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Hi everyone, After more than 10 years of...

Hi everyone,

After more than 10 years of searching for a surgeon I finally found him and have decided to have a revision rhinoplasty! It has been a very slow and hard process to find a surgeon that I truly trust for my revision procedure. Over the past years, I had many consultations with doctors but I didn’t feel comfortable enough to go with surgery. At one point, I almost gave up to have a revision because after my first experience I was scared that my nose might look worse. I knew I needed time to research as I learned that revision is more difficult than the primary operation and requires a skilled surgeon to get satisfactory results.

Thank God, last year I joined this site and since then I have been learning from all your experiences. I have found this community to be very informative and supportive. I have even made some friends through this site; we exchange information and support each other. In general, I am a very private person and usually don’t feel comfortable to share personal issues. However since I have benefitted immensely from this site, I feel it’s my duty to write a review in the hope that others might benefit from my experience.

Why revision?
I have been trying to avoid surgery again but it seems that I just can't stand my nose any more as it’s getting worse every day. I have been unhappy with the results of my primary surgery since cast removal day. Originally I had a big nose and like many of you I really disliked it since I was a teenager. I avoided taking especially profile. After extensive research I decided to have a rhinoplasty surgery in 2001.The hump was removed and the nose length was shortened. I was happy with the profile for a few years. But I was very dissatisfied with the width of my nose and the bulbous asymmetric tip that lacks definition. My nose became twice its width prior to surgery and it gets wider when I smile. I was told by my surgeon that this was due to excessive swelling and that things would get better when swelling goes down. Unfortunately that didn’t happen. In addition, my nostrils were somewhat uneven befor the primary uneven and that didn’t really bother me at all but after surgery they have become larger and more asymmetric. There is also a dent (probably difficult to see in photos) on the bridge. I have noticed recently that my nose has become worse. When I went to consultations I thought it would be a good idea to show the surgeons my before and after photos (the after were taken just a couple of months after rhino). I even asked one of the doctors that I consulted if he agreed with me and he said that my nose after surgery had more symmetry than the way it is today.

What I would like to achieve from this revision: I feel my nose is way too big for my face. The only thing I see in my photos is my huge crooked tip that doesn’t have any definition. I am looking for a feminine nose with natural results that will fit my face. Specifically I want the base of my nose to be narrowed, make the nostrils smaller, and make the tip less bulbous and more defined. Also, I would like the bridge to be straightened. I feel like my left profile is different than the right profile (what do you guys think?).

My consultation with Dr. Kofi Boahene took place on December 11, 2013 and lasted about 45 minutes. The assistant took some pictures. Then I was taken to another room to meet the doctor. Dr. Boahene spent some time reading my operative report. He then asked me what I liked and what I didn’t like about my nose. The question about what I like about my nose took me by surprise because I don’t like anything about my nose. After carefully examining my nose he explained in details what he would do to achieve the goals. Dr. Boahene made some simulations to show how my new nose might look like after the surgery. He said he would first use a close approach as it’s less invasive but if it’s necessary then he might use the open approach. I really hope that I don’t require the open approach. It appears that there is enough cartilage in my septum if needed; if not then he will use ear cartilage. He pointed out that I have medium skin thickness. He recommended no change to the length of my nose. One surgeon that I consulted thought my nose was a bit long.

Surgery booked – I felt at ease with Dr. Boahene after the consultation and knew in my guts that I would choose him for my revision. In fact immediately after the consult I asked his assistant about available surgery dates. In the coming weeks after the consult I exchanged with him a couple of emails asking more questions and he promptly responded with detailed answers. So far, I have found Dr. Boahene to be very knowledgeable, personable and down to earth. He also does a lot of ethnic rhinoplasty and this is another reason I chose him as I am of Middle Eastern descent.
It took me almost 7 weeks to think things over and I finally scheduled my surgery for March 25! I just can’t believe it.

Second consult – I scheduled another consult with Dr. B for March 5 to discuss everything once again and to make sure we are both on the same page. I will also ask him to show me the simulations for reassurance. If there is time I plan to show him some pictures of noses that I like.I will update you on this consult.

Thank you all for reading my post and for your support! I look forward to your comments. I will upload more photos soon!

Photos

Here are some photos. I will add more soon.

Post primary photos

Another post primary photo

2010 post primary photos

Wide nose with bulbous tip.

Current nose

Here are some photos that I took yesterday. There are many issues with my nose. Beside the crooked and bulbous tip, the nostrils are large and the left nostril is not at the same level as the right nostril. The bridge is not straight. I think the left profile is different than the right profile but this doesn't bother me and is not the main reason for the revision.

More photos

Noses I love

I know my results won't look like these noses but we are allowed to day dream. Right! Just for fun :-)

I feel relieved

in the last couple of weeks I have been trying to tell my fiancé that I scheduled the surgery but I just couldn’t do it in person. So this morning I thought maybe I should tell him by sending him a text message. Well I did and now I fee relieved. He knew about my consultations but I never told him this is a revision. He doesn't think I need a nose job anyway but he is supportive of my decision.

Second Consult

Hello everyone,

I hope you are doing well. I had the second consult with my surgeon on March 5. During the consult photos were taken again and then I met with Dr. Boahene for about 30 minutes. Basically, we went over things that I don’t like about my nose. I mentioned to him I have noticed that my nose has changed so much in the last couple of years. I showed him some photos that were taken during different times after my primary that show my profile was straighter and my tip and nostrils were more symmetric. He said my nose seems to have collapsed and this happens when cartilage is removed and the nose is not supported. I am happy that he will do the closed approach instead of the open one. I still have a scar under the columella from the primary. Dr. B said he will fix it. I hope and pray that I don’t need any ear or rib cartilage.

Dr. Baohene explained to me once again what he would do to make my nose more feminine. He will make the bridge straight, reduce the tip and the width of the nose, and make the nostrils a bit smaller and more symmetric. We agreed that the length of my nose is fine. He seemed to understand very well what would look nice on my face. I showed him some photos of noses (the first nose on my nose wish) that I like and he agreed that this kind of nose would suit my face. As a reminder he asked me to bring those photos on the day of surgery. He showed me a computer simulation of my nose; hopefully my results will be better especially the front.

I still couldn’t believe it that I will be having the procedure in less than 3 weeks! But after I made the payment, I realized it is official and real!!

I’m scheduled to see my primary care physician next week for the pre-op physical exam.

I plan to get my post-surgery supplies this weekend.

List of post-surgery supplies:

- U-shaped travel pillow
- Arnica montana, Bromelain
- Arnica gel
- Vitamin C
- Hydrogen peroxide
- Antibiotic ointment
- Facial wipes
- Lip balm
- Gauz pads
- Q tips
- Saline nasal spray
- Humidifier (already have one)
- Ice pack
- Note book and pen to write when I took my med

Question: when should I start to take the arnica tablets?

During recovery I plan to have food such as:

- Unsalted crackers
- Ginger ale
- Jell-O
- Pudding
- Pineapple juice
- Home-made mashed potatoes
- Home-made soups
- Home-made smoothies

I found this recipe for a pineapple-banana smoothie that I like because it’s easy to make
You need
• 4 ice cubes
• I small banana cut into chunks
• 1/4 fresh pineapple - peeled, cored and cubed
• I cup pineapple juice

Directions: Place ice cubes, pineapple, banana, and pineapple juice into the bowl of a blender. Puree on high until smooth. The banana may be substituted with other fruits like strawberries or mangoes.

Surgery preparation

Last weekend I got all my pre and post surgery supplies. I’m glad I did that. So it’s out of my way and this weekend I can do other things on my list to do. I’m also done with my pre-op exams and was clear for surgery, that’s a relief. I started to take vitamin C as recommended. I was told to take Arnica Montana 2 days before surgery. My work leave has been approved, yay! I’m taking 9 days off work and with the weekends, it should be 13 days. I took these days from my personal vacation days because I don’t want anyone at work to know about my elective surgery. I hope 2 weeks should be enough for recovery. My surgery is scheduled at 1:45 pm on March 25. I wish it was in the mid morning because I will be fasting almost all day! I plan to take some food items with me like unsalted crackers, water, ginger ale etc. so I have something to eat after surgery. The surgery center is almost one hour and half drive from my house. I anticipate being home after surgery between 7-8 pm depending on the rush hour traffic. It will be a long day for me! I asked my surgeon if it’s better for me to stay in a nearby hotel the night after surgery but he said I should be fine to go home.

I hope everyone has a great weekend!

More before photos

My Day is here!!

Hi friends and supporters. Wow! Time does fly; I just can’t believe tomorrow I’m having my surgery.
I spent part of the weekend cleaning and organizing things around the house. I placed all my post surgery supplies in a basket so I have an easy access when I need them. I packed some food items and drinks that I will take with me so I can have something to eat and drink after surgery and take my medication. It’s going to be cold here tomorrow so I plan to wear warm and comfortable cloths.

I’m a bit nervous and that’s normal I guess, after all it’s a surgery. I remember before I had my primary I was too nervous the night before surgery that I didn’t even eat dinner!

My fiancé is taking me to the surgery and will be driving me back home after surgery. The surgery is at 1:45 p.m. and I have to be there at 12:30 p.m. I will be seeing Dr. Boahene before surgery to go over things that I like to be done to my nose. We are planning to leave early since there is snow in the forecast and traffic can get slow on the Beltway. Thank you all for those prayers and kind words. Your support means a lot to me and it truly has helped me to go through this surgery. PLEASE keep praying for me. I will update you as soon as I can. Take care!

DONE!!

Hello my friends. The surgery went well. I got home around 8:30 p.m. I'm concentrating on the recovery procedures. Thank you very much for your kind words. I will post the details soon. May God bless you!

Surgery Day & Post Op Recovery

Hello everyone. I want to thank all of you for checking in and leaving kind words, I’m blessed to have your support. I’m sorry I have not been updating; I’ve felt tired and washed out during recovery which keeps me off the computer.

On the morning of surgery I got a call from the surgery center saying that the surgeon is ahead of time and if I could arrive at 12 pm that would be better. Anyway we were planning to leave home early. The snow was not bad and we arrived at the surgery center before 11 a.m. I signed some papers and then just waited. Surprisingly I was not that nervous as I was waiting. I just had some headache and I guess that was from lack of food and drinks. At around 12 pm a sweet nurse called me and escorted me to the prep room and I changed into a gown. At this point I started to get nervous. They called my fiancé and he came and I felt more comfortable. Another sweet nurse came into the room and asked me lots of questions about my medical background. They started the IV fluids and my blood pressure and pulse were taken. During this time I felt cold. The nurse was so kind and brought warm blankets and a warmer. After that it felt so good and warm. Then the anesthesiologist came. She was super nice and soft spoken lady. She explained things to both of us really well. Afterwards Dr. Boahene came into the room. I discussed with him what I want done to my nose. He talked about the possibility of the rib cartilage then he left the room. I felt the urge to go to the bathroom and the nurse said I can do that before surgery.

At 2 pm I was taken to the surgery room. On the operating table I was made comfortable with warm blankets. The anesthesiologist was talking to me and she kept saying how adorable my fiancé is ? and asked me how we met. I just remembered telling her how we met and after that there was a BLACKOUT!! I woke up and found myself in the recovery room with one of the nurses and my fiancé. I was told that Dr. Boahene came to talk to me in the recovery room but I vaguely remembered seeing him. My fiancé told me that Dr. B came and told him everything went well. I felt relieved that the operation was over and I’m ALIVE and going home! All the nurses were very professional and nice and did everything to make me comfortable.

My procedure took 3 hours and 8 minutes and the doctor decided on the open technique. Immediately after I woke up from surgery I was groggy and had a sore throat as a result of the intubation. I was in the recovery room for about an hour and a half after the procedure. I was given cranberry juice to sip on. The nurse offered me some crackers but I didn’t feel like eating right away.

On the way home I was a bit hungry and had a soft cereal bar and drank the rest of the cranberry juice. The ride home was fine. My fiancé thinks if we had to do this again then we should have stayed in a hotel and driven home in the morning. The reason is because the anesthesiologist cautioned that I might get nauseated afterwards. The nurse told my fiancé they would give me medication to prevent nausea. That worked very well and I didn’t get nauseated at all. We arrived home safely around 8:30 p.m. and I took my medication and went to bed.

On the second and third day my throat was hurting so much. I took some throat drops and it helped a bit. Yesterday and today my throat feels much better. The hardest part of the recovery is the inability to breathe through the nose which makes your mouth very dry. My nose feels very stuffy. Also sleeping upright is hard and makes my back stiff. I have been taking it really easy especially the first two days. I stayed in my bedroom all the time. Yesterday and today I started to walk around my bedroom and outside the room a little.

The day after surgery the nurse called to check on me. Yesterday Dr. Boahene also phoned to check on me. There were some surprises during the operation: first of all I had enough cartilage in my septum so I didn’t need ear/rib cartilage. Secondly, he said my septum was very crooked and he straightened it up and this should help me breathe better through my nose. He placed a splint to keep my new nose in its place.

Recovery food: I have been eating very soft food like oat meal, mashed potatoes, pudding, jello, smoothies, etc. I really recommend homemade chicken soup and papaya. My fiancé is around and taking care of me. What a blessing!!!

I iced for the first 48 hours and luckily I don’t have any bruises. I do have some swelling on my face and that is normal.

I got very constipated because I didn’t take stool softener until yesterday. So I would recommend that you take it on the second day after surgery.

My follow up appointment is on Wednesday April 2 at 1:30 p.m.

I will update again soon on how my recovery is progressing. If you have any question please fell free to ask me. Thank you again for those sweet words. You really have helped me go through this. I love you all.

P.S. when I came back home after surgery my cat was staring at my nose! She is staying with me in the room and wouldn’t go anywhere else. I Love you sweeeet cat!

post op photos

5-7 days Post Recovery

Hi guys. So tomorrow the cast and splint will come off. Can’t wait for that to happen and be able to breathe through my nose. Right now I’m not thinking about how my nose will look aesthetically after cast removal, but my excitement is all about being able to breathe through my nose and not feeling this itchiness that drives me nuts.

In the last few days I have been up and around, sometimes feeling exhausted and washed out. My nose hurts, sometimes getting prickling pains and other times stabbing pains. It’s very stuffy. I remember Dr. B me told me just before surgery that if he uses the cartilage from my septum then I would feel vet stuffy. I have been cleaning my nostrils twice a day with hydrogen peroxide diluted in water using Q-tips and then I put antibiotic ointment and moisturizer. I moisturize the incisions whenever they get dry. I have found that Arnica gel has a soothing effect when applied on the incisions. The left nostril is constantly dripping mucus and this irritates the skin around the nostril. I use a small Kleenex tissue to dab the mucus.

Sleeping at night has been hard due to the stuffiness and dry mouth which makes me wake up every 1-2 hours. I keep a bottle of water on the night stand and sip some water whenever I need to. Also, usually I sleep on my side and I find sleeping on my back all night is very tough. Last night was the hardest. I experienced post-nasal drip a couple of times and that kept me awake for a few hours. My lips were painful. I rub some antibiotics on them and that helped. My poor cat would wake up and look at me as if she was saying “are you okay dear?”

My back is another story. It has been aching like crazy; I did some stretches today and that seems to help a lot.

Overall recovery is harder this time than after I had my primary.

I continue to eat the low sodium diet. I have been eating lots of strawberries, kiwis, mangoes, pineapple, and my favorite fruit papayas.

My cat is the sweetest thing. She stays with me and follows me wherever I go. She’s always curious about new stuff, like she wants to sniff the post recovery supplies. She likes to stay in the sink watching while I clean my nose.

My fiancé has been – as usual- an angel. He is making me fresh home meals and always reminding me to stay positive throughout.

I am ready for tomorrow, which right now feels far away. I have prepared myself for the reveal and honestly I don’t think my nose will look great immediately after cast removal because I feel it is super swollen especially the tip. I will update you soon. Thanks for reading.

Some photos

Here are photos taken today.

photos

Cast removal and.........

Hello friends,

I hope you're enjoying the weekend. First I would like to thank you for your kind messages and I apologize for not updating sooner. After cast removal I have been taking things easy, relaxing and enjoying the rest of my vacation.

So last Wednesday I went for my follow up and cast removal. The nurse called me and then I was seated comfortably on a chair. She then started the process by peeling the cast. To make things easy she put some sort of a solution. As she was pulling the cast I felt like my whole nose is being pulled off. It was not painful but uncomfortable. When the first half of the cast was peeled off the second half peeled a lot easier. I felt some relief immediately. Then she started removing the sutures but first she cleaned them with hydrogen peroxide. Some of the incisions hurt as they come off. Here comes the worst part, which is removing the splints. She was reminding me that I do have splints so the process is not over yet. Then in a split second she started removing the splint in the right nostril. Ouch it hurts so much and I screamed. But she continued and pulled it out. Then she said you got another one in the left nostril and she pulled it. The second one didn’t hurt as much as the first one. At this point I felt much better. She continued the process and cleaned my nose.

Afterwards I just can’t describe how relieved I felt. I felt like a human again!! The nurse asked me to wait and Dr. Boahene would see me shortly. There was a mirror next to me but I didn’t want to look at my nose because I wanted the doctor to be present when I look. In about 10 minutes or so Dr. Boahene came into the room and greeted me warmly. He was thinking to remove the splints but I told him that the nurse did that already! He then examined my nose and cleaned it some more. He also massaged it a little. While he was doing that I asked him to tell me the details about the operation. He said my septum was very crooked and he fixed that and it should help me breath better now. He further explained that when the hump was removed and my nose was shortened during the primary rhino, the tip was left without enough cartilage so it didn’t have any support and eventually collapsed. I also had a lot of scar tissues. Of course Dr. B explained this process much better. This explains why my tip looked so huge and the base got really wide after the first op!! I had no cartilage in the tip!

Then Dr. B actually asked me to breathe through my nose after he was done cleaning it. I took a deep breath and felt all the air going through my nose. It was a very good feeling for the first time in a long time. Wow I haven’t been breathing well though my nose in years! I thought it was all due to allergies because that’s what my allergy doctor told me. I told Dr. Boahene that I could breathe better and he was very happy.

Well, now comes the moment that all of you have been waiting for patiently. Viewing the NEW NOSE. I told Dr. Boahene that I haven’t seen my new nose yet. He grabbed the mirror and handed it to me. I was expecting to see a huge swollen nose because that’s how I felt about the swelling and its effects. I looked at the mirror and it’s not what I was thinking. My nose was smaller and with smaller nostrils and an improved symmetric tip. At this moment I couldn’t hold myself but cry out of joy and told Dr. B my nose is beautiful and smaller. I hugged Dr. Boahene maybe 3 times as I was looking at my nose in the mirror!! Hahah. I could tell from his eyes that he was very happy with the results. He said it will even look nicer when all the swelling subsides.

When I got home on the day of surgery, before the swelling started full force, and then again in the morning of the second day before much swelling, my nose looked narrower and I realized he made it nicely narrow. I think this is how it will look after all the swelling is gone.

Another fact to mention is that my nose looks so natural after the revision. This is not true after I had my primary. In fact my nose after the primary looked so huge and had that operated look for months. My fiancé is impressed with the outcome. He said my nose looks proportional and in much harmony with my other facial features.

By the way the doctor also taped my nose and gave me some tape to take with me. I taped it last night. So, I don’t know for how long I should be taping it. Anyone has any idea?

My follow up will be in 6 weeks and my doctor said he would inject steroid to decrease swelling.
In the last few days after cast removal I have been breathing much better through my nose. I have been getting good night sleeps. It’s really a blessing to be able to breathe through my nose after all these years. I can say that the procedure has delivered dual benefits function and aesthetics. I am very grateful to God, the Almighty and then to Dr. Kofi Boahene!!

Thank you again for your great support throughout this process. I look forward to your comments and inputs. Enjoy your Sunday!!

Here comes my new nose

All but the first photo were taken yesterday. Keep in mind there's tons of swelling especially on the tip.

more photos

Sorry the first photo was taken on cast removal day

more photos

Baltimore Facial Plastic Surgeon

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You look GREAT! Glad it went well.
  • Reply
I'm really happy to know you've finally done it! I know you've been trying for a while, but the research and wait have been worth it because...it already looks really elegant and fitting. I actually didn't think anything was wrong with before, but the small changes you had will only add to your appearance. Happy recovery to you! It is only going to improve from here.
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Hi Zooster, you must be back at work by now...how are you feeling? You must be truly happy to be on the other side of your surgery now. Mine is 2 weeks from today... Yikes!!!! when i wake in the night and think about it i feel like backing out, i will be glad to have this over with. PS i have'nt told my fiance yet.
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Hi, You look so good so far! I'm really happy for you and I'm so happy that you're already happy:) Have there been any big changes in swelling this week? Also how does your scar look? I think that you mentioned he was going to improve it for you.
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WOW girl!! Its REAL!! we DID it!!!! I LOVE your new nose!! It already looks amazing and will only improve as swelling sub sides.. This is a dream come true..and just THINK how awesome we will both feel this coming holiday season!! Just think how we both felt last Christmas time..this is IT girl!!! Waaaa-hoooooo!! raising a champagne toast to you and US and ALL of us who will FINALLY feel happy and content with our NEW noses!!!!!!!! :) you deserve it girl!!! So happy for you!!!!!
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Thank you very much jcathope, for your support and encouragement. You're very kind my dear. Yes, we did it and we got great results and can't wait for the holidays this year!! We're blessed we had great surgeons. Our noses will only get better from now on. Enjoy life and enjoy the lovely spring weather!
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I'm so happy everything turn out great! but most importantly that you are happy with it because we all know that it doesn't matter what other people think, but what we think of the result =). Well, i can't wait to see how much more happier you get with your new new nose =). I hope that one day when i get my revision i'll be as happy with my result. Take care and keep drinking your pineapple juice!
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Thanks mango1990 for your kind words. I am happy with my results and I think it's a great improvement from my old nose. I pray that you get the revision and the results you desire my dear. Everything is possible! Yeah, I fell in love with the pineapple banana smoothie. Just had it last evening! So refreshing too.
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Thanks for all the photos..it's really helpful! I cant wait for Dr Boahene to do my nose! Looking forward to seeing more photos of your nose..it's still very swollen so it's going to get even smaller! Please keep us posted with your great pics! Good luck! :-)
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Hi dkcaramel. Thank you for checking in. I will post photos as my nose is healing and changing. It's very swollen but the change is dramatic and you can appreciate this more in person than in photos! I'm glad Dr. B is performing your rhinoplasty. You're in great hands! When is your surgery?
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Looks good!
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Thanks.
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It's looking awesome already! Happy you're happy :)
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Thank you very much. I appreciate your kindness. -:)
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Congratulations! looks lovely!
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Thanks dear. We did it!!
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Its so good to finally meet your new nose... wishing you speedy de-swelling :)
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My new nose is pleased to meet you my dear I like the expression speedy de-swelling. I appreciate your support.
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I love it! It suits your face and is very symmetricale. I'm very glad for you.
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Thank you very much. I am sure yours will turn out perfect!
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Oh Zooster, you are filling me with confidence, for that i thank you from the bottom of my heart xox Your new nose is just perfect for your face!! I can only dream about such great results, but you have shown this is possible. I have just started to prepare for my BIG day which is now in 3 weeks...YIKES, you must be feeling soo much better now! Take care :)
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I'm so happy that my review is helping you. Thank you very much for the compliments. I pray that you get perfect results. I am excited for you. Wow 3 more weeks. Xoxo
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So happy for you, you deserve it. Your nose will look even more beautiful with time :)
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Thanks so much. You're very kind. I pray it will.
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Wow, your nostrils look great and symmetrical! I'm really liking the 3/4 view; the shape of the nose looks so natural! Dr. B did an amazing job!. Enjoyed reading your review (your cat is adorable btw) and look forward to progress pics! :) I also went to Great Falls shortly after getting my cast off too! Haha that is so cool. Hope you get to see the Cherry Blossoms too? Good idea on wearing the wide brimmed hat. My skin was so clogged that sun screen looked terrible on my nose but it's something we all have to do. So happy for you! :)
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