Behind the Double Doors: I Thought About My Nose for 20 Years – Andrea’s Rhinoplasty

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Since her 20s, Andrea was self-conscious about her nose, often tilting her head to the side to hide its asymmetry and bulbous tip. For decades, all she could see in the mirror was that flaw. 

By her 40s, she was mentally and financially ready for rhinoplasty. After rhinoplasty with Houston facial plastic surgeon Dr. Taylor DeBusk, she sees her entire face in a new way.

As a teacher working face-to-face with people, Andrea spends a lot of time making eye contact. Feeling confident in her appearance has transformed the way she connects with others.

Before surgery, people always told Andrea she looked just like her dad… not exactly what a girl wants to hear. Now, she has the best of both worlds—the nose she always wanted while still looking like part of her family. 

Read more about Houston facial plastic surgeon Dr. Taylor DeBusk

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See Andrea’s before and after photos:

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Transcript

Dr. DeBusk (00:11):
Welcome back to Behind the Double Doors. I’m Dr. Taylor DeBusk, and today on the podcast I’m interviewing a past rhinoplasty patient of mine. Her name is Andrea. Thanks for joining us, Andrea.

Andrea (00:22):
Thanks for having me.

Dr. DeBusk (00:23):
Just in regards to your rhinoplasty, what made you want to move forward with nasal surgery or what made you decide to eventually pursue rhinoplasty surgery?

Andrea (00:33):
Well, I had always had an issue with my nose ever since I was about in my twenties. Once my face became what it was as a woman, I just kind of ignored it, always turned my head to the side for pictures and smiling at people. Once I got to where I was in my forties and I could afford it, I really wanted to do it. It was a priority for me.

Dr. DeBusk (00:56):
Yeah. So how long ago was your surgery?

Andrea (00:59):
It was a little over a year and a half ago.

Dr. DeBusk (01:02):
One of the biggest things with rhinoplasty surgery, I feel like patients really need to know, understand, and aren’t necessarily aware of is the recovery. Tell us how long your rhinoplasty swelling occurred. Did you notice that the swelling improved in stages and now that you’re over a year out, do you feel like there’s been a big difference from the first couple months till now in regards to the swelling and recovery?

Andrea (01:27):
Yes, I was surprised. I knew it was supposed to take a year or two to take its full effect, but it was really like a year and a half when it was still swelling. And I suppose that was about really three months ago. So my surgery was in August of 2023 and now it’s March, 2025, and it wasn’t until about December, so about a year and a half after the surgery date, that I felt like the swelling was done, and I knew that because the numbness had gone away. But that entire time, even though I loved the look of it more and more, and I started to be able to breathe through my nose unlike I had ever had before, I knew it was better. I could still tell that there’s something left that hasn’t really healed yet because it just felt a little numb. It didn’t hurt. It was still a work in progress. Initially it was so swollen and I have to say, looking back at those pictures, they kind of make me laugh. I mean, I remember when I first saw my nose, I was kind of shocked, but even after a couple of weeks, I started feeling like it looked better than it did, I think because I was just so ready for something new. I was just ready to see a change and it sure had changed.

Dr. DeBusk (02:46):
I know I feel like a lot of people see on social media, the cast reveals or the immediate rhinoplasty results 7, 6, 7 days after surgery, and that’s not necessarily the true for every single patient because everybody bruises, everybody heal, everybody swells differently. That can be misleading. And for me as a rhinoplasty surgeon, I always try to prepare people for the swelling, especially as soon as we take the cast off. This is nothing like the final product. You have to be aware that the nose will be swollen. You kind of have to trust the process and as a patient going through it the first time, not really knowing what to expect. I know it’s different for everybody, but it can be a little bit startling when you see your nose as soon as that cast comes off. So now that you’re year and a half out, are you satisfied with how the nose, the swelling has come down, the overall shape, the changes that were made?

Andrea (03:39):
Absolutely. I love it. I love it. I love what you did. I’m really grateful. I am so proud and confident and happy with my new look. The shape that you were able to make out of what I had, it was exactly what I wanted. I remember I definitely wanted to be able to breathe better and I wanted some of the obvious flaws taken care of. So I had a lot of asymmetry. I had a bulbousness to the tip of my nose that bothered me, and you helped also with a bump on my nose, so that was kind of a bonus. But really right before the surgery I was looking at wishlist type model photos, and I was like, it’d be really cute to have a little button nose, and I brought that to you and you said, well, I’m not sure if I can, but I kind of liked the idea of just something extra and I feel like it did happen and I’ve had even somebody do a little boop on my nose and I’d never experienced that before in my entire life. It’s pretty cool that you were able to not only take care of the flaws, but really give me something extra special. So thank you so much.

Dr. DeBusk (04:46):
Yeah, no, I mean, my pleasure. Rhinoplasty, kind of the stigma associated with nose jobs or nasal surgery is that every nose ends up looking over scooped, really pointy, over rotated, kind of the who nose. What people are seeing now is you get a very natural nose, natural shape, not that kind of rhinoplasty look, which I think is really important. And I think people need to realize that the nose doesn’t necessarily change your face by any means, but it can really compliment your other facial features.

Andrea (05:17):
I mean, I just look at my face completely differently now. I used to only just look at that flaw. Unfortunately, I feel like as a woman you’re always trying to fix things. So first I had to fix my acne when I was a teenager, and then as I got older I’m looking at facial creams and how to take care of the wrinkles, and I was always just looking at this spot right there in the middle. So I certainly don’t anymore. It’s really nice to just get to look at myself in the mirror and have a more productive conversation.

Dr. DeBusk (05:49):
The nose is something that typically we see people really think about for a long time compared to facial aging or facelift surgery because like you said earlier, once you hit puberty, you develop the nose that you’re going to have for the rest of your life, which can be vastly different than it was in your adolescence. So by the time people are ready to pull the trigger for many different reasons, they’ve been thinking about it for quite a while as opposed to all of a sudden they start to see these age related changes to the face. So the threshold to pull the trigger on, that’s a lot lower. Whereas with noses, people tend to want to think about it longer because it’s a big thing. It’s right in the middle of your face. You can’t really hide that thing.

Andrea (06:28):
Do you feel like noses get more bulbous with age?

Dr. DeBusk (06:32):
So what happens as we age is your skin on the tip of the nose can change, can potentially get thicker, but what does happen is the cartilage at the tip of the nose starts to actually drop or fall and it can give it a more round or bulbus shape to it or that droopiness. So with rhinoplasty, by really reinforcing that ligament that holds the cartilages to the tip of the nose not only resets the clock on age related changes to the tip, but it really prevents some of those droopiness that people tend to develop as they age. So in regards to recovery, how would you say the first week or month went in regards to pain, pressure, discomfort, and then when were you able to get back to work or feel like you were able to get back to your normal daily routine?

Andrea (07:17):
It interrupted my life way more than I expected. I’ve had surgeries before and this was something that was just so major. The pain was severe and the medication was fine, and I went off of it in about maybe five to seven days, maybe it was a week or two, I don’t know, but it wasn’t a long time, so I was fine with just you’re over the counter medication. It was just having it on my face and not being able to go out and do the things that I normally do. I am a dancer and choreographer, so I take my look everywhere I go and people are looking at me because I’m out there dancing and getting attention. So I had to stay private and not work for three or four weeks before I felt like it was a bruising, put a little makeup on, I was fine. But I remember the first few weeks I felt like what I did to myself was just so beyond what I ever would’ve imagined. Going in there and doing that to my face. It wasn’t traumatic, it wasn’t like that, and I didn’t cry about it and I didn’t regret it. I was just overwhelmed kind of feeling like, I can’t believe I did this. Knowing it was worth it and it was going to be over, but it was like I didn’t realize how big of a deal it was.

Dr. DeBusk (08:33):
Yeah, totally. And I talk about that with you with every rhinoplasty consultation is that this is something you have to be all in on and for and be prepared for the recovery. And everybody’s recovery is different. Some is easier than others, but the nose is a big deal. It’s technically very challenging as a surgeon because every nose is different. You’re dealing with bone, cartilage, skin, muscle, mucosa, all these different things. You want it to look great, but you also need it to work well. So I tell people, if you’re on the fence, this isn’t something that you just do on a whim. This is something that you have to be all in for and on because yes, the immediate recovery, your nose, you have to breathe out of and if you can’t breathe well out of it during that first week or two when things are swollen, it has a pretty tremendous impact on your day to day, your quality of life.

Andrea (09:23):
Before surgery, I was really just a mouth breather. I could barely get a breath out of my nose. So that wasn’t anything new to me, and really that was just all improvement from the time the swelling started going down.

Dr. DeBusk (09:34):
Yeah, well you had those big old splints in there too, isn’t that?

Andrea (09:37):
Oh yeah. Well, that was weird.

Dr. DeBusk (09:38):

Andrea (09:42):
Even though when my nose was swollen for a few months from August to maybe November where it felt kind of clownish and I really didn’t like the look of it, I was really used to having a nose that I didn’t like the look of whatever it looks like this instead of what it looked like. It wasn’t a big difference. It was different, but it wasn’t like I didn’t feel like I went from 10 to a four or whatever. It was just like, ugh, my dumb nose? But eventually it all worked out.

Dr. DeBusk (10:10):
I dunno if you recall, but I usually tell people at one week you’re not going to like it. Typically, nobody likes it at a week. At a month, the swelling’s starting to come down. Most people can’t really tell that, didn’t know you had a rhinoplasty, that you had a nasal surgery. But when you look in the mirror, all you see is a round tip, like a ball at the end of the nose, and then once you hit that third, fourth month, things start to really improve. You’re starting to see the shape. Then it’s a more gradual improvement from that fourth month into that 12/18 month timeframe. And like you said, you’ve noticed changes really all throughout that 12 and 18 months. And do you feel like as the swelling has really subsided, gone down, you started to get all the sensation to the back of the tip of the nose. That’s really helped your confidence or changed the way you feel about people see you or the way you look at photos of yourself?

Andrea (11:01):
Definitely. Yeah.

Dr. DeBusk (11:03):
Good.

Andrea (11:04):
Absolutely. Yeah, I feel more balanced and younger. Being a dance teacher, I teach couples how to dance and so I am just face to face with people all the time. Dancing, it’s a beautification process and you’re also constantly making eye contact and making faces at each other, and I feel so much better about everyone looking at me, which they’re going to do every day when I go to work and every night when I go and perform. Yeah, it just feels amazing. I know I look better and, not to brag, like thanks to you, I feel like I look really, really nice. So definitely the best I ever have and it’s awesome.

Dr. DeBusk (11:42):
As a rhinoplasty surgeon that gives me the most joy, seeing the confidence that it gives people, patients. Knowing what you know now and what you experienced, going back would do it all over again?

Andrea (11:54):
Yes, I would just do it sooner.

Dr. DeBusk (11:57):
Yeah.

Andrea (11:57):
I would sooner, yeah, for sure. I had saved up a bunch of money to remodel my house and before I pulled the trigger, I decided I was going to do myself first. If I could go back to when I was in my twenties and I first felt like I wanted to do this or I started feeling that insecurity about it, I wish I’d just saved up and done it then. Because it just would give me longer to enjoy it. That being said, I feel like being in my mid forties has also given me a lot of experience to be able to appreciate what’s happening now. I know the way people respond to me and look at me and I have a lifetime of experience so far that helps me appreciate the difference that this has made, how I feel and how I present and how I’m received.

Dr. DeBusk (12:46):
I mean, taking all that into account, what would your advice be to anybody that is considering rhinoplasty, that’s been thinking about it or just started really thinking about changing their appearance or changing their nose? What advice would you give those patients?

Andrea (13:00):
Like you said, it’s something to take very seriously, so that for sure. That being said, if you know want to do it, you should go for it. Act now, don’t delay just because it’s something you’re going to get to enjoy for the rest of your life. Find it like a friend that can really take care of you during the recovery process. Just know that this is going to completely side line you and you cannot do it alone. I have two children who were seven and 10. They were helpful and they were understanding, but I could not have done it without my mom’s help, and I definitely needed somebody to look out for me too.

Dr. DeBusk (13:42):
And it’s a lot and it really takes a lot of energy those first couple weeks because your body’s focusing all of its energy on healing your face from recovering. So I think you make a good point. Having somebody there help you on a day-to-day because you’re exhausted, especially when you have the normal obligations of day-to-day life. Having that extra support I think is really crucial in the recovery process.

Andrea (14:06):
Also, I think just in looking for a doctor, I did talk to different doctors and I got different plans on what could be done with my nose and my breathing issues, and I felt like I really connected with you because of the artistry that you brought to the conversation. You had creative ideas and you had a vision for my face that you were able to describe clearly to me, and you did pull it off. I just feel like that’s something that you want to feel like you’re really working with that kind of craftsmanship, that idea, someone who’s really got a vision for you. If you can’t say it, how are you going to be able to do it? Talk it through.

Dr. DeBusk (14:41):
No, no, I appreciate that. And I think that like I told you, and I tell every patient, you have to one, be confident in the surgeon you’re choosing, for obvious reasons, but two, this is for you and for me, this is at least a 12 month relationship that we’re both embarking on as soon as we make that first incision. You have to make sure that you’re comfortable and confident in who you’re choosing. And it’s taboo to say in plastic surgery that you should shop around, you should consult with as many physicians, make you comfortable proceeding forward. But I tell people that regularly, you need to do your research, your homework, and you need to be comfortable and confident with whoever you decide to choose. And then in regards to the breathing, you said you had some difficulty breathing before, and then though you were doing the surgery for cosmetic changes, but also to improve your breathing. Were you able to notice a substantial improvement in your breathing at night, during the day? Has it improved your quality of life?

Andrea (15:36):
Yeah, so it started about six months post-op that I started breathing through my nose, and I never have. I am a runner too, and so I dance and I run and I’ve just always breathed through my mouth. I have an ENT, I’ve taken lots of different medications. I’ve tried all these things to try to be able to breathe easier as I do a lot of cardio, but this is the first time that anything’s worked. It’s nice to be able to just go for a run and breathe through my nose. I never really, I just can’t imagine not doing that now. But before it was impossible. And now also it gives me more expressions, because I use my face to express myself on a day-to-day basis, but also in my art and I don’t have to have my mouth open at all times now. I can make different expressions and that’s pretty cool too. It gives me a little more versatility.

Dr. DeBusk (16:27):
I tell people always that it doesn’t matter how good the nose looks, if you can’t breathe out of it, you’re not going to like it.

Andrea (16:34):
Right.

Dr. DeBusk (16:35):
So in regards to the changes that you wanted to make to the nose were, a lot of times people say, I want the bridge to be improved or improve the contour, but I don’t want it to completely go away. I kind of have the same shape nose as my mom or my dad. And people are weary of making too drastic of a change because they don’t want to look like they don’t belong in their family or they don’t have the same nasal characteristics as their parents. Was that anything that you were concerned about or were there any things with your nose that you didn’t want to change too much?

Andrea (17:07):
Definitely growing up, I was always told I look exactly like my dad. And as a girl that doesn’t usually feel like a compliment. I definitely had his nose, but I wouldn’t necessarily want my mom’s nose, but I didn’t want, his nose was a pronounced feature on his face. I wanted that change, but I didn’t want a standard nose. I didn’t want to go up to a shelf and just pick the perfect nose and put it on my face. I wanted my face and my family’s look and I don’t want to look generic or whatever. I just needed some things de emphasized and made more symmetrical. Those were improvements. Even though I don’t have what I started with, I still feel like I fit into my family’s facial features. I think I might have the best nose in the family now. I don’t think anybody really cares. They’re happy for me.

Dr. DeBusk (18:00):
Well, I agree. I think you’ve definitely got the best nose. One thing that I realize that is very consistent with patients during the initial consultation is that your understanding of the nose in the different parts of the nose changes significantly during our consultation and definitely after rhinoplasty. Do you feel like you had a more detailed understanding of the different parts of the nose after we talked or even more so after you had surgery?

Andrea (18:30):
Oh yes. We just, as an artist, you have the language. So not only the technical components, but also just the way you describe the words you use, the adjectives. So I mean, all of that was completely new to me. You were able to suggest things that I didn’t really think about. I don’t know how to solve this problem. I’m not a sculptor, no idea. I just know it’s like there’s a problem here. You gave me the words and that vision, and it was exactly what I knew I wanted, which was beautiful, but I didn’t necessarily know how to do that.

Dr. DeBusk (19:03):
My main role in the consultation or meeting patients is really teasing those things out, trying to figure out what you’re trying to say, but people don’t necessarily know how to describe it because all I do is face, majority rhinoplasty. Trying to figure out what you want and decipher that and relay it back to you in a way that we both understand, I feel like is a challenging, but probably the most fun part about rhinoplasty surgery. Always a challenge, but always so gratifying once we are eventually on the same page.

Andrea (19:34):
And I think me coming back to you later saying, how about a button had to do with that? You open me up to looking at these things different, finding what it is that I want. You have three ideas, and then after you told me about those, I went away and kind of was like I got another idea about my nose. And I never had any idea going into it about any of it. And I love that part of it. And that’s something that I certainly, I don’t think it would’ve been on the shelf if there was a shelf. I just saw it in the world and was like, that’s something that I think is so cute. So yeah, you got me really interested in noses.

Dr. DeBusk (20:08):
They are interesting.

Andrea (20:09):
Yeah. Yeah, for sure. So what I see here are my before pictures, I can see at the tip of my nose in the first one, my left side is lower than my right side and pulling my face down in the middle picture, you can see that the end of my nose is going out and around. That’s that bulbousness. It kind of has a ball in it. There’s a pretty significant ridge in the middle at the tip. In my right picture, there’s a little bit of a bump. So those are the flaws I see. I mean other than that, it looks okay.

Dr. DeBusk (20:48):
Yeah. So on the far left, in the first frontal view, you can see the tip. I agree, you have a little bit lower of what we call the infratip lobule or the nostril in your left side. And when you look at the white, the reflex of the whiteness up the tip, you could see how the one on the right is a little bit more broad. On the left it’s a little bit sharper. And then in your oblique view, I think that you’re able to see a little bit more pronounced of that bulbous shape or that bulbous tip. You can see that there’s separation of the cartilage right in the tip of the nose, which just accentuates that round shape. And then in your profile, you can also see because of the shadow, more of that bulbous roundness to it. There isn’t a very sharp or pronounced tip defining point. And then also you have a very subtle kind of dorsal convexity on the bridge. And those are all the things that we kind of talked about during the initial consultation.

Andrea (21:45):
So this is my very soon after surgery post-op picture. This might’ve been a week or 10 days out. I just don’t understand how I was smiling in this picture looking on it, but I really was honestly smiling in the moment. It’s like, yep, this is me. I’m making progress and I’m doing something. I liked how you can already tell that there’s an up turn to my nose. So this is especially prominent in the last picture, but the oblique one, too, and that was something I haven’t mentioned yet, but I was interested in having that up turn as opposed to it did kind of stay even or go a little bit down previously. So I was already excited about that. And then you told me the swelling was going to go down, so I just was hoping for the best.

Dr. DeBusk (22:33):
Yes. So I would say you were a little more swollen than the average person. You can see on the frontal view is very broad. The tip is very broad, very asymmetric. Even though with the surgery we tried to make those nostrils as symmetric as possible, the swelling made it look even more asymmetric than before. On your oblique view, there’s not really much definition to the tip. You still have a whole lot of swelling over the bridge of the nose, and it is in that potato phase of swelling. And then on your profile you can see, yes, the nose may look even exaggerated in how up rotated the tip is. You still have a ton of swelling on the bridge and on the tip, and there’s not really a great transition point between the bridge and the tip. Which is common, especially at that first week, there’s so much swelling that you can’t really see those subtle relationships or those fine relationships between the different parts of the nose. And this is always concerning at a week. So that look of fear in your eyes is totally normal.

Andrea (23:39):
We went through it.

Dr. DeBusk (23:41):
We did.

Andrea (23:42):
Okay. This is probably six months out, I’m guessing. I’m pretty happy at this point. I was really feeling like the symmetry had come together, the bulbousness was gone. I was really happy with it. I mean, I just felt like my profile was super cute. It had a little up turn, it was smooth on the way down. I was just absolutely thrilled at this point.

Dr. DeBusk (24:04):
Yeah, I think this is actually your three month. I was just looking.

Andrea (24:07):
Oh, just three months. Okay, cool.

Dr. DeBusk (24:09):
Yeah, yeah. So three months. This is where you start to see the bridge swelling coming down or the bridge swelling has come down nicely, but the tip stills a little bit swollen. I think on your frontal view you can see that you have the white reflexes or the reflection of the light on the tip is much more symmetric. You have more symmetry of the nostril height on both sides on your profile. You can see the bridges come down a lot nicely. You can still see the tip definition, how it’s a little bit more up rotated than the nose was prior to surgery, but there’s still a little blunting between the tip definition point and the bridge. But overall, you’re really at this point starting to see the shape of the tip, the overall shape of the nose, and it’s a massive improvement from one week out.

Andrea (24:57):
So this is my full before and after as of yesterday, and I’m loving it. I just feel like I see that symmetry that I really wanted in the first place, and the thing that’s been bothering me for 20 years is long gone. If I could, I would just boop my nose right now.

Dr. DeBusk (25:18):
Yeah, I agree. I think the biggest difference, especially on this view, is the tip. When you look at again, what emphasizes those white reflex on the tip is much more symmetric and the distance between the two as well as the shape is almost perfect. And then you look at the nostril shape is much improved, as much more symmetric. And then you also look at the bridge in the middle of the nose, the white reflex is much more symmetric. So you don’t look like a different person, but you definitely, all these small, subtle changes are really synergistic and do make a big difference. Even though, like I said, you don’t look like a totally different person, you just look refined. I think when people look at the before and after, their eyes don’t necessarily go to those subtle asymmetries. Now you just look good. You looked good before, but now you look great.

Andrea (26:10):
Thank you.

Announcer (26:18):
Basu Plastic Surgery is located in Northwest Houston in the Towne Lake area of Cypress. To learn more about the practice or ask a question, go to basuplasticsurgery.com/podcast. On Instagram follow Dr. Basu and the team @BasuPlasticSurgery. That’s B-A-S-U Plastic Surgery. Behind the Double Doors is a production of The Axis, theaxis.io.