One of areas within facial plastic surgery that Thomas Lamperti, MD specializes is in performing facial feminization surgery. In the second part of this video series Dr. Lamperti reviews before and after photos of a male to female transgender patient who is undergoing facial feminization rhinoplasty to create a more feminine appearing nose. Dr. Lamperti then shows a portion of her first post-operative visit in which he removes the patient's cast and reveals her new nose for the first time. You can see the first part of this nasal feminization rhinoplasty video series here.
"Dr. Lamperti: This is Seattle facial plastic surgeon, Dr. Thomas Lamperti. Today’s video is the second installment of my prior nasal feminization case study video. You can find that video link in this video description section. Today we’ll see footage from a portion of our patient’s first postoperative visit which was about 1 week after the septo-rhinoplasty surgery itself.
I’ve already trimmed a few of the sutures along the bottom of the nose. I’ll now begin to gently lift the patient’s cast off her nose. I first loosen the tape from her skin on each side and then the cast itself easily lifts off. To help with this process I place a non-stick dressing strip over the nasal bridge. This piece of telfa (which is the same material that makes up the white of a band-aid) allows me to remove the dressing without accidentally lifting the nasal skin off of the underlying bone where we want it to adhere.
You can see that the actual cast removal process isn’t particularly painful. Now that the cast is off it’s time for the big reveal where the patient gets to see her nose for the first time.
>> Patient’s spouse: Wow.
>> Dr. Lamperti: There you go. It’s looking very good. Let me grab you a second one so you can see your profile a little better.
>> Patient’s spouse: That look on her face.
>> Dr. Lamperti: That’s right.
>> Patient’s spouse: There’s a mirror on the door.
>> Patient: Oh my God.
>> Audrey: You like it?
>> Patient: It’s coming down. Oh yeah.
>> Patient’s spouse: It’s going to be so nice, baby.
>> Dr. Lamperti: Here’s the second mirror so you can use it at an angle to see your profile view. Is that working ok. Oh, yes you can see it. So it’s looking good. That marking pen will come off. It’s going to be a little flaking over the next few days. The skin under the cast will flake off. But it can get wet now like normal, in the shower.
>> Patient’s spouse: Can you put lotion on it?
>> Dr. Lamperti: Lotion’s ok. You don’t have to but lotion is good.
>> Patient: I’ve noticed like with my eyes it’s set different. My face actually…the whole atmosphere went kind of like back into it. So I don’t know how much you actually had to pull in, but it was that much off.
>> Dr. Lamperti: The crookedness, yes.
>> Patient: I mean I’m looking at it right now and it’s like “Oh my gosh” I have not seen my face this straight in years.
>> Patient’s spouse: How long does she have to wait until she can blow her nose?
>> Dr. Lamperti: We have you wait 10 to 14 days total so another few days. But it is ok to do the flushes…
>> Patient’s spouse; Ok and what about laying down all the way at night?
>> Dr. Lamperti: It’s up to you. You’ll find that you’ll throb and ache a little more maybe and get more swelling so you can transition whenever you’re comfortable with that. And we’ll see you back in a few weeks and we’ll continue to follow it along. You’re healing great.
>> Patient’s spouse: You look beautiful.
>> Patient: Thank you.
>> Dr. Lamperti: You’re doing very well. You’re doing great. Oh my pleasure.
It’s moments like this where you can see why I find my job so satisfying."