Should teens have plastic surgery?
What is a deviated septum?

By Jessica Bernstein, 17, Beverly Hills HS
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Old nose at Jessica's Sweet 16 birthday party.
Photo by Bonnie Sachs (Jessica's father's fiancée)

For as long as I can remember I’ve had major breathing problems. I felt like I was sick almost all the time because I was so congested. Sometimes I woke up during the night all stuffed up. It was awful!

I have several allergies. Some are food, such as peanuts, pistachios, cashews and milk. Some of my allergies are environmental, such as dust, horse hair, mold and grass that grows between May and August. But what really made my breathing difficult was my deviated septum. A deviated septum means that the wall dividing the nostrils is pushed to one side so that one of the passages is blocked.

At the end of my junior year I met wita a plastic surgeon about my breathing problem. I decided to have my nose done before senior year because I was annoyed with not being able to breathe. And I wanted it to look good for my upcoming senior portrait. I didn’t have it done sooner because with any reconstructive surgery you have to be finished growing. My older sister didn’t wait until she was done growing and she had to have her nose done a second time.

I told the plastic surgeon, Dr. Robert Ruder, about my problems. And I figured that since I was talking to him about fixing my deviated septum, I might as well tell him how much I hated the bump on my nose and also the tip of my nose because it’s square, not round like most people’s.

He agreed to shave off the small, but noticeable bump on my nose but said no to changing the tip. He told me that my nose’s square tip was unique, so I decided to leave it. I like to be different.

Next, he needed to look inside my nose with a light. Before inserting the light, he sprayed the inside of my nose with a mild numbing spray so I wouldn’t feel any pain. The light is fairly small but it’s attached to a 20-inch wire so he could see into my sinus. At first it wasn’t so bad, but the light got stuck before it reached my sinus so the doctor had to give it a little push. He told me that I had a deviated septum, which I knew already, but he couldn’t tell how badly. After getting a CT scan (a picture of the inside of my face) I found out that not only did I have a badly deviated septum, but also a cyst taking up most of my right sinus cavity (think of an almond blocking the hole of a garden hose).

Before my surgery I turned to my older sister for advice, but instead of telling me positive things she scared the daylights out of me by telling me all the gross stuff that would happen. She emphasized that there was a good chance I would throw up blood; just the thought made me gag. She then told me how excruciating the pain would be. This was not what I wanted to hear.

On July 28, the night before my surgery, I surprisingly was not nervous. My mom came in the next morning at 5:15 to wake me up. I got dressed (something comfy and a shirt that either zipped or buttoned, because I wouldn’t be allowed to put things over my head after the surgery) and got ready to go to the hospital. When I got there, my mom, my little sister and I went up to the waiting area on the fifth floor and waited for an hour. I was annoyed beyond comprehension at the wait so I fidgeted and paced. Meanwhile, my little sister had fallen asleep.

At 7 a.m. they admitted me into the surgery waiting room where they told me to change into a gown with nothing on under it except for underwear. I was given "shoes" that were made out of the same material as the gown and a shower cap to keep my hair out of my face. My anesthesiologist (the doctor who administers drugs) put an IV into my arm and gave me some medication to calm me down. He said one of the drugs would burn when it went in. It didn’t hurt, but it was a weird sensation because it burned inside my veins.

A few minutes later my plastic surgeon came in to give me a pre-operation pep talk. First, they would hook me up to a monitor with a brain strip attached to my forehead that would track my brainwaves while I was under the anesthesia. Then they would insert a tube into my throat to catch excess blood that went down, so I wouldn’t choke. After the surgeon was done he’d remove the tube and I would wake up. Now I was nervous. My heart was pounding. I wanted to get up and run. But then I remembered that I would soon be able to breathe better. My mom and sister told me I would be OK and that the surgery would take only a few hours.

It’s weird to learn about your own operation

Until I had to write this story I didn’t know what they did during my surgery. As I interviewed my doctor, I wanted to stop listening but I couldn’t; it was grotesquely interesting.

They didn’t make any cuts on the outside of my nose. It was all done inside via a tiny camera that they stuck up my nose before the surgery began, while I was knocked out. The doctors made several tiny incisions inside my nose to remove the cyst that was blocking my right sinus. My doctor also made more small incisions in my nose so he could shave down the small bump on the bridge of my nose using a tool like a nail file.

Fixing the deviated septum, also known as septoplasty, was more detailed and complicated. The surgeon had to make an incision inside my nose to remove the obstruction and the excess cartilage that caused the deviated septum. The septoplasty and rhinoplasty (the cosmetic portion) together took about two hours.

The only thing I remember is being moved from my gurney onto the operating room table and then hearing my anesthesiologist saying, "Jessica, Jessica, can you hear me?"

I was discharged from the hospital a couple hours after my surgery. I had a plastic cast covering my nose. Also, I couldn’t breathe through my nose because of the packing (which is a tea bag-looking thing) in my right sinus and the gauze catching the blood that came out of my nose.

When I got home I rested on the couch and watched DVDs. I refused to eat because I felt sick and about an hour after I got home, I threw up blood. After throwing up I decided that I should eat and my mom made me some Kraft macaroni and cheese, something I hadn’t eaten in about five years.

Breathing out of my mouth for more than two weeks was horrible. My lips were chapped and I woke up in the morning with cracked lips. And if I smiled, they bled. I also had sore throats because my mouth was so dry.

But sleeping was by far the worst. For two months I couldn’t sleep on my stomach, which happens to be my favorite way of sleeping. And for the first four nights I had to wake up every couple hours so that my mom could change the gauze padding blocking the end of my nose. I was on Vicodin for pain and Ambien to help me sleep. I liked sleeping because I didn’t have to feel the overwhelming pain.

There were points during my recovery when the pain in and around my nose was so horrible that I did regret having the surgery. Thankfully the pain medicine helped. Most of the pain was just awful achy pain. It would come and go in long sharp spurts; occasionally it got so bad that I started crying.

Six days after my surgery I went back to my doctor. He took off the cast and removed the packing from way up in my right sinus. In each sinus I had a splint, a piece of plastic about 3/4 of an inch wide and about 3 inches long. Getting them removed didn’t hurt me, but my mom almost fainted. Getting the splints removed actually felt good because they were stretching the inside of my nose.

My nose was still backed up but not as badly as before. My doctor put tape on the bridge of my nose and I still had the gauze covering the tip to stop any excess blood or snot from dripping.

New nose for Jessica's senior portrait.

Three days later I went back to my doctor and he took off the tape and used tweezers to remove the stitches inside my nose. Having the stitches removed felt awkward. The first little tug would hurt, because of a knot that kept the stitch in place, but after the knot passed through the skin it slid out painlessly. The ordeal was finally over!

I went back two weeks later for a check-up and the doctor told me I was doing great, and that I didn’t have to come back for a month.

Now, nearly eight months later, I can breathe through my nose and I love my face. Before my surgery at least one sinus was always blocked up, but now (except when my allergies act up) I can breathe out of both. When I pass a mirror I look and can’t help but smile. Even though the bump was small, I noticed it. Having the surgery has boosted my confidence and I feel so much better. My friends and family think that I look the same. But when I see myself in the mirror I love what I see.