FEMALE VOICE: The reason that brought me here to Dr. Cochran’s office was that I’d had a rhinoplasty before and I wasn’t happy with the results from that. I also had continued problems with breathing and my sinuses. I also had worked with Dr. Cochran in the operating room and knew some of his work and how conscientious he was and that he was coming to work in a rhinoplasty practice.
So I came to him for a secondary rhinoplasty and revision of sinus surgery. I couldn’t be happier with my results. I feel, I love my new nose. I can breathe better. I can smell better. It looks better. Every person in this office treated me like I was part of the family, like I was a very important person, even from the receptionist telling me directions of how to get home in bad traffic, to Dr. Cochran, you know, calling to check on me the night before surgery and stuff like that. So overall my experience has been wonderful and I’m just so glad that I did it.
FEMALE VOICE: When I was a child I broke my nose when I was about 4 years old. I was running down the sidewalk, tripped, fell on concrete and flat on my nose. So and many years later they said it’d be better to wait until I was fully grown to operate. When I started to consider getting my breathing problem corrected and knowing that I would have to face surgery for a second time after a tough first surgery many years prior to by another doctor, I started checking with doctors in the Metroplex, I started checking with friends in the Metroplex that I knew always chose the top doctors. And hands down from friends to doctors, whether it was general practitioners or a dentist, Dr. Gunter was the person that everyone recommended and they said that he is number one for what he does. In fact, another plastic surgeon in the area said that he is the person to go to for that procedure. He has a gift for what he does and what he does is a miracle, in my opinion.
FEMALE VOICE: I came to Dr. Cochran for a second opinion, basically. I had been to two or three other doctors because I had an issue with my breathing and a little nodule inside my nose. So, you know, there were some issues with that. Nobody could figure out what was going on, and I had been to about three other doctors and a friend of his dad’s sent me here and said this man will know what to do for you. And he is the only one that diagnosed me properly.
So I came for a second opinion and left with my first choice of surgeons. And I cannot tell you how much better I feel, how much better it looks. My main objective was to be able to breathe properly. My goal was not necessarily to have a better looking nose, but I’m please with it. It’s much better than it was.
What impressed me was he not only described everything in detail, made sure I understood the entire procedure and made sure I was comfortable with everything that was going on, he gave me illustrations, an overlay of my face and my profile to show me exactly what I was going to look like. And it does, and I was very impressed with that.
MALE VOICE: I actually grew up with probably a semi-non-functioning nose from the time that I was a baby. And they tried to correct it when I was 16, not Dr. Gunter but somebody else. And I had kind of a nose that whistled and it always has sort of difficulty sleeping, never woke up with energy. And I think really once I got married, which I just got married about three years ago, my wife was one of the first ones to go, like, we’ve got to do something about your nose ‘cause she had to sleep next to me. So my snoring was probably what brought it on. That and her Bichons couldn’t sleep.
So essentially she did the research and found Dr. Gunter. And We came in and after we were referred by another doctor also, and a few people that we ran into just along the way once you started saying I need something done about by nose who had been here. And came in, got the consultation, found I had a deviated septum. What also I didn’t realize at the time that my wife was unhappy with the look of my nose, which was a little broader on my face. It was sort of early Michael Jackson.
And I realized that we were simultaneously fixing the functionality of it while doing something about the nose. And I’d run a film festival for the last seven years and had always seen people who had either done it well or not done it well as far as getting their nose fixed. So I dreaded that a little bit. But I’d heard great things and we went in and actually came in and corrected a deviated septum.
And you know it’s a painful process. Not so much, it’s just any time anybody goes in there and corrects your nose. And the staff did a great job. They really took good care of me. They walked me through the process. And Dr. Gunter was there for me throughout. And after the swelling went down everything was kind of based exactly on what they said, the timing of it, and you know, how long I’ll be uncomfortable and how to deal with that. And what I found afterwards is that I sleep well and I have better energy during the day and it’s improved my athletics and working out. So I think it’s been a big success.
DR. JACK P. GUNTER: A male nose is certainly different from female noses. And in general the male nose is a stronger looking nose than the females and it usually has a straight bridge. It’s got a tip that is more projecting than the female has and the length of the nose looks a little bit longer in an up and down direction. Whereas a female’s nose is more turned up, the tip is slightly more turned up, the bridge is lower, and the tip usually sticks out a little bit more than the bridge does, and in general looks a little bit softer. The main thing, though, in either a male or female nose is to keep it natural appearing and be sure that it’s functioning properly after the rhinoplasty.
DR. SPENCER COCHRAN: Rhinoplasty is a common procedure that young adults and teenagers contemplate. And we see a large number of rhinoplasty patients who are in their teens at our practice. While there’s not any specific age cut off or requirement for rhinoplasty, it is important that patient’s be both physically and emotionally mature to undergo rhinoplasty. This is something that needs to be evaluated on a case by case basis. It’s also important that there be an open dialogue between the patients, the parents, and the doctor. This ensures that the motivations and expectations for surgery are all in agreement.
DR. JACK P. GUNTER: Ethnic rhinoplasty is a rhinoplasty for the different races. And in Dallas the type of ethnic rhinoplasty that we usually perform are for African Americans, Asians, mid-easterners. Each one of these races have common traits and characteristics of their noses. And one of the things you always are concerned about is whether the, how much of the ethnicity the patient wants to keep. You know? They don’t want to be changed too much but yet they want something changed.
So the main thing about ethnic rhinoplasty is you have to have a very good consultation with them. And to really get down and talk about exactly what they want, because you know some people with the same deformities won’t want the same thing. So that’s the main thing in ethnic rhinoplasty. We do a lot of ethnic rhinoplasties and you know they’re very happy, as long as both sides know what we’re trying to achieve. And so that’s what I, that’s what we think is the most important thing, is to individualize the operation for them and try to get them exactly what they want.
DR. JACK P. GUNTER: Well the nose is the most prominent feature of the face and certainly it plays a very important role in the facial aesthetics. So rhinoplasty has actually two benefits, improving facial aesthetics and also improving nasal function. The nose has a very strong psychological effect on ones self-image and can decrease ones self-confidence, especially in the younger patients.
It’s very satisfying for us to see a patient come in to the office with a big smile on their face and very outgoing who, before their rhinoplasty, was very shy, retiring, and you know didn’t have much to say, but has become a much happier person. And this makes us very, it is very satisfying to us.
We also must remember though that the nose is functioning organ and that the air that goes through the nose is healthier for the lungs than if it goes through the mouth. So it’s very important that when we’re improving the aesthetics we also must keep in mind the problem of decreasing breathing and to open the airways so that they can breath better.
DR. SPENCER COCHRAN: Our rhinoplasties are usually performed under general anesthesia, which means patients are asleep. Typically surgery lasts approximately three hours. The surgery may last up to five hours for patients who undergo a secondary rhinoplasty. For patient who have a rib graft we often keep them in the hospital overnight, but generally rhinoplasty is considered an outpatient procedure.
After surgery the nose will appear swollen and there may be some mild bruising around the eyes. A cast is placed on the outside of the nose to help maintain its shape during the recovery period. One week after surgery the cast and any sutures or splints are removed. When the cast comes off the new shape of the nose is apparent, although it may appear a little bit swollen. That swelling generally subsides over the next several weeks so that by approximately four months the final shape of the nose is apparent.
DR. JACK P. GUNTER: Secondary rhinoplasty is a rhinoplasty performed for patients who have already had a previous rhinoplasty and either they’re dissatisfied, well they are dissatisfied with the operation for one reason or another. Now there can be, these can be due to minor deformities that they have or major deformities. And if it’s a minor deformity it can be fairly easily fixed. However if it’s a major deformity it becomes more difficult and is much more difficult than primary rhinoplasty. And it can be a problem with the aesthetics as well as a problem with breathing.
And when we go into secondary rhinoplasty we start having to take cartilage from other parts of the body because the cartilage inside the nose has been operated on, some of its been removed, some of it is distorted, and sometimes we have to build a complete new framework and it’s under the skin. And then if the skin’s been damaged it’s very difficult to improve the skin. So because of its difficulty it is very important that the patient select a highly qualified surgeon to perform any type of secondary rhinoplasty.
