"Dr. Sigler excels in her work ethic and skills. I had septoplasty done primarily for my allergies and blocked nasal passage but the adjustments left me with an improved appearance and most importantly I no longer suffer from terrible and chronic sinus issues and infections. I am very happy with the results. She is a caring, warm and hard-working surgeon who truly loves what she does for a living."
‍— RealSelf patient

There are two primary approaches:
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• Open rhinoplasty
• Closed rhinoplasty.

Both place incisions within the internal nostril region, and the open rhinoplasty approach adds an short and inconspicuous incision on the undersurface of the columella — the area between the nostrils). Open rhinoplasty allows better access to the surgeon for tip refinement.

In certain cases,  further refinement may be accomplished in a secondary follow up surgery.

You are an ideal candidate if:
• You are in good health
• You do not smoke
• Your pre-op lab work is normal
• You have reached your desired weight
• You are willing to follow post-operative instructions
• You are able to take 7-14 days off work to rest at home and heal

Consultation
During the consultation, your medical history will be taken in order for Dr. Sigler to evaluate your general health.  A careful examination will also be conducted.  Together with Dr. Sigler, you will discuss the procedure and communicate your desires, your concerns and the results you hope to achieve. You may bring photographs to show Dr. Sigler examples of what you are looking for. Dr. Sigler will go over details of the procedure itself and the possible risks and complications as it pertains to any medical or structural issues she sees in your case.  She will go over the type of anesthesia to be used. Once you have all your questions answered, you will both agree on a surgery plan and a proposed date. Photos are taken before and after the surgery in order to determine the amount of improvement.

Setting Your Surgery Date
A deposit is required to confirm the date and time of the procedure. See pricing and payment above for details.

If You Smoke
If you smoke, this habit should be stopped at least two months prior to surgery. This includes vaping and marijuana smoking.

Two Weeks Prior to Surgery
Review and download this list of medications and supplements to avoid. Stop taking any medication on this list two to three weeks before the surgery.  Avoid any intake of aspirin, ibuprofen, Naproxen (excedrin, Motrin, Aleve, Advil), vitamins that include vitamin E, and energy drinks as well. Arrange for family or friends to be available for assistance when you return home to recuperate. Clear your schedule. Make a list and organize your environment to be safe and conducive to bedrest. Stock your kitchen and plan ahead for a period of time spent watching TV, reading or simply relaxing.

Labwork
Pre-op labwork should be done two weeks before the surgery with your own doctor, and then sent to Dr. Sigler. If you prefer Dr. Sigler to do the labwork, you will need to make arrangements prior to your surgery date. Required labwork includes:   CBC (Complete Blood Count), CMP (Chemical Metabolic Panel), PT (Prothrombin Time) and INR, PTT (Partial Thromboplastin Time) and any other labwork specific to your particular medical condition(s), such as a Thyroid Hormonal Panel.If you are over 50, it will be necessary to have a cardiovascular assessment including an EKG and possibly a chest x-ray. Dr. Sigler will advise.

Approval for Surgery
If you are currently undergoing treatment for a medical condition or disease, a letter from your treating specialist must be sent to Dr. Sigler at least two weeks prior to the surgery stating you are cleared to go ahead with the procedure, and include any pre-op and post-op recommendations in order to avoid possible complications during or after the surgical procedure.

Night before Surgery
You are required to fast for at least 8 hours prior to surgery. Eat a lighter dinner and do not eat or drink past midnight.

Day of Surgery
Do not eat or drink anything except a little water. Allow sufficient time to get to the surgery center. Using Dr. Sigler’s car service is usually the most efficient way to ensure a timely arrival. Intake is typically scheduled two hours prior to the actual surgery. You will meet with Dr. Sigler for your pre-op consultation, pre-op photos and markings on body or face, and for a final discussion about your procedure. Paperwork is completed and final prepping by your surgical team is carefully performed.

Back to work: 7-10 days
Regular activities: 2-3 weeks
Regular exercise: one month

First 24 hours:
When you go back home you must sleep at a 45 degree angle with your head up.Avoid any physical efforts, bending over, carrying or holding anything heavier than 1lb, Avoid any sunlight and heat to the face. Continue these instructions for the first two weeks.  

First week:
You will be scheduled for several follow up visits with the surgeon for the nose packings removal, tape change and stitch removal.  Usually every 5 to 7 days.

When the nose packings are removed in two to three days, do not blow your nose and always sneeze with the mouth open.

Care should be taken that tapes remain dry so it is best to have your hair washed in a salon or by a friend, salon-style, with your head tipped backwards over a sink.

Two weeks:
While initial swelling subsides within a few weeks, it may take up to a year for your new nasal contour to fully refine. During this time you may notice gradual changes in the appearance of your nose as it refines to a more permanent outcome.

Continue following directions above and attending any follow up visits with Dr. Sigler.

One month:
Swelling will be down in one month after the surgery.
Return to your routine physical activity.
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As your body ages, it is natural to have some gradual changes to your face including your nose. But most of your improvement should be relatively permanent..