Dr. Behmand's Blog

Gigi Miller’s Patient Comment

I would like to express how wonderful Dr. Ramin Behmand is as a Plastic Surgeon. I visited his office in Walnut Creek, recently with my partner. He is as knowledgeable as he is warm and informative. I honestly can not say enough positive, truthful, wonderful things about this Doctor! I do not work for Dr. Behmand or his staff, I experienced his kind professionalism with my partner, who was his patient. If anyone reading this blog is remotely interested in Plastic Surgery, Dr. Ramin Behmand is the Doctor to have a consultation with, at the very least. You will not be disappointed, he is simply awesome as a Surgeon and person!

All You want to know about Rhinoplasty or “Nose Job”

If you’re considering Rhinoplasty in Walnut Creek, or the San Francisco Bay Area, this information will give you a basic understanding of the procedure and the process associated with being evaluated by me to undergo a nose operation customized to you. You’ll learn when Rhinoplasty or Septorhinoplasty can help you, how nose surgery is performed, and what results you can expect. It is likely that I won’t have answered all of your questions about Rhinoplasty or nose surgery here, since much depends on your individual concerns and your anatomy. However, the basic principles of Rhinoplasty or Septorhinoplasty are common to most nose surgery procedures.

Rhinoplasty, more commonly known as “nose job”, is one of the most common of all plastic and cosmetic surgery procedures. The goal of Rhinoplasty is to create an attractive nose which brings natural balance to your face. This may require work on the tip, the dorsum, the base of the nose and nostrils or any combination of these. For some, breathing through the nose may also be a problem. In such cases, I will discuss with you internal nasal surgery, such as septoplasty, to straighten the nasal septum (the internal wall which separates the airflow of each nostril from the other), or reduction of internal structures called turbinates, which may help relieve some breathing problems. We will also talk about other changes which may also be used to improve breathing.

The consultation

I find that most patients who are unhappy with the cosmetic appearance of their nose have spent a significant amount of time figuring out what exactly it is about their nose that they don’t like and, in fact, what they do like. The consultation will give me a chance to hear your concerns and at the same time examine your nose. We will then talk about a surgical plan for improving the shape and function of your nose. Age is a consideration in nose surgery. For younger patients reading this, ideally you will have completed your growth spurt. For girls this is usually around the age of 16 and for boys about the age of 18. The reason age is a consideration in Rhinoplasty is to avoid any disturbance of the natural facial growth patterns as a result of surgery performed too early. During your consultation with me in Walnut Creek, I will discuss with you other factors which may influence the outcome of your surgery such as the structure of your nasal bones and cartilages, the shape of your face and the thickness of your skin. We will talk about the techniques which I use, the type of anesthesia, and the potential risks. Our patient coordinator, Anna, will discuss scheduling, our surgical facilities in Walnut Creek and San Francisco Area, and the costs involved with you. Most insurance policies don’t cover cosmetic surgery; however, if part of the procedure is performed to correct breathing problems then that portion of the procedure may be covered either partially or fully by your insurance. My office will help you determine if your insurer does in fact provide this type of coverage for Septoplasty and other internal nasal procedures and will also help you get clearance from your insurance before the surgery.

It is important that you share your complete medical history with me during the consultation. These include your general health, history of previous nasal surgery and any injury to your nose, even if it was many years ago. I would also want to know if you have any allergies or breathing difficulties; if you’re taking any medications, vitamins, or recreational drugs; and if you smoke. Also, the consultation is the time that you get to ask your questions. Don’t hesitate to ask any questions you may have regarding your expectations and concerns about the results. You will also have a chance to go over things again during your preoperative visit to my office in the San Francisco Area. For those who come from out of town, my office can help you coordinate your pre and postoperative visits with your surgery so that you can make maximal use of the time you spend in the Walnut Creek-San Francisco Area.

Preparing For Your Surgery

In preparation for your surgery, I will ask you to avoid certain medications, limit drinking of alcoholic beverages, stop smoking two weeks prior to surgery, and avoid taking certain supplements and vitamins prior to your surgery. You should arrange for someone to drive you to and from the surgery center and to be available to take care of you for a few days after the operation. Most patients need only some help after a Rhinoplasty. Prepare your house such that you will have a place to sleep with your head elevated for the first week after surgery. You can do this by sleeping with several pillows under your head and back or by sleeping in a recliner chair.

The Surgery

I will perform your nose surgery in Walnut Creek at the Aspen Surgery Center outpatient facility. This is a private surgery center located on the first floor of the John Muir Medical Center in Walnut Creek. You will be asleep for the surgery, usually through general anesthesia. This provides maximal comfort for you during the surgery and maintains safety of your airway. Minor nose procedures may be performed under sedation. During your nose surgery, the bone and cartilage are sculpted to the desired shape. The reshaping of your nose may require controlled fracturing and repositioning of your nasal bones. The intricacies of Rhinoplasty surgery, however, center more around the refinement of the nasal tip cartilages, proper reshaping of the middle portion of the nose and delivering a balanced and natural looking nose for your face. I use both the “open” and “closed” Rhinoplasty techniques. In open Rhinoplasty, a small stair-step incision over the skin between your nostrils, called the columella, allows direct access to the cartilages and bones of the nose. The open technique is extremely precise and allows me to directly visualize the structures which need to be reshaped. In the closed Rhinoplasty, I place the incisions inside your nose. This technique has the advantage of less swelling after the surgery and is ideal for those who do not require significant reshaping of the cartilages of the nose. I will discuss with you the appropriate procedure for your nose during your consultation in my office. When your nose surgery is complete, I will apply a splint to the outside of your nose to help your nose maintain its new shape. Also, if any internal nose work was done, I will place internal nasal splints to stabilize the septum and minimize the risk of bleeding.

After Your Surgery

You may go home the same day after the surgery. If you are here from out of town, I would like you to stay the night in the San Francisco Bay Area or at a hotel in the Walnut Creek Area. You will have pain medication prescribed for you to keep you comfortable after your nose surgery. There are two things for you to be vigilant about right after the Rhinoplasty. The first is to maintain your head elevated at all times for the first week after surgery. Use two or three pillows, or a recliner to sleep. This will reduce swelling and minimize risk of bleeding after surgery. The second is to make sure your splint stays on your nose by keeping it dry. Avoid hot, steamy baths or showers as this will cause the nose splint to loosen.

After Rhinoplasty surgery, particularly during the first forty-eight hours, your face will feel puffy, your nose may ache, and you may have a dull headache. Plan on staying in bed with your head elevated, except for going to the bathroom, for the first couple of days. The swelling and bruising around your eyes will increase at first, reaching a peak after two or three days. You’ll feel a lot better than you look after the first couple of days and most of the swelling and bruising will disappear within the first ten days to two weeks. A little bleeding is common during the first few days following surgery, and you may continue to feel some stuffiness for several weeks. Avoid blowing your nose for the first two weeks after your nose surgery, while the tissues heal. The nasal splints will be removed around 7-8 days after the surgery. The sutures I use are usually self-dissolving and do not need to be removed. In the days following surgery, when your face is bruised and swollen, it’s easy to forget that you will be looking better. In fact, many patients feel depressed for a while after plastic surgery-it’s quite normal and understandable. This may be exacerbated by disrupted sleeping patterns and use of pain medication in the first few days. This stage will pass. Day by day, your nose will begin to look better and your spirits will improve. Within ten days to two weeks you’ll no longer look as if you’ve just had surgery.

Most of my Rhinoplasty patients are up and about within two days, and able to return to school or sedentary work a week or so following surgery. However, it will take a few weeks before you are back to your preoperative self. Avoid strenuous activity (jogging, swimming, bending-any activity that increases your blood pressure) until I have given you clearance. For the first six weeks after nose surgery, avoid hitting or rubbing your nose, and avoid wearing glasses which rest on the bridge of your nose for three months. You can wear contact lenses as soon as you feel like it, but once the splint is off, glasses will have to be taped to your forehead or propped on your cheeks to avoid forming a bump on your nose, until your nose is completely healed at three months. Your nose will sunburn easily in the first few months after surgery, so apply sunscreen.You will follow-up with me for about a year after surgery. After the initial couple of visits, I would like to see you back at six weeks, three, six and 12 moths after your Rhinoplasty operation. In addition to these visits, feel free to contact me at any time, if you have some concerns.

A majority of the swelling in your nose will resolve by six weeks. However, a residual amount will remain, especially in the tip area. The final results of Rhinoplasty may not be apparent for a year or more. Also, keep in mind that after your surgery you might experience some unexpected reactions from family and friends. They may say they don’t see a major difference in your nose, or they may act resentful, especially if you’ve changed something they view as a family or ethnic trait. If that happens, try to keep in mind why you decided to have this surgery in the first place. If you’ve met your goals, then your surgery is a success.

Risks

Complications in Rhinoplasty are infrequent and usually minor. Nevertheless, there is a low possibility of complications, including infection, nosebleeds, or a reaction to the anesthesia. You can reduce your risks by following the instructions that I provided above for before and after nose surgery. Occasionally, small burst blood vessels may appear as tiny red spots on the nose skin’s surface; these are usually minor but may be permanent. Scarring from Rhinoplasty is usually minor. Once the initial healing and redness of the incision resolves, in most people scars are usually very difficult to see. Infrequently, a small second procedure may be required to correct a minor deformity.

I look forward to seeing you in person at my office in Walnut Creek.

Joan’s Patient Comment

I met Dr. Behmand in February of 2003 at John Muir Hospital while he was tending to a friend who had suffered a serious accident. I was extremely impressed with both his skill as a surgeon and his wonderful bedside manner. A year later, Dr. Behmand performed a cosmetic procedure on another friend. I was again impressed with his confidence, sincerity and warmth. Her results were amazing.

I was in the process of losing a large amount of weight and knew that I was going to need plastic surgery to deal with all the leftover skin that was appearing on my body. I decided then that should I have the nerve to do it, Dr. Behmand would be the one I would see. My initial consultation with Dr. Behmand was literally life altering. I consider myself a shy, somewhat modest person. But as Dr. Behmand looked over my sagging body, he never once made me feel uncomfortable, or ashamed of what I had done to myself. He spent a long time talking with me, and really listened to my desires and concerns before we settled on the specific procedures he would perform. His professional, caring manner convinced me that I was right to do this and place my trust in him. After a nine hour extensive and detailed surgery, Dr. Behmand gave me all he had promised and more. He and his staff were readily available and attentive when I needed them those first few days of recovery. At each follow-up visit, I felt encouraged and supported by both he and his great staff.

I am now more than a year post-op and thrilled with my results. I thank Dr. Behmand daily for the gift he has given me, and know that choosing him was the best decision I have ever made.

JS’s Patient Comment

I feel the same way as the other posters: the staff is incredible, Dr. Behmand is both very kind and very talented, and the experience of care as well as the care itself was life-changing. I am amazed by the results and I feel like a new person (I had a tummy tuck, and lipo).

I think the best way to know who people are at work is to ask their co-workers. When I was in the hospital, I checked in with all the nurses I had contact with, it was obvious that they all respected his work and respected him. When I spoke with his office manager Kris, I asked her how she felt about her job. Her genuine response was that she absolutely loved it. She said she had been there for four years and she loved seeing all the positive changes in peoples’ lives. She couldn’t imagine working for anyone else.

Generally, when something seems too good to be true it usually is. In this case, it really was good and true.

I usually don’t post on these things, but I am so blown away by the quality of this experience, I feel like I need to share it with everyone.

Janice’s Patient Comment

Another happy poster.I went through a Breast Reduction surgery in October and I have had a speedy recovery. Dr. Behmand was recommended by my insurance company. That can be sort of scary. Turns out, Dr. Behmand is a great surgeon. I highly recommend him to anyone considering plastic surgery. His employees Kris and Susan were wonderful to work with. Very helpful. Before seeing Dr. Behmand I had several people tell me it could take your insurance company up to 5 years to approve a breast reduction. So I thought I would start the long haul. I had my first visit and was told it would take up to four weeks to get approval. Think of my surprise when Susan called two weeks later and told me the procedure was approved. WOW.

I had the surgery the next month (something I have wanted to do for many years now). I feel wonderful and I’m very happy with the results. I have to admit I was a little worried when Dr. Behmand told me I couldn’t go to the gym for 6 weeks. 6 WEEKS. I’ve been going for over 6 years. I’m a very positive person so I looked for the good in this. For over 6 years I’ve been telling myself, I didn’t go to the gym yesterday so I have to find time to go today, even if I’m tired or have something else to do. Wow, just think I don’t have to go to the gym for 6 weeks. I get a vacation. A vacation away from the gym. Something I decided I deserved. When I went back 6 weeks later, I had a different drive in me. I now get to go to the gym.

Thank You Dr. Behmand, Kris and Susan, You are the Best!

Plastic Surgery Patient Testimonial Walnut Creek California

My name is Margaret. I’ve been a patient of Dr. Behmand’s for two years now. Experience has been fantastic. I’m a repeat customer. I probably come between one and two times a month so I’m very pleased with his service and the things I’ve had done here. The front office staff is very friendly. I’m greeted promptly. I have usually a scheduled appointment time. That time is usually met within five minutes. I’m brought back to one of the exam rooms here and wait just a couple minutes for Dr. Behmand to come in and whatever procedure is going to be done we perform. We go over it, what the expectations are, pain level, just an all around good experience. It’s always very comfortable.

Breast Augmentation Patient Experience Walnut Creek California

I just want to thank Dr. Behmand, his assistant Chris, and his staff, for all their wonderful care. I had breast augmentation for two years now and it was the best decision I have ever made for me. I would recommend Dr. Behmand to anyone who is considering cosmetic surgery because Dr. Behmand is the best.

Cosmetic Surgery Patient Experience San Francisco East Bay CA

My name is Laurie and my experience with Dr. Behmand has been nothing but positive. I am at a point in my life where I needed some changes in my physical being and I was recommended to him by my daughter, who is a nurse. And he gave me everything I wanted in a very positive way. I wanted to look natural. I didn’t want to look like I had any surgery and I absolutely got what I wanted. Besides that he’s a delightful person and his staff is fabulous. I met with other doctors, several other doctors, thinking that that was the way to do it and once I met with Dr. Behmand I knew that I’d come home, I’d met the person that I was very comfortable with, very compatible. It was a no-brainer for me at that point and if I have anything done in the future it will be with him.

Plastic Surgery Patient Experience San Francisco East Bay CA

I was referred to Dr. Behmand by a family member who had some work done and she had such fabulous results. And so I had three children and when I hit forties I decided that it was time to go back to looking the way Kelly used to look before children. And so I came and met with Chris, and Dr. Behmand, and you know, I loved Dr. Behmand as soon as I met him, and I didn’t feel like I needed a second opinion. I had already seen the results from his work and I was very comfortable when I talked with him, and my husband came and met him, and so there was no reason for me to get a second opinion. I was really, really pleased with the results and I just saw the before and after pictures. I knew I felt better about myself after the surgery and my husband loved it. And then when I saw the before pictures I didn’t realize how bad it was. Then I looked at the before pictures, and the after pictures, and it was just phenomenal.

Male Plastic Surgery Minimally Invasive Procedures East Bay CA

Much like other cosmetic surgery patients, men also benefit from both non-invasive or minimally invasive procedures as well as surgical procedures to enhance their appearance. Things such as soft tissue fillers, wrinkle reduction injections with BOTOX, can significantly improve a man’s appearance without any significant downtime. And at the same time, surgical procedures such as a face and neck lift, eyelid surgery, nose surgery, can bring about what a man desires and feels he should look like but does not when he looks in the mirror.

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Ramin A. Behmand, MD, FACS
1776 Ygnacio Valley Rd., Suite 108
Walnut Creek, California 94598
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Phone: (925) 939-9200

To learn more about plastic surgery, contact our Walnut Creek practice near San Francisco.