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It's Done and I Wish I Had More Patience - Denver, CO

I have only recently been more bothered by my nose...

I have only recently been more bothered by my nose starting in my 30s. I was disappointed to learn your nose only gets bigger with age. I really feel as if I have noticed that in the last 5 years. I just would hate every picture, especially the ones where I was having the most fun and my nose just appeared bigger and bulkier with a bigger smile.

More Before Pictures

Here are a few more that illustrate what I disliked about my nose.

Day One - Oh the bruising

Despite listening and being very strict about preop instructions and all possible homeopathic agents to prevent bruising.....I had the shiners!!! I really was hoping they would not be as bad but kind of expected it as I have always been easy to bruise and when I get a bruise it lasts forever; one to two months sometimes.

Continued recovery

And then the swelling.... I was already so concerned and bothered by how upturned my nose looked with the splint on. My surgeon warned me of this stating it would drop but it is so disturbing to look at. Started to notice day 2-5 how much the swelling was altering my appearance and was really starting to worry about my smile at this time, but figured it was just par for the course. And was excited to just get the cast off!

Cast off - I wanted to be elated, no luck

My cast was removed 8 days after surgery. I have to admit I was overwhelmed with complete dislike. I was reassured straight away that I am extremely swollen and the surgeon stated she could see the end result in her head being fabulous, reassuring but such a bummer to not get that elated feeling straight away. Especially when I've heard so many people report that they love it on cast removal day then it swells but goes back to what they liked eventually. I have no desire whatsoever for my final results to be anything like what I saw when my cast came off. Also I realize sutures were used at my alnar base to keep my nose from getting so wide when I smile, but I see how that really is pinching my sides and impacting my smile reversely in a negative way. I am so concerned this is going to permanently impact my smile. I hated my nose when I smiled but now I'm so worried I may have lost my smile altogether. My teeth aren't showing at all, even when I talk, much less smile. I realize this can really be due to swelling but I can't believe after trolling this site for so long, every picture I've seen of people even a few days out shows them retaining their teeth in their smile. I'm so very concerned about how many months it will take to get my smile back and have my lip lifted when I smile. I did a little research here and for those that this happens to some report 6 to 12 months. I was really prepared for watching a swollen nose change over time but this loss of smile is really impacting me. It gives me such a distorted look. This is a huge curve ball for me, I didn't ever think to ask about how a rhinoplasty would impact my smile.

Pictures didn't post

Pictures to go with above post

Rollar Coaster of Emotions and Fear

All in all I had been starting to feel better about my nose the past two days, feeling was starting to return (which has to mean swelling would follow suit) and I was feeling confident my nose looked fine (as long as I didn't smile). I even put on the most foundation I ever have to cover up bruises, put on a hat, and had a great time out with some great and supportive friends. They were all very reassuring that my nose looked great, they all agreed my smile was off but kept reassuring me that it must get better with the reduction of swelling. Then, just this evening laughed at a friends story and caught a glimpse of my reflection in the window and was still so mortified that the pull on my face by my nose was so disturbing. I started really wondering how the tightness around my nose was ever going to subside.

During one of my pre op consults early on the surgeon and I talked about reducing the alar base to decrease width of the nostrils. We talked about this being a bit of a gamble because I have a history of hypertrophic scarring but she did say it would be something we could monitor and deal with if scarring did occur. Then in a second consult I asked again for her to explain how a wide nose that is only wide upon smiling would be reduced. She mentioned a stitch is placed that keeps the nostrils from flaring. I listened and it all seemed reasonable. I was shown some pictures and was satisfied what I saw. Now I have to be clear here that I think some pictures involved an alar reduction and some a stitch but I'm not actually sure. Right now I am so upset at myself that I did not ask for a distinction.

I have since come to realize that it is most likely that I had an alar cinch suture placed and not an alar reduction because even right after surgery I noticed the stitches on the side of my nose did not go all the way down to the base of my nostril instead they looked like a slit. I was kind of surprised at this at the time because I really was expecting the see a full alar reduction and full stitches down the entire sides of my nose. I honestly was kind of relived because that would be less surface area for a scar to develop.

Now after the cast was off the first thing I noticed was the pulling and tightness on the sides of my nose then how horrible my smile was, with a smaller upper lip and my smile covering my teeth.

Now I am just in utter meltdown mode, because as I research here and read doctors answers, this procedure (cinch suture) does not seem as common mostly because of the way it can alter the smile and thin the lip permanently. I am in utter shock and devastation. I am realistic that the surgeon also could have made the right call for me, and this all could work out, but am so shocked to learn that the recovery of the smile could take so much longer than regular swelling as much as 8 months to 12 months. Had I been warned about this I think I would have really asked more questions and been more specific about researching this procedure. The thought of going through even 6 months with this much altered of a smile is so depressing to me. This could rob me of a whole year of smiles and happiness. I've always been really pleased with my full lips and thinking I may have lost that for up to a year or even permanently is killing me right now.

Of course this meltdown is occurring right as I approach the weekend and I'm not sure I will be able to contact the office until Monday to get an appointment. I really want to go in and discuss this face to face and get some clear answers. I don't think a phone call or simple chat with the P.A. is going to do.

Please if anyone hear has had experience with an alar base cinch suture I would love to chat about your experience.

Feeling a tad better after a call from the surgeon

I ended up calling the office on Saturday knowing I would be able to take to one of the physicians assistants. She was reassuring and went through trying to explain my procedure and let me know that the amount of swelling I have is directly proportional to the amount of work I had done and I just need time to heal. I stated I'm most worried about the tightness and puckering on the side of my nose. I made an appointment to go in sooner based on the fact I'm also a bit worried about how my incision sites are scarring over, on one side a small bump is developing.

Well, I must have left a really nervous impression with the P.A. because and hour later my surgeon called stating the P.A. could sense my nervousness, and thought I would feel better if I had a chance to talk to her. I thought it was so amazing that she made the call on the weekend, and while it was reassuring to hear her describe that I would without a doubt definitely get my smile back, she could only say it could very well take 6 months. Yikes, I can't imagine spending half of my new 35th year without being able to smile. It's just so depressing. I'm really trying to keep a positive attitude and take care of myself health-wise to speed this up. I just can only hope she had to say that to cover herself and it will take way less time.

She also described the pinching and that the sutures used had to be tight in order to prevent my nose from flaring in the future (my primary complaint). And with time and the swelling going down this will not look so deformed.

I made an appointment to go in this week to have her look at the incisions sight and proceed from there.

Now I'm back to drinking soooo much water and trying to star upright as possible even in sleep to help this along as fast as possible.
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Hi! How are you doing now? I just had my cast taken off and I freaked out about the front of my nose. The profile is cute but the front is SO wide and pudgy. My nose was not wide prior to the surgery so this freaks me out (hope it's not permanent). As for the upper lip, mine is currently paralyzed and will be for 2-3 weeks according to my surgeon. I can relate to freakish smiling, haha! Hope you're doing well.
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I'm surviving at this point. I wouldn't say I'm well. My smile has very slowly start to return. I can completely identify with you in that my residual swelling has distorted my face and still about 8 weeks out gives me a frozen and stoic appearance. It is a horrible waiting game. It appears I could be the type that has sweeping for months to come. I really was prepared for a swollen nose but so unprepared for how the swelling would distort the whole face. It's been hard for me to come back here and keep up with updates as I could tell I'm a bit depressed. If your interested in sharing some progress pics private message me.
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That typo was meant to say "swelling" not "sweeping"
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I'm also in the waiting game right now...didn't have the same procedure as you entirely, but everything is awful when I smile. Did you wear the tape to work??
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I was only taping at night, so no went to work. No one noticed a thing. I'm still waiting. My smile and teeth have returned but I still have pinching by my cheeks. Waiting until next week to see some changes. Will then discuss options with my surgeon.
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I thought of you today when I was trying smile. I'm glad you got some reassurance and clarification from the doctor. I hope your first day of work went well :)
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Your nose looks amazing! So improved and feminine! Try to stay calm and be patient :) it will turn out beautiful! You are fortunate, upturned is cute! Love it.
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It took me a while to get my smile back! Don't be discouraged sweetie. Your nose will look different as swelling goes down. I thought my nose looked like an upturned sausage when my car came off lol I now love it... give it some time
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Thank you so much for your encouraging words, I can actually see more of my teeth now when I smile, so there is some progress. The main worry has not progressed to the cinching and pinching on the side of my nose when I smile. These were from sutures and I can only hope they will loosen up in time and decreased swelling in the nose won't make them so obvious. Your pictures are amazing. Your nose and your whole face is beautiful!
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Hello all, For me it has been 4 years now, since i had the operation. Basically it was a correction operation where the doctor took cartilage from the back of my ear and put it at my nose in an attempt to support my nose. My nose needed support because the cartilage from there was removed when I had the first failed operation some 15 years ago, and it has started to collapse. The operation has affected my smile permanently. My smile is now maybe 70-80% natural but it’s not 100% natural and it’s definitely not how it was before. I still feel pressure below my nose when I smile, my upper lip doesn’t move up. I guess the extra cartilage there is blocking the way. People that I meet now and didn’t know me from before can tell that something is wrong with my smile. I guess im not the same case as you due to the extra cartilage added. For me the mistake was the first operation, this is where things didn’t really go as they should have. Before the second operation though even though the doctor told me he would put cartilage from my ear to my nose, he didn’t even mention anything about my smile getting affected like this. Im sure he knew, being a surgeon for 30 years. Anyhow, I don’t think it’s a good idea to touch my nose again, so I have learned to live with it. (looking not so good when I smile). If there are any suggestions please let me know here, or at a private message. Regards yannis
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I'm so sorry to hear this Yannis...I realize I am barley out of surgery and need healing time, but I am so afraid the type of work that was done with my cinching sutures is likely to require a revision some day. I can really see how doing more revisions complicates the issue on such a more intense level. It is so troubling to realize a procedure could be so failed. I am very sympathetic and in agreement with you that it seems really unfair that surgeons don't think to go over every possible risk associated with what they do. Mine did not ever mention how it could pinch on the side of my face and impact my smile!!! I would think that would be such an important thing to mention. I'm just stunned because we did have very candid conversations, that this didn't come up. Today when I saw her she mentioned it just needed time and the suture sights just needed to loosen up but from where it stands now even when loose I don't like where they pull on the nose. I will say we are way more critical of our own face, I have found out, and I would venture to say if your smile is at 80% you are likely to look okay, especially if you like the way the nose turned out.
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I really do think you are going to be so happy. You will get your smile back but I know how frustrating that wait can be. You come out of surgery looking like a completely different person for a few months and it's so scary because you don't know what the outcome will be. Whatever you do, don't google it. I got myself into a state over things I read and my smile came back fine, it just took a little longer than most. X
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Man you are right about staying off google. Why didn't I listen to you sooner? My smile is actually returning. The trouble more is the pinching of my face right by my nose where the sutures were placed to cinch the nose. Why oh why do we google.....I'm so afraid now reading that this procedure often is a risk and causes the lip to flatten and can get loose over time just putting me right back where I started?! I really am hoping my result will be like yours and the suture sights will loosen up and my cheeks will return to pre-op status.
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I like to think medicine has come a long way and they wouldn't use these techniques if it was going to badly affect the appearance of another part of your face. Unless they are a cowboy surgeon of course in which case they just want your money. Unfortunately only time will tell and you will be sick of hearing it. I still have another six months before I can evaluate my nose and see where I go from there. I really hope the sutures will relax and it's just swelling of that area. Swelling has a lot to answer for!! X
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You look beautiful! Already the 8/10/2014 smile photo shows improvement! Hang in there :)
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Thank you. I am trying I really am trying.
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i hope ur smile comes back soon. I know how upsetting it is, cos ive been thru it myself. Im praying for u for a speedy recovery :)
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Agree with the other comment. Your nose looks much much better. It's going to look really beautiful.
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I think the latest pics you posted 8/8 were all ready a lot better than the 8/6 pics. There is tons of swelling to go down. Your smile will return to normal, it just takes time. I think your nose looks good. Hang in there, don't be discouraged!
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hello, i just wanna say my smile is exact like your, see my pictures and you can see... i miss my smile the most it makes my face looks so distorted, but i am still 1 month post op and can not smile, it has improved a little but it still feels so tight around the cheeks and the upper lip......pray that it comes back sooon :I
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I just was not expecting or ready for this. I try to convince myself that all it needs is time but now I've realized it is likely to need upwards of at least 6 months. I can't believe I have to spend half a year or more being so uncomfortable with my appearance. Even the thought of avoiding the opportunity to smile is completely depressing to me. Please keep me updated on your progress. I would love for both of us to find some happiness very soon but it might be a long haul.
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I think it looks nice, just swollen! Here's what some doctors say about nose tips dropping over time. Hang in there!
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Thank you so much, you can read my recent update and realize now my whole other concern about my smile has taken over. I would even take the amount of upturn in the nose right now if I could just have a guarantee that I would have my full lips and smile back.
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I'm in Denver too! The waiting sucks, let me tell you. But I agree 100% with Zooster. So much so I'm jealous of what your nose is going to be. It's already looking so great! Every day will be different. I love the little freckles on your nose, so cute. Happy healing - focus on your health. The hard part is done.
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Thanks a bunch, this encouragement is just what I need. I'm so afraid of looking so different to people, I don't think the nose does that but the smile and tightness really does. Anything you did to reduce swelling? Did you keep icing after cast was off? I'm trying to drink water like crazy, but who knows?! I'm so jealous of your nose! It is looking great! Hahaha, it took me years to me okay with my freckles then one day I was at peace, until I started staring at my nose!
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