To doctors Michael Elam & Jacob Freiman in response pertaining to aggressive/unsatisfactory nasal surgery

By lwfm on 30 Dec 2011

Well, in my view (upon reading of many similar experiences & having some doctors admit to the POSSIBILITY of hair loss from the nasal surgery- as it hardly seems coincidental if it was a non factor prior to the surgery), of course there is no "proven correlation" as no one would want to be the "pioneer" of admitting this such 'discovery', of course.. That would be another of many risks & complications which your profession would be looked at to explain or as being held responsible for if permanent shedding hair loss was a recognized problem & risk of nasal surgery. Here are the factors pertaining to my specific situation relating to the hair loss I've continually experienced post op: a considerable amount of my nasal spine was cut out, leaving the septum leaning much to far to the right, nasal wall (egg shell feeling collapse) gone on one side, as well as valve collapse & my turbinate being completely removed also. When you can't breathe adequately out of either or both sides, I could understand how it makes sense & validates the other accounts around relating hair loss (amongst other cosmetic/life quality problems) resulting from nasal surgery. Site will not allow responses/follow ups to question responses, so had to go this route.

Comments (6)

Jacob Freiman, MD 20 Jan 2012

Thank you for the follow up. What did the doctor who performed your surgery say about your problem? Was he a plastic surgeon certified by the American Board of Plastic Surgery? It is possible that there is an association between change in airflow in the nose and hair loss but I do not know any research first hand. In no way was I trying to belittle your discomfort. In regards to the assumption that plastic surgeons try to hide complications, I can only speak for myself, but I strongly disagree. The preop consent that my patients sign are 12 to 20 pages long and go through every possible documented complication. In regards to charity work, I have led missions to Haiti, Vietnam, Cambodia, and Peru not to mention rarely getting paid for emergency room work in the U.S. There are many hard working plastic surgeons like me who truly care about their patients.

View answers from Jacob Freiman, MD

lwfm 21 Jan 2012

Yes he certainly was certified, that credential does not always compensate or guarantee quality care & expertise in the specific rhino-realm though or even honor unfortunately- pertaining to my particular horrid experience with the aforementioned scenario. I also appreciate your response & general acknowledgement of the airflow alteration and possibility of hair loss relating to this amongst many other potential & definitely existent complications. I never received a consent form that long or thorough with this surgeon, and unfortunately the particular doctor that botched my job had in retrospect, proved to show that his only major concern & attention to detail was making sure that the payment was received in full and cashed before he performed his 'operation' on me. That is very nice to hear about your genuine care & foreign involvements that are not money-motivated, sure wish that was readily offered & available here... I have obviously had many sour experiences within the field, as it took me seeing many, many local doctors in appointments post op to hear only certain bits & pieces of what was all done incorrectly, or just some that would outright discredit the work while offering no details of what was done as well as not offering their own services to remedy; Or many in the larger majority (especially general otos) would act as if nothing was done wrong at all, while also more often than not- asking me in a weird tone of voice "who performed the surgery on you?!", as they did not want to badmouth a peer or yet others that would tell me that i "may need a rib cartilage graft down the line" which many cannot do & good luck getting insurance to cover it as I'd found from my continual research. It also seems that in hospitals/universities, a general ent or plastic surgeon will more readily refer you to the rhino experts within their departments as opposed to a private practice where they are just performing it themselves whether or not they are able provide the best quality result. Another big peeve of mine that i have come to experience, has been in finding that many of the review sites around seem to very readily remove bad or negative performance reviews on doctors very quickly and without explanation; That is important & hurtful to the general public as it is the patient's only real resource to get uncorrupted reviews or detailed experiences about physicians & their general quality and performance record, yet when we can't find out about potential events or ratings that would raise concern, how are we supposed to better prepare on what to look for, know whom to go see & let alone trust, you know? Can be very frustrating & misleading at times, but at least not with sites such as this around. I guess most devastating to my own self respect (besides the cosmetic issues resulting from) was when I actually became slightly desperate enough to indulge when these doctors whom intended to repair nothing would tell me it was psychological, yet I seemed to be alot happier and peaceful without these problems PRIOR to the procedure; I just could not ignore some of the comments and recommendations that the willing to address (verbally atleast) did make pertaining to the nose work.

lwfm 9 Jan 2012

Yes, was already well aware of this approach to remedy that, as I was forced to do lots of reading and research when very few would be straight forward about what was all done wrongly to me. Unfortunately for me in reality they screwed my nose up in such a multitude of ways that it is quite a tall hurdle to get over in correction(s). Even besides affordability because of the lack of accountability & the very unlikelyhood of the doctors in this realm EVER wanting to do 'charity' work- It's finding a "specialist who can & will do it all at once with the right approaches as many have different solutions of course, then dealing with them fixating on the 'cosmetic-card' the ins cos play and wanting their money I cannot afford to remedy all that's been done. Whew, no fun

Angiemcc (Community Manager) 8 Jan 2012

Hi there,

I did click over to that site. It looks like a very unpleasant condition. I didn't see anything about hair loss, though I was only on the site for 5 to 10 minutes. It does look like turbinate surgery is difficult to reverse, but here's what some doctors have to say about too much airflow after an aggressive turbinate reduction. I hope you find this comforting.

lwfm 5 Jan 2012

I must disagree, because if you read around about empty nose syndrome- there's multiple websites such as emptynosesyndrome.org (a Christopher Martin even wrote a book about the subject), & it is referred to as an "iatrogenic condition" in which the turbinates have been aggressively over-operated on. Amongst the various negative effects resulting are: a constant dryness, crusting, an air resistance breathing issue affecting sleep/life quality which is also noted is hair loss & potential skin issues (which I believe is why lots on Ent's readily refer unhappy patients to dermatologists). My hair is not genetically in an alopecia or a receding/balding type state, though sheds too thoroughly when in the midst of normal combing- post op, and has more just overall very noticeably thinned out & unhealthy looking all over and not coming back- in effect causing bladness, just not in the "traditional way" i suppose. This was a complete non-factor be4 surgery as my hair was very thick & even felt different texture-wise (in a positive way) prior too the surgery, and much like the slight facial cosmetic disfigurement & head tension, offset eyes post op, can only be attributed to the nose job as repeated blood work and physicals show no other reasons or concerns. So I must say timing is not the factor. If a 5 year old operated on someone's nose (not knowing or caring what in the world they were doing), i am sure that it would be worldly recognized & official that all the crazy unorthodox problems possessed afterwards were from such a surgical-assault, and I must believe in the same with potentially careless (or inexperienced) physicians, despite hoping against & not wishing to recognize such atrocities.

Angiemcc (Community Manager) 5 Jan 2012

Hi there,

I just read the question you're referring to here. I'm sorry you're experiencing hair loss. That sounds very frustrating. I'm not a doctor or even a nurse, but it seems likely that your hair loss is not related to your rhinoplasty and that it's an unfortunate coincidence that started around the same time.