly attainable. I like this option, even if he's less "famous" than the others. Overall, a good impression.

Rhinoplasty in NYC: CT Scan

5/3/09. Today at 10am I had my CT Scan done. It was a sinus CT scan with "No contrast" meaning no injectable dye. My co-pay w/ insurance was $40. Inside the machine room, I was told to lay supine on this little bed, and a protective smock was put on top of my chest and body. She told me to close my eyes and don't open them. The bed I was on starting moving slowly back and forth toward the machine and away from it several times. Within a matter of minutes, I was done. It was TRES simple. Now, in a few days time, the results.

Rhinoplasty in NYC: Appt 4

4/23/09 Yes, it's my second appointment of the day. After work, I went back uptown to Dr.Howard Bellin's office. Another man who is famous for rhinoplasty in NYC. I didn't do extensive research on him, as I'm a bit exhausted at this point, but I will say that I like how long he's been in the business, and his site's before & after photos are great. I sat in the waiting room of his office with 2 patients ahead of me. First, I met with Patti, his assistant. She told me about what I'd have to do before the procedure and after, how the doctor doesn't pack the nose anymore, how to prevent bruising (she told me that taking vitamin C for a week before the surgery makes a huge difference), where to get photos taken, where to get blood work done, etc. She was very sweet, and warm. She took me up to see Dr.Bellin in his "office"...Um...
It's more like you'd expect of Sherlock Holmes' study. There are what appears to be African artifacts & antiques, and books galore. There are stacks of papers completely crowding the desk and surrounding the computer behind the desk. And yes, the man is aging. Is this a deterrant for me? NO. He's been at the game a long time, if he doesn't know, then who does? He came around from his desk and sat across from me, and asked me what I was looking for (better than Rosenblatt, I'd say). He showed me that I don't need my tip lifted, bc the look of "droopiness" is actually an illusion (my cartilage alaris major, or the thing between my nostrils touching my upper lip, is a little low. If it's tweaked upward a bit, it lifts the appearance of the tip without having to actually move the tip up and give me a pig nose). Well, Bellin, thank you for being the only doctor who noticed that. I will certainly bring that to the attention of whomever I chose because I think you're right.
Now, time out. The man picked a spec up off the mirror on his desk and stuck it in my nose. They've all done this, but all the other surgeons took the tool out of a package. Did you just stick a dirty spec up my nose? Seriously? Whose nose was that just in? You didn't use alcohol on it or anything?! Eek! Bad sign. Then, I asked to see some before and after photos on his computer, since the ones on his site seemed a bit outdated, though great. His after work was not "cookie cutter" and looked great, consistently; every patient he showed me looked awesome after, and he wasn't just chosing the "best of the best" like you'll see on Dr's sites, he literally randomly chose one, and clicked "next" time and time again. Patient after patient looked great. I went back downstairs, and talked to Patti again w/ Dr.Bellin by her side. After assessing my deviated septum, and telling me the next step in arranging this, I was quoted $3,500 if my insurance covers the facility, anesthesia and septoplasty. Amazing! How could I not be happy about that?

Rhinoplasty in NYC: Appt 3

Now, if you Google "rhinoplasty NYC" and you start reading posting boards, and online blog forums, you can't seem to get away from one doc. He's posted everywhere, and has a great reputation. Dr.Philip Miller. When I had initially called for my free consultation with his office, they took down my mailing address to send me an informational packet about rhinoplasty in general and about Dr.Miller. I liked that. I researched his site, and saw all the publications he's been in; all of his accreditations, etc. People seem to really like this man, and what he offers. I do have to admit, though, that going through his before and after rhinoplasty pics, it seems that some of the work in just inconsistent. I thought some of the after photos were pretty unattractive. Is that because they're just not appealing to me as a hypercritic? Or, is it because that is actually what the patient requested, which I just don't think is attractive? Is it because the patient didn't mind that he/she wasn't "great" looking after, since the before was SO much more hideous? WHY does some of this man's work look shoddy to me? I have no intention of tarnishing his reputation, but, Godfrey's before and afters didn't look this way; his were perfection, and NOT cookie-cutter at all. Hmm...

On appointment day, I was seen by one of the aestheticians. A blond-porceline doll who has had everything done under the sun (and everyone knows within a second of a glimpse), and looks like she belongs on either Dr.90210 as someone's wife, or a "Real Housewives of ____" show on Bravo. She asked me a hundred questions, and created an online profile to save my requests, health status, etc. She didn't actually say anything of substance; she was really more of a promotional tool, who sat down and explained (and reiterated) that Dr.Miller has never had a lawsuit filed against him, and how everyone loves him, how this changed her life (I think her nose looks COMPLETELY worked on...it's not smooth, at all) etc. I felt like she was really trying to sell me, which automatically put my guard up. Let the results sell themselves and stop trying to jam your promotional shpiel down my throat. She took some pics from different angles, just as Godfrey did.

When Dr.Miller came in, he used a speculum and checked up my nose. His demeanor was very pleasant, and he was kind. I found him personable, professional, and he told me I have enlarged turbinates, and a deviated septum. The before pics were pulled up onto the screen and adjusted so that I could see what I'd look like if my nose were straightened and aligned, the bridge narrowed a bit, tip narrowed and slightly lifted. I remembered what Dr.Godfrey told me about semantics, and how drastic a change can be by a mm or two. I said to Dr.Miller, "how do you know exactly how many mms to take off and from where, etc?" and to my dismay, his reponse was completely untechnical and more along the lines of him being the doctor, and going in, as "Picasso" would (PS, Mr.MedSchool, Picasso was primarily a cubist and surrealist, and the noses on his characters are literally deliberately crooked and awful, lol. Not being overly nit-picky here, just thought that was relatively comical) and sculpting & refining until he sees fit. Now, Dr. Picasso, this is my face we're talking about, and if I wind up looking like one of the afters that I think are less-than-great on your site just because it's better than the before, I'll be MORTIFIED. Then, the real kicker: PlasticSurgery Barbie comes back out with a quote. "This is after the insurance deductions." So, with anesthesia, facility, and surgeon's fees, the total is $10,400 but they'll give me 10% off (because I'm sooooooo special), so my final quote and responsibility is $9,000. Oh, and BoobieBarbie will "throw in some free skin treatments and stuff." LOL. No thanks.

Rhinoplasty in NYC: Appt 2

4/15/09: Second rhinoplasty consultation, first w/ Dr. Norman Godfrey, M.D. I have been online now for a few weeks looking at before and after shots of different doctors not only in NYC, but around the country. Dr. Godfrey’s before and afters were by far, the absolute best I’ve seen. He seems to do incredibly beautiful work. Well, despite my desire to not have my pockets raped, I decided to schedule the $200 consultation, because when I spoke to the receptionist, she told me that my insurance can be billed for the visit, and I'd just have to pay the co-pay (to see a specialist, my co-pay is $40). The office is nice, and the examination room was above average looking; very clean, well kempt. Dr.Godfrey seems intelligent and slightly eccentric. He closes his eyes a lot when he speaks. He provided me with the information that semantics shouldn’t play a role here, and that what may be “slightly smaller” to him and me, might be very different, so he takes a more technical approach. He can show me on before and after shots what the subtraction of 1mm off the bridge will look like compared to 2. His approach was comforting; he put me at ease, and in general, I felt very comfortable as his patient. He took me into his office in front of huge professional lights and a screen, and snapped several photographs of my face from different angles. Before leaving, Dr.Godfrey gave me a prescription for a CT Scan, explaining to me that in order for me to have a septorhinoplasty, my insurance will have to step in and cover some of the costs (Anesthesia fees, facility fees, and some of the procedure itself). He wouldn't discuss cost until he could look at my CT Scan results. I'm to request "CD" or "film" from the CT Scan...then I have to book a follow up session. Overall, my impression of this doctor and his facility is great.

Rhinoplasty in NYC: Appt 1

4/1/09: First rhinoplasty consultation, first (and only) w/ Dr. William B. Rosenblatt, M.D. @ Lenox Hill Plastic Surgery Center. My first impression is that this is not a “nice” office. It seems old, weathered, and above all else, dirty. The examination room is pretty standard; seats, drawers, cabinets. Dr.Rosenblatt comes in to greet, and asks me what I’m looking for/tells me what he sees. He uses a pair of speculums to look into my nose and tell me “You have a nicely deviated septum” and explains to me about cycled breathing and how my septum affects that. He tells me he can narrow and straighten my bridge, even out the crookedness, narrow the bulbousness of the tip and lift it slightly. He seemed very authoritative; “I’m the doctor, I’ve been doing this for a very long time” type of thing. When looking through his before and after books, there were a lot of after shots I didn’t think looked nice at all. When pointing one out in particular, I said “that still looks crooked to me,” he said sternly, “Well, it’s NOT!” Then, his assistant Jackie gave me a quote in another room. $6,000 surgical fee for Rhino/Septoplasty + $1,000 OR fee + $1,100 Anesthesia fee. Total $8,100, but if I pay cash, then surgical fee goes down to $5,500. $1,000 OR fee? The OR is in this dirty facility!! What the heck am I being charged for? I think it’s pretty clear I won’t be back here.