African American revision rhinoplasty, not happy with results - Baltimore, MD

I want to start off by saying i battled back and...

I want to start off by saying i battled back and forth with myself on weather i should write this review because i would open myself up up criticism and judgment from others but i figured if i had someone who i could have learned from their mistakes it would have helped me. This is my honest and true review. I had my first rhinoplasty in 2010 it was by a surgeon who was not qualified in the least bit to work with African American noses and i believe i was her first ever "ethnic" rhinoplasty. I've always hated my nose, it's something I've been teased about all my life so when i finally was able to save up enough money i consulted with two surgeons, the first was dr mobley and my surgeon Dr barr, my gut told me neither were really qualified for what i was wanting/needed but if i had to choose i definetly would have gone with Dr Mobley, the reason i choose to go with Dr barr was due to the cost being lower. Long story short i ended up hating the results! My nose was left uneven and left disphormed, after a year of no change she agreed so i had a revision which made things i would say 1% better. 

A year had gone by and i knew i had to have another revision, this time i did extensive research and felt confident that doctor kofi bohene was the answer to my prayers! I had surgery with him early january of 2012, my goals were to narrow the nose, reduce the nostrils and give me a smaller tip, all which he said could be achieved but one thing i would have to do on my end was be patient with the results. Immediately after having my cast off i noticed my nose was defiantly smaller but that the bone he used to form my bridge was shifted waay to the left instead of being in the middle like a normal nose and that my nostrils were noticeably not symmetric. 

I had flew from another state and my flight was due to leave the following day, he assured me that as long as i taped the nose to move the bone back towards the middle that would correct it, and as time went on the insymmetric in the nostrils would become even. I would say five months after surgery i came to the conclusion that the bone shifting was not going to move any further and that the swelling had increased instead of decresed which made my nose look 10× worse then my early stages of having the cast off. I reached out to him and he told me to schedule a visit to fly out to address the bone and swelling. He gave me a kenalog injection for the swelling and juverdem a temporary filler to camaflodge the shifting of the bone pertruding to the left and fill In the areas where the bone should have filed to the right side to make things even. He also used the filler on my nostrils to help camaflodge/fill the insammetric areas. 

After that visit i could honestly say things looked better. After a few months i noticed the filler had started to disappear. Instead of spending over another $1000 in expenses i decided i would go to a local doctor to have them inject the same temp filler, which by the way I've been having to get injected every 3months to keep up with the camafloging. I would say about over a year into doing this i was fed up and could not afford to pay 450-500 to get a temp filler when I've already spent over 25k in medical and travel expenses. Frustrated i reached out to him and he told me to fly out again to see what he can do. At that time i had the filler reinjected so he pretty much told me There was nothing he could do to address that issue since there was a filler in and if he used a permenete filler it would contriact and would not know where to place it since there was already a filler, at the time it made sense but now looking back i wish he had let me know ahead of time so i could have either stopped getting the filler or had it dissolved by my local doctor. He did however performe an in office procedure witch took about 3 and a half hours where he "fixed" my nostrils to where i would no longer need to get the temp filler, he also did something else with them to where when i smile my nostrils would not spread out as much, and shaved down a bump in the middle of my nose that had formed. 

After this in office produce i was given stitches and bandages for the blood and sent on my way. I looked 1000x worse i felt like my nose was 10x bigger specially in the tip and nostril area. It will be a year in October since i had this in office procedure and my nose looks worse then it ever has. I have reached out to him several times but his pretty much told me his done all he can do. I plan on getting my fourth revision with dr jason s hamilton in california within the next 6-7month's once i have the funds. I've done a phone consult and plan to do a in person one within the next 2-3 month's. He seems very confident that he can help bring the asymmetry back to my nose and harmony to help balance instead of take away from my other features, and help end this nightmare of botched rhinoplasties I've had. A part of my feels bad for writing this review because dr boahene is hands down an amazing person, and has been nice i would say throughout most of the process, but i just wish my results came out half as good as his level of "customer service" sorry for this loooong review but i really wanted to share my experiance to help others. The pictures I've posted are how my nose looks now.

pictures of before surgery and after

Time for an update!:)

I just thought i would update everyone who's been following my story. After writing my review Dr B did contact me to talk about my concerns. To sum up the hour conversation we had I think a lot of the confusion he and I had comes from miscommunication. In one of my comments i made mention of it being really hard to understand Dr B via email at times, which I let him know. To help with that I thought it would be best to communicate via skype or phone call which we schedualed a few times but he was never able to keep it. This left me with only being able to communicate with him via email. I was always under the impression that Dr B wanted to address my bridge area with a Permanente filler like silicone, but he recently let me know that it would be diced up cartilage or fascia he would either inject or tunnel into the bridge. I was shocked to find that out because like i said i had always thought it would have been an artificial filler. Which I've read and have been told comes with risks. This made me start to rethink things! Before I tell I you what he said about my tip i need to back up a little....

Within the past two months I've had 2 consultations with two different doctors. The first consult i had was with Dr John Bittner. He is suppose to be the local go to doctor for rhinoplasty and revision. I had a great consultation with him because I really felt like he understood my concerns and got MY esthetic view on how I want my nose to look, he was able to see pretty much very concern of mine before I told him. He did tell me upfront that he is no expert in African American noses like Dr B is but that he has worked with Polynesian, Hispanic and Asian noses which are similar in frame and skin thickness to AA noses. This was my one main concerns that kept me from booking surgery with him that day. I really felt like this time around I needed to go with someone who is expertly skilled in working with African American noses. I really need this to be my last revision and for things to look better than what they do now! I would say 2-3 weeks after consulting with Dr Bittner i flew out to LA for my second consultation which was with Dr Jason S Hamilton. My consultation with him also went really well but left me feeling more lost! In my consultation with Dr Hamilton he examied my nose really throughly and told me that the bridge did warp which is a complication that can happen from using rib. He was confident he could addres that area with a revision and advised against using a permenete artificial filler. As for the tip he said he see's my concerns but i would be taking a gamble. The way he put it to me is my nose has frame ie bone support but once you reach the tip it's just meaty, it needs support! At the time i did not know what type of cartilage Dr B used for tip support. Dr Hamilton said the cartilage that was used before probably got eaten up or dissolved. He said their is a chance of that happening again, hence I would be taking a gamble. He told me the reason my nostrils look uneven is due to my collumela/tip being shifted unevenly. He said if that was straight and addressed correctly i would not have the appearance of the tip and nostrils looking uneven and tilted. Overall he said my nose does not look THAT bad! But he sees my concerns. He told me if it were him in my situation he would only touch the bridge and not the tip. He also encouraged me to reach out to Dr B one last time and see if he could address the issues and take things from there. which Is what I did! Overall i loved how honest and straight forward Dr Hamilton was! He is the type of doctor that will tell you upfront if he can help you or not. His not one of those doctors that are just in it for the money and is not willing to take risks at the cost of his patients getting a unsatisfied result. He was also very detailed which I apprciated. He even gave me a referral to another doctor in Texas that's suppose to specialize in rhinoplasty for a second opinion. His name is Anthony Brissett.

After I came back from seeing Dr Hamilton I decided to take his advise and reach out to Dr B. To sum up the email sent, I told him how the other doctors have advised against me using a permenete filler to address the bridge, the recommendations that were made by the other doctors and if he could address them. That is when he replied back telling me he does not use artificial fillers in his office and that it would diced fascia or cartilage that would either be tunneled or injected into the bridge area. He also told me he will exam my tip to see if it's a matter of the collumela shifting the tip or if it needs an alar rim graft. I schedualed a in person consult with him for December 10th.

I kept getting this gut getting that I should not have crossed Bittner off my list just yet without atleast talking to him about my concerns. So I schedualed another consult with Dr John Bitner. I told him out of all the doctors I've met with he was the only one that really understood my esthetic concerns which was huge for me! I also let him know my concern about him not being a specialist is AA noses. He explained to me again that he is no expert in AA noses, but has experiance with thick skinned, boulbouse noses similar to mine. I stressed to him that this had to be my last surgery and that I really could not afford both mentally and emotionally to have things look worse and go through this again! He assured me he would not take me on as a client if he was not confident he could deliver. Once he said that I decided to book surgery with him for the following week 11/19/14.

Sooo here I am not even officially 24hours after surgery, and I cant sleep due to it being so uncomfortable sleeping on my back with my head elevated, and the discomfort from the ear cartilage and fascia. So I figured I would update my review. I'm going to be writing a separate in depth review along with pictures to share my full experience with him since this review was on Dr Boahene. I just want to wait till the cast is off to really be able to assess my results. But just to sum up what he did he used ear cartilage and wrapped it in fascia to address the bridge, he used the rib he took out to add more structure to the tip and nose, had to remove and thin out the scar tissues and skin that formed inside and did a scar revision with my nostrils which required him to slightly bring them in. He told me he is very pleased with the results and things look 90% better! He said the inside of my nose structure wise things were not that bad but he pretty much had to reinforce and "clean out" the work that was done before.

Its only been less than 24hours like I said so I can't really judge the final outcome Just yet but, I can already tell things do indeed look better! It seems more refined and seems to have more support within the tip area even with the swelling and cast on. I still do not want to get my hopes up too much just becauseI've been let down and disappointed 3 other times, but I'm trrying to stay positive and pray for the best!

I did delete my pictures for personal reasons, but will post before and afters of my nose once the cast comes off!

I was getting alot of PM and didn't want anyone thinking I was ignoring then so I thought it would be easier to just post an update. Hope this helps!:)

Updated Pictures

I decided I would post a picture of my nostrils after surgery with Dr Boahene and how it looks now. I get my cast off Tuesday but I personally think there's improvement with the overall shape and symmetric view from the bottom. It's still too early to really judge due to swelling but I'm happy with the bottom view so far. Once I get the cast off I'll be doing a full separate review. Hope this helps!:)
Baltimore Facial Plastic Surgeon

Dr Boahene is a very present guy! But I'm not pleased with my results.

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