Other Face & Nose Procedures

+ What is post acne facial scarring?

• The common form of acne seen in teenagers and young adults is called acne vulgaris.
• This is commonly treated by a Dermatologist, who is an Internal Medicine specialist treating diseases of the skin.
• Active acne is treated with topical creams and medication taken by mouth.
• There are varying degrees of acne severity . Some cases are mild and leave little or no significant facial scarring. Other more severe cases can leave a variety of facial skin deformities including scarring, dents, dimples, contour abnormalities and pigmentation changes.
• Once the acne has burnt out, and there is no further active disease, there are surgical options to treat the cosmetic deformities that may have occurred from the acne.

+ What can be done surgically to improve post acne facial scarring? Scar revision:

A deep wide pore, or a skin depression produced by a scar is difficult to camouflage with makeup because of the irregular skin surface over the scar.

This can be treated under local anaesthesia (freezing) by excising the scar and closing the defect with surrounding normal skin using stitches. Once healed, the depressed scar is replaced with a very fine straight scar easily camouflaged with makeup.

+ What can be done surgically to improve post acne facial scarring? Dermabrasion:

• In more extensive cases where there are numerous areas of facial scarring, a procedure called Facial Dermabrasion is a consideration.
• This procedure can be done under Local anaesthesia (freezing) if the area is fairly limited or under General Anaesthesia if a full face is being treated.
• The irregular topography (surface) of the skin produced by the facial scarring cast’s irregular shadows from overhead light which exaggerates the irregular skin appearance.
• A special medical tool called a dermabrader smooths the skin surface, somewhat similar to sanding down a rough piece of wood to make it smoother.
• The depth of the dermabrasion is carefully controlled in order to avoid violating the deeper layers of the skin dermis which could produce scarring. The dermabrasion depth reaches the superficial layer of the skin dermis where fine bleeding is produced (similar to an abrasion you get if you fall on your knees on an asphalt road).
• For this reason, very deep acne scarring is improved but not eliminated.
• Often a dermabrasion may have to be repeated once, and sometimes twice, to get the desired effect.
• After the surgery is completed, a special dressing and moisturizers are applied until the dermabraded areas heal. It takes 7 – 10 days for all the scabbing to disappear.
• The patient is left with fairly bright red – pink healed fresh skin which is smoother and wrinkle free.
• The pink color fades over a period of 3- 6 months. The pink color can be camouflaged with makeup during this healing period.
• The healing skin is very vulnerable to sun exposure during the first 6 months after surgery. Sun exposure during this time may produce increased pigmentation in the dermabraded areas, which may persist for years. For this reason, dermabrasion is often done in the late fall to early spring seasons.
• Dr.Giuffre strongly recommends sun block protection during the healing period following a dermabrasion.

+ What can be done surgically to improve post acne facial scarring? Facelift:

• In more severe cases of post acne facial scarring, in addition to a dermabrasion option, some patients will benefit from a facial skin tightening procedure called a Facelift.
• When a patient with severe facial scarring pulls the skin of the cheeks toward the ears, the skin irregularities smooth giving an improved appearance. This is what a facelift does.
• The opposite effect can be produced by moving the skin of the cheeks toward the nose and mouth. This exaggerates the irregular contour of the skin. This manoeuver mimics the effect of gravity on the face over time. A patient with severe post acne facial scarring will have an exaggeration of the irregular appearance as time passes and gravity affects the face.
• In this instance, a facelift procedure on a younger person may provide a significant cosmetic improvement to the facial skin.
• Because gravity continues to affect the skin, a retightening procedure is often necessary as time progresses in order to maintain the improved effect of skin tightening.
• Dr. Giuffre will discuss all of the option combinations and demonstrate these manoeuvers during the consultation discussion with the patient.

Please tap here to view FAQ Facelift

+ What about having my Cosmetic Surgery in another country where it is cheaper?

There is a current trend to have surgery out of your country where the surgery may be cheaper.

We call this tourist surgery.

There are a number of additional risks associated with tourist surgery, which include:

The surgical skill, experience, licensing and education of an unknown surgeon.

Canada has very strict rules and requirements to be a licensed Plastic Surgeon (FRCS(C)) in our country. Your Plastic Surgeon has completed an undergraduate degree (4 years), an MD degree (4 years), a Fellowship Degree in Plastic Surgery (5 years) and often a post Fellowship (1-2 years).

• A “friend” is not a good reference, nor is glitzy advertising.
• The safety, sterility and equipment quality, including anaesthesia machines in the hospital or private surgical suite could be questionable; this may lead to increased risk of infection and anaesthetic risks.
• Post operative care is limited to the time you spend in their country.
• If you have a complication, to see your original surgeon, you will have to fly back to where your procedure took place, or see a new surgeon in your own Country.
• If you have an unsatisfactory result, you will have to fly back to see your original surgeon or find a new Surgeon.
• The cost of the repair may exceed what you originally paid, and the final result, fixing a mistake, is often not as good as it could have been had the surgery been done correctly the first time.
• After accounting for the accumulated costs of the air travel, hotel, surgery and postoperative care, the perceived cost savings may not be significant.

If you have a severe, life threatening complication, Alberta Health Care will cover the medical costs for your care.

Correcting the reconstructive problem, as a result of the complication, would be the patient’s financial responsibility.

+ How do you treat facial wrinkles (rhytids)?

How do you treat facial wrinkles (rhytids)?

There are two types of facial aging:

Skin Aging:

• How quickly the skin ages depends on the quality and quantity of the elastic and collagen tissues within the skin. This speed of aging depends on a patient’s’ inheritance and how well the skin has been looked after (sun and wind protection; moisturizing; non-smoking).
• There are unwanted wrinkles (rhytids) that develop from aging.
• There is premature wrinkling that may develop from excess exposure to environmental elements like sun, wind, and smoking.

Gravity Aging:

• Here we see the gentle and progressive “falling of the facial tissue” as time passes.
• As we age, the soft tissues in the face start to descend from the effects of gravity. These gravity changes may affect the brow, eyes, cheeks and jowls, and neck:
• Heaviness of the upper and lower eyelids with descent of the brows
• Heaviness over the nasolabial folds
• Bitterness and marionette lines around the mouth
• Jowls
• Heaviness of the neck with fat collection under the chin and neck (“turkey gobbler deformity) and cording of the neck muscles.

These gravity changes are treated with a surgery that reverses the effects of gravity.

Please tap here to see FAQ for: Brow lift, Upper Eyelids, Lower Eyelids, Facelift

+ What are the options for resurfacing of the facial skin and decrease wrinkling?

There are non-surgical conservative options for treating skin aging

Cosmetics:

• This is a huge industry dedicated to decreasing facial wrinkling. There is a significant component of facial moisturizing in these products that increase the water content within the skin cells which will temporarily improve the smoothness of the skin. Unfortunately the effects of these products are short lived.
• The camouflage of makeup use is a very useful and economic way of improving the appearance of the skin, but again short lived.

Retin A acid cream:

• Retinoic acid was used to treat acne in the 1950’s. A side effect of this treatment was the slow but definite decrease in facial wrinkling which was maintained as long as the patient continued to use this cream.
• Today this product can be prescribed by a physician to be applied to facial rhytids (wrinkles) with beneficial effect. It will often cause irritation and dryness of the skin being treated and sun avoidance is advisable.
• Using the cream continuously, it will take up to one year before the patient notices a therapeutic effect and a skin improvement.
• The concentration of retinoic acid in over the counter cosmetic products is too small to produce any therapeutic effect.

Botox, Fillers and Fat grafting

Please tap here to view FAQ for: Botox, Temporary Fillers: [Juvéderm & Restylane], Fat Grafting

+ There are surgical options for treating skin aging:

Surgical options:

Tap here for Dermabrasion

Tap here for Chemical peels

Tap here for Laser resurfacing

+ Dermabrasion:

• Facial Dermabrasion is a consideration in patients who have developed numerous areas of facial scarring from bad acne.
• Another application of this technique is in the treatment of heavy wrinkling around the mouth over both the upper and lower lips and cheeks.
• This is often done at the same time a Facelift is being done (See FAQ Facelift)
• This procedure can be done under Local anaesthesia (freezing) if the treatment area is fairly limited or under General Anaesthesia if a full face is being treated.
• The irregular topography (surface) of the skin produced by the facial scarring cast’s irregular shadows from overhead light which exaggerates the irregular skin appearance.
• Heavy wrinkling around the mouth causes a “Lipstick Bleed”. This form of skin ageing cannot be improved with a Facelift.
• A special medical tool called a dermabrader smooths the skin surface (somewhat similar to sanding down a rough piece of wood to make it smoother).
• The depth of the dermabrasion is carefully controlled in order to avoid violating the deeper layers of the skin dermis which could produce scarring. The dermabrasion depth reaches the superficial layer of the skin dermis where fine bleeding is produced (similar to an abrasion you get if you fall on your knees on an asphalt road).
• This removes all but the very deep acne scars and wrinkles.
• Often a dermabrasion may have to be repeated once and sometimes twice to get the desired effect.
• After the surgery is completed, a special dressing and moisturizers are applied until the dermabraded areas heal. It takes 7 – 10 days for all the scabbing to disappear.
• The patient is left with fairly bright red – pink healed fresh skin which is smoother and free of superficial wrinkles and improved deeper wrinkles.
• The pink color fades over a period of 3- 6 months. The pink color can be camouflaged with makeup during this healing period.
• The healing skin is very vulnerable to sun exposure during the first 6 months after surgery. Sun exposure during this time may produce increased pigmentation in the dermabraded areas which may persist for years. For this reason, dermabrasion is often done in the late fall to early spring seasons.
• Dr. Giuffre strongly recommends sun block protection during the healing period following a dermabrasion.

+ Chemical Face peel:

• This procedure involves “painting” on to the wrinkled facial areas, a chemical that produces a superficial burn to the skin.
• There are different types and concentrations of chemicals that can be used.
• Examples of chemical peels are a TCA (trichloracetic acid) peel and a Phenol peel.
• The stronger the chemical, the deeper the skin burn and the better the result but if the skin is injured too deeply, scarring can result, therefore this technic must be used by a trained physician and the chemicals require a prescription.
• Over the counter “peel” products purchased in the cosmetic section of a retail store can produce a mild inflammation (redness and swelling) to the areas treated for up to three weeks. There is no permanent effect on the skin from these OTC peels once the inflammation disappears.
• After the procedure is completed, a special dressing and moisturizers are applied until the peeled areas heal. It takes 7 – 10 days for all the scabbing to disappear.
• The patient is left with fairly bright red – pink healed fresh skin which is smoother and free of superficial wrinkles and improved deeper wrinkles.
• The pink color fades over a period of 3- 6 months. The pink color can be camouflaged with makeup during this healing period.
• The healing skin is very vulnerable to sun exposure during the first 6 months after surgery. Sun exposure during this time may produce increased pigmentation in the peeled areas which may persist for years. Dr.Giuffre strongly recommends sun block protection during the healing period following a chemical peel.
• The deeper the chemical peel, the more likely that the patient may experience varying degrees of decreased pigmentation to the areas treated. This takes many years to develop (5-10 years).

+ Laser resurfacing:

• A laser is a very sophisticated piece of equipment designed to concentrate light into an energy beam which can be used for various surgical procedures.
• Certain lasers are designed to treat skin scars and facial wrinkling.
• The use of these lasers requires special training.
• The effect of laser resurfacing is to create a burn on the superficial layer of the skin being treated, similar to the chemical burn created using a chemical peel, or mechanically removing this layer with a dermabrasion technique.
• After the procedure is completed, a special dressing and moisturizers are applied until the peeled areas heal. It takes 7 – 10 days for all the scabbing to disappear.
• The patient is left with fairly bright red – pink healed fresh skin which is smoother and free of superficial wrinkles and improved deeper wrinkles.
• The pink color fades over a period of 3- 6 months. The pink color can be camouflaged with makeup during this healing period.
• The healing skin is very vulnerable to sun exposure during the first 6 months after surgery. Sun exposure during this time may produce increased pigmentation in the laser treated areas which may persist for years.
• Dr.Giuffre strongly recommends sun block protection during the healing period following a laser resurfacing.
• The deeper the depth of the laser resurfacing, the more likely that the patient may experience varying degrees of decreased pigmentation to the areas treated. This takes many years to develop (5-10 years).

+ What is Liposuction?

This is a surgical operation designed to improve the contour and shape of prominent areas of the body by removing unwanted fat. Liposuction is designed to “spot reduce” the unwanted area of excess fat.

It is not designed to assist in overall body weight loss or control.

Liposuction does not treat or improve skin abnormalities or irregularities.

Skin deformities listed (but not limited to) below are NOT improved with liposuction:

• Stretch marks (striae)
• Cellulite
• Excess skin and skin wrinkling
• Dents , dimples ,waves or any contour irregularity within the skin
• Skin discoloration or fine veins (telangiectasia) in the skin

+ Who can have this operation?

• The typical patient who is a candidate for a liposuction procedure has little or no excess skin over an area of fat prominence which produces the unwanted contour deformity.
• Often the patient has tried numerous diets and exercise regimes to reduce the unwanted fat, neither of which has successfully improved the cosmetic concerns.
• Alternatively, a patient may be happy with their weight and life style, but have unwanted contour deformities caused by excess fat in areas that they would like to have removed without changing their weight.

**LIPOSUCTION IS NOT A PROCEDURE FOR AN OVERWEIGHT PATIENT TO REDUCE GENERALIZED EXCESS BODY FAT. IT IS VERY LOCATION SPECIFIC DESIGNED TO “SPOT REDUCE” A SPECIFIC ANATOMIC AREA TO IMPROVE THE CONTOUR IN THAT LOCATION.

This applies to both men and women.

+ Why do these deformities occur?

People in general will distribute excess fat differently and in different anatomic areas in their body, based on their anatomy and inheritance.

Excess fat may accumulate in unwanted areas, even in patients with an ideal weight:

• An example of this is seen in the thin petite woman with prominent outer lateral thighs (saddle bag deformity) despite an ideal body weight.

The typical fat distribution in women and in some men is peripheral. This means the excess fat occurs in the layer between the skin and the underlying muscles.

If there is excess loose or hanging skin overlying the areas of unwanted fat prominence, removing the fat alone with liposuction without dealing with the excess skin will make the area look worse by creating an increase skin redundancy and skin wrinkling.

• An example of this is seen in a person who has youthful full cheeks, then becomes ill and loses a considerable amount of weight resulting in an older looking, hollow sunken cheek, with skin wrinkling.
• Another example is the arms. If there is excess fat AND skin, by removing the fat only without addressing the excess skin will create a worse deformity like a “bat wing.”

+ When can Liposuction be done?

The patient’s weight and life style should be stable. Typically, the patient has tried both weight loss and exercise to correct the excess fat, creating the unwanted prominence.

+ What anatomic areas can you Liposuction?

Any combination of the listed areas below can be liposuctioned at one or more operative sittings.

If the areas and the amount to be liposuctioned are very large, then staging the procedures is done for patient safety and to reduce risks.

The COMMON areas of the body that can be treated with liposuction include:

• abdomen
• lateral breast and axilla
• back & bra line
• hips (love handle area)
• outer thigh and outer buttocks (saddle bag deformity)
• inner thighs
• inner knees, calf and ankles
• neck and cheeks

+ Neck and Cheeks:

Younger patients (<35 data-preserve-html-node="true" years old) may have an excess accumulation of fat in the neck and cheek areas. This is most often inherited. It does not respond to weight loss or exercise.

A liposuction procedure can reduce the neck and cheek fat producing a slimmer face and more sculpted neck with a sharper neck jaw line angle. Because of the youthful skin, there is no concern about producing excess redundant skin.

This same fat accumulation can also occur in a heavier patient. In this instance, significant weight loss may produce a reduction in the fat accumulation in the face. Alternatively, a liposuction procedure can reduce the neck and cheek fat producing a slimmer face and more sculpted neck with a sharper neck jaw line angle. If a very large amount of fat is to be removed, there is a risk of excess skin.

Dr. Giuffre would assess the quality and character of the skin over the area to be liposuctioned to determine if the patient is a candidate for liposuction.

In the 35-49 year old patient who has excess neck fat, but has no muscle or excess skin problems, a liposuction procedure may be a reasonable alternative to a facelift procedure depending on the quality of the neck skin. The quality and character of the skin over the area to be liposuctioned will determine whether this patient type is a candidate for liposuction.

In the 50+ year old patient, a heavy neck is most often accompanied by other gravity changes in the face including loss of muscle tone in the neck (the neck muscles start to hang and form cords), loose skin (turkey gobbler deformity), and a descent of the cheek fat along the jaw line (jowls) accompanied by creases from the outer mouth to the jowl (marionette and bitterness lines).

This cannot be corrected with liposuction. A facelift, neck lift procedure addresses this skin, muscle and fat deformity.

Please tap to view: FAQ Liposuction:Neck & Cheeks; FAQ Facelift

+ What if I have difficulty breathing through my nose?

There are a number of reasons that a patient can have difficulty breathing through their nose.

An isolated nasal breathing issue without a nasal appearance issue is best assessed and treated by an Ear Nose and Throat surgeon.

If the patient wants the appearance of the nose improved (Rhinoplasty) and also has nasal airway obstruction, this can be corrected at the same time as the Rhinoplasty surgery. This is called an SMR (submucosa resection) Rhinoplasty (nasal appearance change) which is done by Plastic Surgeons.

This may involve straightening the nasal septum (the septum divides the right and left side of the nose) and reducing the size of the internal air warmers within the nose (inferior turbinates). This surgery is done within the nose. There is no external scarring.

This nasal obstruction surgery does not change the appearance of the nose.

+ When SMR and Rhinoplasty are done together:

• A photograph of the face is taken the morning of surgery.
• The surgical plan is again reviewed with the patient at this time.
• The surgery is done either under General Anaesthesia or Local anesthesia with intravenous sedation.
• The appropriate incisions are made (depending on whether an Open or Closed Rhinoplasty is being done).
• The adjustment to bone and cartilage and nostrils is done as planned.
• The incisions are closed with dissolving sutures.
• A cast is applied that remains on for 7 days. It is to be kept dry.
• If nasal obstruction corrective surgery is done, vaseline gauze is inserted into the nostrils for 24 hours. This is removed by Dr. Giuffre’s staff the following morning.
• At one week after surgery, the cast is removed and replaced with tape by Dr. Giuffre. The tape is worn for one more week.
• At the end of the second week, the patient will remove this tape and apply tape to the nose in the evening before bed and remove it in the morning. Dr. Giuffre will instruct the patient on how this is done. This is done for 6 weeks.
• At 6 weeks after surgery, the patient returns to the office. The preoperative photos will be given to the patient and Dr. Giuffre will assess the result with the patient. At this time the nose will still have some swelling and firmness to the tissues.
• The patient will return to the office at the one year anniversary of the surgery for a final assessment of the result. It takes a full year for the nose to heal completely following Rhinoplasty surgery. If there are minor surgical adjustments that could be made to improve the result, these would be discussed with the patient. They are done after the one year mark following the Rhinoplasty when healing is complete.

+ Risks with Nasal Obstruction Correction:

• nasal bleeding,
• recurrent nasal obstruction
• septal perforation (rare)

This list is not complete.

**During the consultation with the patient, Dr. Giuffre will outline and explain each of the risks in detail.

+ How often do I need to come back for a checkup after the surgery?

Postoperative visits include:

• 24 hours to remove the nasal packing
• 1 week visit to remove the cast
• 6 week visit to review the early result and photographs
• a one year anniversary visit

If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access.

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre office and an expedited visit is arranged.

+ I no longer have access to my original surgeon. What can I do?

For cosmetic or reconstructive concerns, patients are invited to contact Dr. Giuffre's office (780-428-7737) for an appointment.

Dr. Giuffre does not require a referral.

There is no charge for the consultation.

+ How much does it cost?

The Rhinoplasty is considered a cosmetic procedure and is not covered by Alberta Health Services.

The SMR is a functional improvement of a patient’s airway and is therefore covered by Alberta Health Services. The patient’s AHS number will be billed for this portion of the procedure.

The cost of cosmetic surgery is covered entirely by the patient.

The one fee would include:

the cost of the anesthetist if required (who provides the General Anesthetic)

the rental of the operating room and equipment

the staff including the nurses and administration staff

the surgical fee

The cost will vary depending on the duration of the procedure and the quality and sophistication of the surgical facility where the surgery is performed.

The fees will be discussed at the time of consultation with Dr. Giuffre.

There is no obligation to proceed with surgery following the consultation. The patient is referred to our web sites and is invited back for a second consultation if need be.

Our office will endeavour to expedite a surgical procedure to accommodate both business and family obligations.

All fees are receipted. GST payment is required.

+ Can I finance the costs of the surgery? How do I do this?

Dr. Giuffre does not provide in house financing for cosmetic procedures.

There are a number of companies across Canada that will finance cosmetic surgery not much different than financing a vehicle or mortgages. Please refer to the links provided for this information.

**Dr. Giuffre has no financial or business relationship or affiliation with any of these companies.

+ If something goes wrong, do I have to repay for the operation?

You do not have to pay for the treatment of an immediate complication. In the unusual event that there is a problem with your original surgery, you do not have to pay for the correction.

+ How much does it cost?

The cost of cosmetic surgery is covered entirely by the patient. The one fee would include:

• the cost of the anesthetist (who provides the General Anesthetic)
• the rental of the operating room and equipment
• the rental of the recovery room and equipment
• the staff, including the nurses and administration staff
• the surgical fee

The cost will vary depending on the duration of the procedure and the quality and sophistication of the surgical facility where the surgery is performed.

The fees will be discussed at the time of consultation with Dr. Giuffre.

There is no obligation to proceed with surgery following the consultation. The patient is referred to our websites and is invited back for a second consultation if need be.

Our office will endeavour to expedite a surgical procedure to accommodate both business and family obligations. All fees are receipted. GST payment is required.

+ What about having my Cosmetic Surgery in another country where it is cheaper?

There is a current trend to have surgery out of your country where the surgery may be cheaper.

We call this tourist surgery.

There are a number of additional risks associated with tourist surgery, which include:

The surgical skill, experience, licensing and education of an unknown surgeon.

Canada has very strict rules and requirements to be a licensed Plastic Surgeon (FRCS(C)) in our country. Your Plastic Surgeon has completed an undergraduate degree (4 years), an MD degree (4 years), a Fellowship Degree in Plastic Surgery (5 years) and often a post Fellowship (1-2 years).

A “friend” is not a good reference, nor is glitzy advertising.

The safety, sterility and equipment quality, including anaesthesia machines in the hospital or private surgical suite could be questionable; this may lead to increased risk of infection and anaesthetic risks.

Post operative care is limited to the time you spend in their country.

If you have a complication, to see your original surgeon, you will have to fly back to where your procedure took place, or see a new surgeon in your own Country.

If you have an unsatisfactory result, you will have to fly back to see your original surgeon or find a new Surgeon.

The cost of the repair may exceed what you originally paid, and the final result, fixing a mistake, is often not as good as it could have been had the surgery been done correctly the first time.

After accounting for the accumulated costs of the air travel, hotel, surgery and postoperative care, the perceived cost savings may not be significant.

If you have a severe, life threatening complication, Alberta Health Care will cover the medical costs for your care.

Correcting the reconstructive problem, as a result of the complication, would be the patient’s financial responsibility.

+ What is a Rhinophyma?

There is a form of acne called Acne Rosacea which affects the skin and subcutaneous tissues of the nose and sometimes other facial areas like the chin and cheeks.

Slowly over time the nose skin and subcutaneous tissue grows which can produce an enlarging nose. The nose enlargement can be very significant and produce an unsightly deformity.

In the early stages this acne can be treated conservatively by a Dermatologist.

In the later stages, the enlarging nose can be reduced in size by removing this excess tissue surgically.

This procedure is covered by Alberta Health Services.

+ How is the procedure done?

• A photograph of the face is taken the morning of surgery.
• The surgical plan is again reviewed with the patient at this time.
• The surgery is done either under General Anaesthesia or Local anesthesia with intravenous sedation.
• The excess tissue is removed from the nose and the bleeding is cauterized.
• A special gauze dressing and Vaseline is applied to the nose. The patient reapplies the Vaseline daily for 10 days.
• The gauze is removed at 10 days. The patient continues to apply Vaseline for up to 6 weeks. It may take 6 weeks for all of the the scabbing to fall off and for the skin of the nose to completely heal.
• At 6 weeks after surgery, the patient returns to Dr. Giuffre’s office. The pre-operative photos will be given to the patient and Dr. Giuffre will assess the result with the patient. At this time, the nose will still have some swelling and firmness to the tissues.

+ How often do I need to come back for a checkup after the surgery?

Postoperative visits include:

• 24 hours to remove the nasal packing
• 10 day visit to remove the gauze
• 6 week visit to review the early result and photographs
• a one year anniversary visit

If there are any patient concerns, Dr. Giuffre provides his home phone number for patient's direct access.

After the 6 week visit, if there are any future requests for an appointment, they are made directly with Dr. Giuffre office and an expedited visit is arranged.

+ What are the risks of rhinophyma?

With any surgery there are surgical and anesthetic risks.

Aside from the rare risks of an anesthetic event, some of the general and specific surgical risks for this procedure would include:

• Scarring: this is an open technique where the skin slowly heals over the treated area. This can take up to 6 weeks.
• Minor bleeding
• Swelling and bruising which can last 7-10 days
• Discomfort
• Contour asymmetry
• Pigmentation abnormalities
• Prolonged redness (erythema while the nose heals)
• Time off work (at least 2 weeks) and exercise

+ I no longer have access to my original surgeon. What can I do?

For cosmetic or reconstructive concerns, patients are invited to contact Dr. Giuffre's office (780-428-7737) for an appointment.

Dr. Giuffre does not require a referral.

There is no charge for the consultation.

+ Is the treatment of Rhinophyma covered by Alberta Health Services (AHS)?

Treatment for Rhinophyma is a medically covered procedure. There is no cost to the patient. The procedure is done most commonly as a Day Surgery Procedure at a city hospital under local anesthesia with sedation or general anesthesia.