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One man explains how a breathing problem led to a positive physical change.


Name: Sean*


Procedure: Rhinoplasty


Performed By: Dr. David Hacker



Elevate: Why did you decide to seek out treatment?


SEAN: I had been experiencing breathing trouble periodically, and had come to believe that I may be suffering from post-nasal drip. Upon closer examination of my nose, I had also noticed that it was slightly off-centre and that it had a slight curved shape along the bridge. These things were very minor, and therefore, had gone unnoticed for many years. Once I focused on them it became very hard to forget.


Elevate: How did you choose Dr. Hacker as your surgeon?


SEAN: Already having been to consultations with other plastic surgeons, I went into the consultation with Dr. Hacker believing I knew what to expect. In my meetings with other doctors, I was told that what they would be able to do would only result in very minor differences, and that I would have to decide if I wanted to go through with such a procedure knowing that it may not come out exactly as I imagine it would. There was also a debate as to whether it would need to be an open or closed procedure, and the glamour side of things and spa-type care I would receive during and after treatment was stressed.


Upon speaking with Dr. Hacker, I immediately knew it was a different type of consultation. He confirmed immediately that he could deal with, and improve upon, the deviated septum and then from there went into all other aspects he could improve upon esthetically if that is what I wanted. He also knew that he wanted to perform a closed rhinoplasty. He never once tried to glamorize the procedure. He explained that he believed surgery was surgery, and due to what was involved in the procedure, he performs all his surgeries in a hospital, not in a spa or private location. This sat very well with me. The other doctors did seem very professional, but there was something about Dr. Hacker’s realistic approach that put me at ease.


Elevate: How did you feel after the procedure?


SEAN: After I woke up from surgery I spoke with Dr. Hacker, who told me everything went very well, and he even joked around with me to put me at ease. I knew what to expect in recovery because he explained that thoroughly in our previous meetings, but like anyone would tell you it was definitely an uncomfortable first week. Dr. Hacker was never more than an email away when I had questions and responded to me almost instantaneously with advice and reassurance. By the third week I had healed very well and was beginning to look and feel like myself again.


Elevate: Would you recommend Dr. Hacker to others?


SEAN: I would most definitely. He was professional, realistic and always there when I needed him. Even months after the procedure if I had any concerns, he never hesitated to book appointments with me to come into his office and make sure everything was on track for a smooth recovery. As for the procedure, it has affected my life dramatically. My breathing has improved and I feel as though I am breathing clearly through both nostrils now. I am no longer experiencing the feeling of constant congestion and post-nasal drip. The overall appearance of my nose has changed very much, and I couldn’t be happier with the results. To me, it has changed dramatically, but to others, it still looks like my nose and predominantly goes unnoticed.


13 12 rhinoplasty man before after Surgeon canada


Dr. David Hacker, MD, FRCSC, otolaryngologist head and neck surgeon, Toronto Rhinoplasty Clinic, nasalcosmetic.com


Elevate: What were Sean’s initial concerns and what was your plan for addressing them?


DR. HACKER: He came to my office with complaints of nasal airway obstruction, as well as unhappiness with the appearance of his nose—specifically, he didn’t like the fullness of his nasal dorsum and felt that the tip of this nose was too bulbous. In terms of addressing his concerns, I suggested first and foremost that we needed to correct his nasal obstruction, which was due to a deviated nasal septum since regardless of how good the esthetic outcome, the operation would be pointless if he could not breathe properly after. As for his esthetic concerns, he is a very good looking gentleman to begin with and I did not think he required a radical change to his nasal appearance—rather, more of a ‘tweaking.’ I suggested we take his dorsum down to a level that is just slightly more concave than a straight line to soften his appearance without making it look overly ‘scooped out’ or feminine. As for his tip, I suggested that it be addressed by trimming the cartilages and narrowing them with meticulously placed sutures.


Elevate: Did you have any concerns regarding his candidacy for treatment?


DR. HACKER: No, because there are very few contraindications to this type of surgery. In general, I expect patients to be in good overall health and have a healthy sense of body image. Patients need to understand that there are limitations to the procedure and that noses can’t simply be sculpted into any shape they want. There are many factors that have the potential to limit the outcome of a rhinoplasty operation and we consider it our job to let patients know what those limiting factors might be ahead of time. The most common limiting factors typically relates to skin thickness—the thicker their nasal skin, the more difficult it is to achieve a small, sculpted appearance.


Elevate: Are there specific post-procedure steps patients need to follow?


DR. HACKER: Patients need to avoid injuring their nose during the initial healing period. We typically suggest that they keep their nose clean with gentle saline irrigation and application of Polysporin to the nostril rims. If possible, sleeping with the head elevated helps reduce swelling, as does periodic application of ice to the nose. Once the cast is removed, we advise patients as to how they should tape their nose, nightly, for one month. In addition, we ask they use a good sun block if they’ll be in the sun for extended periods.


Elevate: What is the average cost of rhinoplasty?


DR. HACKER: We charge a standard fee of $4,799 for any primary rhinoplasty procedure, meaning the patient has not had any prior surgery performed on the nose. This fee is inclusive of all charges for consultation, anesthesia, surgery, hospital facility and followup visits.


*Name has been changed to protect patient’s identity.