Revision Rhino for Hump Nose, Tip Bulkiness and Slight Tip Asymmetry

I had first Rhinoplasty around 3 years ago. My...

I had first Rhinoplasty around 3 years ago. My original nose had big hump, wide nostril and big tip.... I went to get it done by board certified MD doctor with 15 years of experience, but I have to be honest, his not a bad person or anything but he isn't the most personal doctor out there... he didn't give me any computer generated after pictures, or any illustrated idea of my after-surgery nose. All the details about what I want for my nose, I had to just tell him verbally, and he just nods his head and goes "ok" "uh-huh" "I will try my best". Now I look back I should been looking for other options of doctors.
The cost was $5000.

My nose did improve, but there were still visible hump, still bulky tip, and the worst part is the tip was slightly tilted to the left. Although the tilt wasn't very visible unless I take close-up pictures, I still was unhappy with the result. Doctor told me he thought he did a great job and he even have my before and after picture in his folder for his patients to see, and he doesn't understand why I'm not happy.

After a year of my first nose job, he told me he can do revision surgery for $1500. I was busy for awhile, but a month ago I finally made my mind up to do revision Rhinoplasty.

Same communication problem with the doctor still remained. I can only talk to him about what I want, and I really don't know if he gets it, or if me and him are in the same page. Like the phrase "Making the tip smaller" can be interpreted in so many different levels.

Right before surgery, I even asked him if he can do a little sketch of how my nose look right now, and how my nose will look after surgery, but instead he just repeated what I told him already.

Maybe I should been going for another doctor for a revision surgery... but I couldn't afford for another $5k+ for what I was spouse to get for the first operation.

****

The revision surgery was performed on last Tuesday (7/31/2012). I'm on the 3rd day post op now. The tape under the splint already came off, party due my oily skin. I called the doctor and he told me splint is just for protection so I should be fine, but I just have to be careful not to hit my nose.

I'm pretty happy that my hump is finally gone, but the asymmetry of the tip seems even more severe then before. It seems as if my doctor took out too much cartilage out of the left side of the nose.... and the tip seems little too pointy. But then, I know its way too early to determine the result. Top part of my nose (and between my eyes) is very swollen, and the whole nose is squishy, so I can tell there is still improvement... but I'm still so so nervous. I can eat and drink just fine but my anxiety is making me lose my appetite.

I put some medical tape over it my nose so I won't feel anxious when I look at my nose in the mirror. With the tape on, I don't see little details, and overall shape looks pretty good... so it makes me feel lot better.

I'm trying to feel better now by reading other people's review. I look for stories about people not liking the result at early stage but liking it later. I just want hope....

I will keep updating as I see changes xD

I mentioned that my nose was tilted to the left...

I mentioned that my nose was tilted to the left after my first Rhinoplasty, but I must correct my self, I did already have an asymmetrical nose before surgery. I was just disappointed that it wasn't corrected.

Post op day 4. Alot of swelling between my eyes...

Post op day 4.
Alot of swelling between my eyes went away, but the inner eyelid still looks puffy and whole nose is still squishy as well.
Can't wait for the swelling to go away gradually.

I feel lot better today and I'm worrying about my result less, which is great because I was nearly panicking yesterday and day before yesterday xD
Reading people's reviews and Q&As in this website really helped, because it let me know how asymmetric the nose can look during recovering time (especially with revision surgery), and how it would improve overtime after swelling goes down.

Post op Day 6! I can tell swelling is getting...

Post op Day 6!

I can tell swelling is getting better and better everyday.
Last night I finally washed my hair with help of my boyfriend.
It was about time lol

Tomorrow morning I finally get my stitches off. I'm very exited!

Only thing that I'm concerned about my nose, beside the little asymmetry I still see, is that now I got rid of the hump and reduced my tip, the middle of the bridge seems to be slightly coming out instead. But then that could be caused by swelling as well. I will be patient, and see how this will turn out.

Got the stitches off today! Wooo! I wore light...

Got the stitches off today! Wooo!
I wore light make up afterwords (powder+eyeliner+mascara+brow only) and was able to go outside and grocery shop.
It felt good to finally go outside!

After the stitches are off, there is no visible scar on the columella, except there is a little scab.
Nose bridge & and tip is still quite numb.

So far, I like the shape when I look from the side/diagonally....
But when I look from the front I feel like the tip is too narrow for the width of the bridge, and again, little asymmetrical.
Doctor told me it's still quite swollen, so I will have to wait couple more weeks to see if it gets better.
I hope bridge looks wider then the tip only because it's swollen!

Some parts of nose still have slightly dark bruises, which looks like a shadow and make my nose look deformed under certain light. xD Maybe that's making my tip look more asymmetrical as well. I don't know.

I just have to be patient I guess xD

*Correction for earlier post* I wrote the tip...

*Correction for earlier post*

I wrote the tip is too narrow compare to bridge, but actually the tip itself isn't narrow, but I guess the better word is the tip is sharper/ pinched compare to the bridge. It's hard to explain by words and it doesn't show well in the pictures.. lol

Post op 9 days! Yesterday and this morning I...

Post op 9 days!

Yesterday and this morning I was very worried about my surgeon taking out too much cartilage out of side of my tip, making my tip look sharper then the upper bridge of my nose.
My Ideal shape is like this )( with tip being slightly wider then my bridge.
But comparing my current nose and before revision nose, seems like my bridge is even wider then it was before. And revision included hump removal.
So it must look like this because of my bridge being swollen from bone fracture.. It should become slimmer over time...
I'm telling myself that, lol, so I will feel better.
I really hope that's the case.

Post op 12 days. 2 more days until 2 weeks...

Post op 12 days.
2 more days until 2 weeks.

Swelling is getting better, but the asymmetry of the tip seem to show more because of that. And since my tip is narrowing due to less swelling, the bridge appears wider... overall my nose seemed to look more deformed then couple days ago.
(You can see my new pictures to see what I'm talking about.)
I'm very scared. I have a feeling that dent on my tip is permanent (it was there ever since I did revision and it's only getting worse) but I hope the bridge looks wide because of the swelling and it's just healing slower then the tip....

I asked about this on Q&A, but it made me feel hopeless when a doctor told me "Tip usually heals slower then the bridge".... Does that mean my tip will become more narrow and my bridge stay this way? I'm praying to god not.

When I did my first Rhino 3 years ago, I don't remember my nose looking dramatically different after 1-2 weeks. I know this time it's revision surgery so it heals slower, but I just feel so scared.... and sad.... I just hope all the money and time I put in to this is not going to be wasted.

Since I was so nervous about my result, I made an...

Since I was so nervous about my result, I made an appointment with Dr. Kim on post op 15 days. I was able to book an appointment for day after I made a phone call, so I was pretty happy about that.
So I met my surgeon again, and when I pointed out couple things I'm worried about my nose (like prominent upper bridge, uneven dents and such), he kind of got mad and raised his voice, and told me "It won't get any better then this, You just have at accept it, and LIVE WITH IT." I was little shocked, I was not really trying to complain to him or anything, I came to asking him if it will get better overtime with healing. When I asked him if there's still alot of swelling left, he told me about 90% of swelling went down and 10% is still remaining. I guess my nose won't get any better then this from this surgery :(

Now I have anxiety attack just thinking about my nose.
I have to admit the new picture I posted (The one that says "post-op17") I took it with my iPhone, and it makes my nose look little worse then how it looks in real life under natural light. And the flows are lot less noticeable when I take pictures with little more distance. But still.... I wouldn't call Rhinoplasty a success if I can't take close-up pictures with strong flash.

Now my only hope is to get injectable fillers so I can cover these dents, atleast as a temporary solution. I might get a revision after more then a year... if I do, I will make sure I will get best revision surgeon possible.

Atlanta Facial Plastic Surgeon

I guess the most problem I had with Dr. Kim is communication. I had absolutely no visual idea of what he is going to do to my nose. I can only tell him what I want, and he just goes "ok". To be fair, My first Rhinoplasty performed by Dr. Kim was not bad at all. No deformation or anything. The result was only little too subtle for what I wanted. My nose was slightly tiled to the left, but it wasn't too noticeable. He agreed to do revision Rhinoplasty for lot lower price, that turned out a pretty bad. Now my nose have uneven bridge, dent on middle of both side of my nose, and another big dent on left side of my tip. When I point those out he told me that My nose can't get better then this and I should accept it and live with it, but he thinks he "did a great job".... I'm surprised how much of a poor job he did compare to the first Rhino. I wonder if he didn't try as hard because I payed less. Now I have to find a good non-surgical Rhinoplasty surgeon so I can get injectable fillers in near future, so I can atleast cover the dents I got from this revision. I'm sad because I really thought this will be the last time I make any change to my face....

2 out of 5 stars Overall rating
3 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
2 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
3 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
4 out of 5 stars Wait times
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Comments (19)

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You should try and file a report with the BBB against him. Maybe you can get some of your money back for him ruining your nose
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Dr.Joseph is amazing. I highly recommend him. He turned my HORRIBLE Rhino into a beautiful natural nose. He's so worth the trip and costs.
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Your surgeon only has about a 2.3 rating from 8 reviews on real self. That's not good at all. I'm very sorry you didn't get the results you were hoping for and I'm sorry he acted like a jerk. I'm hoping you see improvement as time passes. Best wishes for you.
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Hang in there.You will be in my prayers.
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Doctor Joseph does silicone permanent fillers. I had sent him pics and this is what he recommended from my old rhino from years ago. I live in PA so it's not that far from me. I am still thinking about it, not sure that I want to do yet. Hang in there. I can't believe how rude that doctor was to you. I think you have a legitimate complaint.
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Permanent fillers does sound great, but I read from couple sources that I should do temporary fillers first, and if I like the result maybe get the permanent fillers... I thought that sounds little safer, since I'm little traumatized from the damage done from this revision... But I sill need to consult with good doctors who I feel like I can trust.

Thank you for your sympathy.... I was really shocked how he spoken to me. He made it seem like I'm whining over perfectly well done Rhino and I'm asking for unrealistic result. I'm not stupid, I know these dents are not suppose to be there.

I did this Revision because I thought it was great timing to improve my nose for upcoming plans in next month, now it's ruined. :'(
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Maybe you should consider non surgical techniques. Look at Eric Joseph's NJ site along with Dr Kotler in CA. The are doing nice work with non surgical techniques instead of doing a revision. This is what I am contemplating.
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Thank you for your comment again! Yeah, that's what I was exactly thinking of, getting Injectable Fillers. Atleast as a temporary solution. Since my nose have alot of unevenness from dents, I can cover that up with fillers. (Ultimately I still want to reduce my prominent bridge, that probably takes a real surgery.)

I just looked up 2 doctors you mentioned... indeed they do have some GREAT before/after photos of non-surgical revisions. My plan was to find a good local surgeon in Atlanta for convenience, but I might consider going to NJ or CA, I will have to see.

I'm just not exactly sure how soon I can do fillers after my surgery. Right now it's 23 days post op. I searched a little online, some doctors says 1-2 month post op is fine, and some says 6-12 month.... that's a big difference lol
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I agree with you.. I would also be disapointed in his work
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Thank you.. yes.. it's pretty bad. Good thing is, the photo I posted looks lot worse then it does in real life. Under natural light it's not too bad, not to the degree of me feeling scared to see anyone. I can still go outside and do my daily things.. but ofcourse that doesn't make it ok. Now I'm scared of taking close-up pictures.
I didn't expect perfection from this Revision, but I wanted atleast an improvement... not deformation.
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Your nose looks really nice, like an irish nose
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Hmmm, I'm not sure if I can agree with you, atleast not with my most recent pictures lol.
It's unbalanced, asymmetrical, and have a big dent on the left side... I will give it 2 month to see if it gets any better though. I will try my best to distract myself from thinking about my nose lol
Thank you for your sweet comment, as always!
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You look in the pictures, what bothers you? Note down on a piece of paper and get another surgery after a year from a better surgeon, start earning right now, your insurance might also cover some part of it if you have one. If I was you I would have worked hard and got my nose done rather then living with imperfect nose(if it is imperfect and bothering you a lot)
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You think I look good in pictures? Like pictures from after the first rhino? Well, thank you!
It doesn't look bad when I compare to my old nose, lol, but I still felt like it was too bulky, and you can't tell from those pics, but from the side view there was still a visible hump... I just never kept the pictures that shows the hump since I hate it so badly. So I can't show you in pictures, sorry!
You are right, I should been saving up for another doctor even if it took longer to get revision, but my financial situation really aren't well right now... My surgeon isn't a bad doctor, he actually seem to have quite a reputation on what he does. I just wished he gave me more visual idea of what he is planning to do to my nose, instead of just saying "ok, ok" to my request.....
It's little too late, since I just got the revision done a week ago xD
Like I wrote on the updates today, I will see how it will turn out. after all it's only a week... Maybe when it heals more I will like the result more.

If not, I will think about saving up for another revision from different doctor.. I really hope I don't have too lol
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Hey, where are your photos gone?
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Glad you're doing better!

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Thank you!! I can't wait to get my stitches off tomorrow :D
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I'm sorry your original rhino didn't turn out the way you'd hoped. Here's what some doctors have to say about swelling after rhinoplasty. You're smart not to look now as best you can, because you'll see changes in the next few weeks/months. Please keep us posted!

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Thank you so much for your comment!

Yes, I was quite disappointed from the original rhino, since it didn't look like my "dream nose". However now looking back at all of my pictures before surgery, I can see that my doctor did do a pretty good job to improve my nose. I just wished he removed the hump like I asked him too.

I have a feeling the result of this revision is still going to be slightly asymmetrical again, since my nostril is naturally asymmetrical, and I didn't do anything with my nostril this time. I'm trying to prepare myself to accept slight imperfection. (Unless the asymmetry is very bad, then I might think about another revision from another doctor... but that's something for me to worry about later xP)
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