Rhinoplasty: Stories
Write a ReviewAlmost 2 months post-op...best decision ever!
- stephaniek21
- posted 3 months ago
- updated 1 day ago
- Worth It
- Cost: $8,500
- Vladimir Grigoryants, MD (Los Angeles, CA)
I have posted some photos. If you have had...
- 12 Mar 2013
- 1 month pre
I have posted some photos. If you have had rhinoplasty and see ANY similarities between my nose and your pre-surgery nose, I would love to hear your thoughts. Or anyone else!
Some of my initial thoughts...
A) I'm not scared about "not looking like myself." I really dislike my nose and I don't like the effect it has on my whole face. I also think my nose is so bad, I think it's only up from here! (half kidding here)
B) I am slightly nervous about a nose that looks super fake. But honestly, as long as there is a major improvement, I don't mind too much if people can tell I've "had work done." I don't plan on keeping it a secret!
C) I am scared that mine will be a really difficult nose to fix, and that makes me think the recovery time will be much more intense. Maybe everyone worries about that?
Anyway! That's all for now.
I have my first in-person consultation today with...
- 19 Mar 2013
- 1 month pre
So! I met with Dr. Aboolian yesterday and Dr....
- 20 Mar 2013
- 1 month pre
Let me know if you guys have any comments. Thank you!
I thought of something I wanted to share that may...
- 23 Mar 2013
- 1 month pre
So I actually went ahead and scheduled a pre-op...
- 28 Mar 2013
- 28 days pre
Woops, accidentally posted this as a comment... ...
- 29 Mar 2013
- 27 days pre
I'm nervous now because I am decided to visit my parents this weekend in Michigan. Sure it will be nice to be home for Easter but more importantly, this is when I tell my parents about my rhinoplasty decision. My dad won't say much on the subject, but my mom is going to FLIP OUT. Dreading the talk but on the plane ride over I wrote out all of the reasons I want the surgery (as well as all of the reasons I am NOT getting the surgery) and I hope they will understand. At this point I'm almost more nervous about telling them than the ACTUAL surgery. Wish me luck!
Finally broke the news to my mom! Thanks for the...
- 2 Apr 2013
- 23 days pre
The only bad thing is that now she wants to be there for the surgery, and she might not be able to come on the 2nd. (She has to fly in from Michigan). I would love to have her there but I assumed she was going to be so against this, I made the plans to do it on my own. At one point I even considered not telling them until after the surgery! Now I'm really glad I told her. I will see if I can get in the week before or after my current surgery date, but I REALLY don't want to push it any further. We'll see!
Hi everyone! Great news - I was able to move up my...
- 8 Apr 2013
- 17 days pre
Also, I have my Pre-Op Appointment tomorrow! Everything is finally starting to feel REAL. I went over a few more specific questions I want to discuss with my doctor. Let me know if you guys have any advice on specifics to ask! Thank you!
I had my pre-op appt today and it went incredibly...
- 9 Apr 2013
- 16 days pre
Next step - I have to go get my blood work done on Thursday. I have to admit, I'm a little nervous about that, maybe more than the actual rhinoplasty! I get SO freaked out when I get my blood drawn. It's odd, because the sight of blood doesn't bother me and I don't mind getting shots. But for some reason, the combo of needles and veins makes me panic. :/ I've only had to do it a few times and I definitely almost fainted on a few of those occasions... what a WUSS, right?! Anyway, hopefully I will suck it up and everything will go well.
I am going to Coachella this weekend and it's kind of my last hurrah before I snap into preparation mode hardcore. :)
Hey everyone! I was out of town all weekend and...
- 15 Apr 2013
- 10 days pre
I went to Bed Bath & Beyond today and went...
- 19 Apr 2013
- 6 days pre
On Monday, I am going to stock up on groceries, soup, oatmeal, mac n cheese, etc. I'm also going to buy a bunch of cold-press juices. I figured this would be a good time to do a "mini" juice cleanse since solid foods will be a challenge! I'm a workout fiend and I'm trying to get as much yoga & exercise in before I am bed-ridden.
My mom is flying in on Tuesday night. She has been SO amazing, I can't believe I thought I was going to do everything on my own. I'm really glad she'll be with me next week to keep my mind off the big day. We're staying in a hotel Wed-Sat to be out of roommates' hair, so I am trying to look at it as a staycation. Except I'll be hopped up on pain meds with a nose cast... Other than that, basically the same (hehe). Anyway! Taking it very easy this weekend.
Hey everyone! Tomorrow is the big day. Today I'm...
- 24 Apr 2013
- 1 day pre
Hey guys! Just wanted to write a quick note since...
- 25 Apr 2013
- Day of treatment
This afternoon I've just been taking it easy and icing my on and off. I took another pain pill at 4:30pm and then took a little nap. My nose is bleeding a little, so I have the drip gauze taped on. Not a big deal though. My left eye is pretty bruised, but the right eye isn't bruised at all. (And I've been SO good with the pineapple and vitamin C... oh well). No worries!.
All in all, so far this could not have gone smoother. I hope everything continues to go okay the rest of the week! I can tell my nose is shorter already which is SO weird to see.
Finally, my doctor literally just called me to check-in. I thought that was SO nice. It wasn't someone from his office, he called on his cell phone! What a stand up man! He went over the surgery and what to look out for over the next few days. But mostly he just wanted to know how I was doing. Seriously, I am so happy so far!
DAY 2 - POST OP I slept pretty well last night....
- 26 Apr 2013
- 1 day post
I slept pretty well last night. I took one more pain med at 8:30pm and went to sleep around 10:30... I woke up a lot, but sleeping at an upright angle wasn't terrible. This morning, I took my antibiotic and a Tylenol around 9am. I just had a tiny headache, but I didn't feel like I needed another pain med. I had yogurt and pineapple juice for breakfast. Loving all the pineapple! I was able to eat solid food for lunch, chewing wasn't bad at all. I also had another Tylenol and a iced coffee around 2pm. After that, I felt SO much better! I forgot how much my body needs it's daily coffee fix. Headache immediately disappeared!
I look swollen and bruised today. My left eye is worse than my right eye. My nose feels a little sore now and then, but overall, this is so much better than I expected! I really thought today was going to be so rough, but this really isn't so bad. I think I look worse than I feel, which is okay by me. :) I booked my post-op for Wednesday afternoon. Until then, more relaxing on the couch with my nasty gauze pads!
Thank you all so much for the well wishes and support. Love all my RealSelfers :) Happy Friday to everyone!
Hey everyone! Okay well maybe I spoke a little...
- 27 Apr 2013
- 2 days post
Okay well maybe I spoke a little too soon yesterday when I was like "oooh this is a breeze!" The swelling and bruising definitely got worse last night. I had a little freak out when I looked in the mirror just because my face looked SO swollen. I was trying to prepare for the worst but it's still so weird to see my face like this. I also had a lot of trouble sleeping last night, I took a pain med at 8pm and I felt okay, I just couldn't fall asleep. Then I kept waking up every two hours, UGHHH... I look like a disfigured salamander or something! Today I am feeling a little rough, but I think a lot of my stress and discomfort is due to the fact that I haven't had a good night's sleep in about 5 days :( But I'm trying to power through! My mom has some Xanax and I think I may take that. I'm totally psyching myself out. Pain isn't too bad at all thankfully!
Tomorrow my mom is heading back to Michigan and I am going home. (We've been in a hotel since Wednesday). I think that will be a good change of scenery and good for me to be in my own home. But, my mom has been amazing though. She has been couped up in this room with me for days, just waiting on me hand and foot. I couldn't have done it without her. :) I hope you're all having a great weekend.
Day 3 - Post Op THANK GOD! I feel so much...
- 28 Apr 2013
- 3 days post
THANK GOD! I feel so much better today... After I wrote that post yesterday, I was sooo exhausted and just wanted to cry. My mom was like "okay you need to calm down and get some rest!" I took a Xanax around 4:30pm yesterday and ended up falling asleep. I woke up at 6:30 and had dinner. Then, I slept from 9pm-6am barely waking up. AMAZING! That was the first time I've ever taken Xanax in my life and oh my! It totally saved me. :) I feel like a lot of the built-up stress finally left my body. I am still pretty bruised and swollen today, but I think yesterday was definitely the "bad" day. We checked out of the hotel this morning... When the valet guy came with my car, I looked right at him with my swollen, bruised, and bandaged face and said, "Sir, do I have something on my face?!" He laughed, I laughed. Great times! Anyway, I posted a few new pics from earlier today.
I am really surprised I haven't taken a paid med since Friday night. I always thought I had a pretty solid stomach and she certainly handled this ordeal like a champ! I've been eating solid foods and drinking lots of fluids. I never took any laxatives but the pain meds definitely made it tough to go to the bathroom. I think my tummy would be in worse shape if I was taking them every day. Sometimes my nose will feel a little tingly and it's still bleeding a tiny bit, but it's really not painful. Uncomfortable, YES! But bearable. I think I may take a bath tonight because I am feeling like a slob kabob! My hair is getting pretty grimy, but oh well. I guess it will feel super fresh when I wash it (eventually) haha! I was just started to get a little stir-crazy in the hotel, but now I am so happy to be back in my own bed. Happy healing everyone!
Day 4 - Post Op Not too much happening today....
- 29 Apr 2013
- 4 days post
Not too much happening today. I took half a Xanax last night (1 mg) and slept through the night. Woke up feeling really great. Gosh, I am so happy I had some Xanax on hand (I only had the pain meds & antibiotics prescribed to me). This was the first morning I didn't take any Tylenol when I woke up. :) Although I did take Tylenol later this afternoon, I feel very lucky! I just felt like I had a little headache, but nothing bad. This is also the first day I haven't needed my drip pad taped under my nose. My nose is still dripping a little, but it's not constant like it was. Slight improvement. I just keep lots of Kleenex and my gauze handy! Bruising has gotten better, but my left eye is still purple and yellow. The swelling around my eyes has gone down, but my chipmunk cheeks are still going strong. I look like I have golf balls in my cheeks, pretty funny. My nostrils are the only "gross" thing. I can't wait for all of that dried blood to be gone, but I am not refusing to touch it until I see my doctor on Wednesday.
I took a bath today and it felt so good to be clean! I have been obsessively wiping my face with cleansing wipes so I don't feel like a complete slob. I'm going to attempt to wash my hair tomorrow night because this nasty mop is getting OUT OF CONTROL.
I'm going to try and go to bed with no Xanax tonight. Sometimes I freak myself out trying to FORCE myself to go to sleep and stressing about being tired the next day. I start to think I will never be able to sleep (crazy I know) and my mind races like crazy. But we'll see how it goes.
Last thing, I am reading Gone Girl by Gillian Flynn, and it's SO good! I've literally almost read the whole book in two days. Highly recommend for anyone recovering and looking for a good read!
Day 5 - Post Op!! Okay sleeping au natural...
- 30 Apr 2013
- 5 days post
Okay sleeping au natural (without taking any meds) was NOT fun last night. I somehow feel like I am more aware of my nose cast and tape when I'm lay down. Then I start to worry if I'm propped up enough and keep readjusting.. frustrating. I definitely woke up a few times. Anyway, not much else to update today. Cast is starting to irritate me, so I'm just trying not to think about it. Better than being in pain :) Best of all, I washed my hair today! Well, half-washed it anyway... I couldn't really scrub the top of my head/hairline, but it's an improvement! That was definitely the most awkward bath of my life, haha.
I posted some more pics. Eye bruises are fading (slowly), and the swelling is getting better, although my cheeks are still a little chipmunky. My only concern is that the left side of my nose is still bleeding occasionally, which makes me nervous. It's not bad, I just have to dab at it occasionally. I still have these little tampon thingys in my nostrils too. But I am going to the doc tomorrow, so I'm just going to hope everything is okay until then, haha. I don't even mind if I have to keep wearing tape, I just can't wait to get the cast off :)
Also, I wanted to share something that only rhino friends can truly appreciate... I actually had a dream last night that I got my cast off. But my nose was pinched and still had a little bump. Here's the hilarious part, even in the dream I wasn't even that upset, I was like, "well, it still looks better than the old one!" HA.
I'm taking a Xanax tonight to avoid any silly dreams!
Day 6 - Cast Off Guys! I honestly don't know...
- 1 May 2013
- 6 days post
Guys! I honestly don't know where to start... I am so, so unbelievably happy. This is going to be a long post, but I just want to share everything with you! Before I get into this overwhelming feeling of absolute elation, let me tell you the technical details :)
Okay first of all, my appt was at 5:30pm today. So of course, the whole day just drags on. I left my house just after 3pm (gotta love LA traffic) to get to my appt. I'm sitting in traffic... watching people in the cars next to me practically break their necks trying to see what the h*** is on my face. (can we swear on RealSelf?) Meanwhile, in the car, I'm just trying not to think about the cast, or the fact that my nose keeps running. Yesterday, when I said my nose was still bleeding, I was wrong... it's just still "running" now and then. But the fun stuff coming out of my nose mixes with the dried blood in my nostrils, and you get the idea. Just gross! Anyway, it takes me almost 2.5 hours to get to my doctor's. I finally get there (hustling in because I'm 5 minutes late) and his office is packed. And then I end up waiting for over an hour... I really didn't mind, except I was SO ANXIOUS. At one point, I really thought I was going to rip the cast off my face. That was a rough hour, haha.
*NOTE to anyone considering Dr. Grigoryants - His waiting room is ALWAYS packed. Plan on padding in some extra time with your appointments. For me, it was 100% worth any wait time. :) I love him and the ladies who work in his office! Just keep that in mind, especially with end of the day appts!
Okay, so let's do this! I'm sitting on the table and right before Dr. G takes off my cast, he gives me a big warning speech... "Stephanie it may look very swollen at first, but it will all go down. Some people think they look like an "Avatar" because of the swollen forehead. The tip is going to be pushed up, like a pig. That too will go down." I'm nodding. Actually I was thinking, "babe, I've spent the past month on RealSelf. With your former patients. Bring on the piglet Avatar!" Anyway, I was SO nervous it was going to be painful, but it really wasn't. He peeled off the tape and cast, then took out the mini-tamps (aka splints). OMG. Talk about a breath of fresh air... It was like a week's worth of pressure suddenly released! So I said, "Wow, I was concerned about those little tampons but that wasn't bad!" He says, "no no, I don't use tampons. No packing!" LOL. Love this guy. Anyway, the only uncomfortable part was when he had to lightly tap on the bridge to check my bones. I'm like "WHAT'S HAPPENING?! ARE THEY OKAY?" But he said they were totally fine. Then he snipped off the stitches and cleaned out some of the dried blood. Major respect, because I can only imagine how absolutely revolting that was... so then I sit up and I see myself in the mirror. I was STUNNED. I look like myself.. but my nose, my nose that I hated sooo much, is gone. In it's place is this OTHER nose, this absolutely wonderful nose. I just started smiling. Smiling at myself in the mirror, smiling at him, then I start saying I-LOVE-IT-THANK-YOU-OH-MY-GOSH-I-LIKE-IT-THANK-YOU... I seriously could have cried right there. I know, I know... my nose tip is quite swollen, I have a little lion forehead thing going on, my lower cheeks are still puffy, and my left eye still has the gruesome bruise... but honestly, it's NOT bad. In fact, it is so, so very good! Even with the tape on it now, I just like what I see. Such a new feeling!
I feel so lucky, grateful, and blessed. This is just, entirely surreal. I DO feel a little vain. Imagine, hating one part of your body so much, for so long, and then all of a sudden, seeing that feature and not hating it at all. AND, actually wanting other people to see it! It blows my mind. I literally can't believe that I get to keep this new nose, I know that sounds crazy. But I already feel so nervous that I will mess it up somehow, or it will change. I feel like I need to tiptoe around the house, haha. Even driving I was extra cautious, like, OH NO a pothole! What a silly goose!
Anyway, I'm so sorry for the long-winded post. That's really all I have to say, other than I am so excited to see how it progresses over the next month. Eeeeeek! I sent some pics to my family and best friend (also posted here for you guys). Good night all!
Day 8 - May 3 Just a quick update. I realized I...
- 3 May 2013
- 8 days post
Just a quick update. I realized I forgot to mention my post-op instructions! Basically, I just have to tape my nose at night until I go see him in 3 weeks. I am so paranoid about hurting it, or messing it up, taping was a process when I did it myself last night. I actually feel "safer" when the tape is on, so I've been leaving in for 15+ hours, haha. I'm sure taping will get easier for me though!
Yesterday I finally went out of the house for a few hours...I have been such a lazy recluse! Anyway, I immediately noticed my sense of smell is SUPER enhanced. I always thought I had a rather dull sense of smell, well, not anymore! (I'm not sure if the rhinoplasty really affected my olfactory abilities, or if it's just in my head because I couldn't smell or taste anything for a week). Either way it's so cool... walking around outside in Santa Monica was like an intoxicating adventure. I hoped no one noticed me sniffing everything hahaha...
Posted a few pics with Before&Afters! I just downloaded this PicStitch app and it's so fun to play around with :) Excuse the residual bruising and Neosporin around the nostrils. One day at a time!
Also, I wanted to thank everyone for all of your compliments and well wishes, before and after surgery. Seriously, checking this site always uplifts my spirits. Love you all!
Day 11 - Post-Op! Hey everyone! Not too much to...
- 6 May 2013
- 11 days post
Hey everyone! Not too much to say here, I am still taping my nose at night. I try to leave the tape on for 12-15 hours. I also apply Neosporin inside the nostrils 3 times a day. My cheeks are ALMOST 100% back to normal, and the last remains of my gruesome left eye bruise have almost vanished. My nose feels a little tender and sore. The tip is still swollen, but not bad. All in all, feeling good. I probably won't update until next week...
Quick question for everyone - does anyone recommend a solid nasal spray? Sometimes my nose gets really dry overnight and I want to use some sort of moistening spray. I thought about using the Biotene mouth spray, but I'm not sure about that? Thanks all!
Day 14 - Two weeks after surgery Hey guys! So...
- 9 May 2013
- 14 days post
Hey guys! So on Tuesday, I had a mini-freak out. What happened was, on Monday night, my nose started to feel very swollen. Unusually swollen. It was pretty late, so I thought I would tape it up and hopefully it would be better in the morning. Well Tuesday I woke up, and it didn't feel any better. It wasn't painful at all, it just felt all tingly. All of a sudden, I was so AWARE of my nose. The weirdest part was that the tip was so HARD. Everywhere around the nostrils felt rock hard. (By the way - this sounds hilarious when I explain it to anyone... the story of my "incredibly hard, swollen tip." No one can take me seriously, haha. They're like, "are you sure we're still talking about your nose here?!" )
I, of course, panic and jump to conclusions. (I'm thinking, "I knew my recovery was too smooth, something HAD to go wrong!) Anyway, I emailed my doc and described what was going on and also sent him some pictures. (The problem is, it looks totally fine from the pictures, just a little swollen). He said it's all fine, the swelling will get better and better. He just said avoid sodium and take it easy. It still felt a little weird yesterday, but it will come in waves. Waves of the nose feeling super sensitive. Today it is a lot better, although I think it looks swollen. I'm just looking that I have a large face with big features to balance the nose out! I still LOVE it, even if it is still swollen.
I just wanted to share that with all of you. I guess you never really know what's going to happen in these first few weeks post surgery. I'm interested to see what will continue to happen! I posted a pic (dark blue shirt) that I just took - not sure if you'll really be able to see the swelling from it.
Day 16 Post Op I just wanted to say I'm happy...
- 11 May 2013
- 16 days post
I just wanted to say I'm happy and quite relieved to hear that I'm not the only one who experienced the crazy tingly feelings and sudden swelling. It was so reassuring to read that some of you guys dealt with that too! Day 11-13 was seriously WILD for me. My nose kept flipping between either: 1) numb and tingly or 2) the entire tip & nostrils felt rock hard. The past few days have been a breeze though!
Somewhat thoughts on food & swelling - today was the first time I kind of "let myself go" diet-wise. I try and eat pretty healthily in general, but normally I'm not as worried about it, because I'm usually exercising on the reg. Since I've been off my work-out regimen the past few weeks, I've been extra careful about what I've been eating. I've mostly been eating fruits, veggies, lean protein, some dairy, and dark chocolate when I need a little treat :) Lots of vitamin C and water too. Well this weekend, all of that went out the window. In the past 24 hours, I've had: pizza, chips, ice cream and candy!! (I went on a field trip with 6th graders and totally caved in!!! hahaha.... Anyway, I feel like a huge slob but the nose actually doesn't feel too bad (I was prepared for major swelling). Other than a little tip swelling, everything seems okay. We'll see how it is tomorrow.... I also haven't drank any alcohol yet. But I'm REALLY starting to crave a glass of wine!
Also, thank you all so very much for your thoughtful compliments and being so kind in your posts. I feel incredibly lucky and am truly grateful for my results. Seriously, so much love for my RealSelfers - you guys are the best.
Day 26 Post Op!!
- 21 May 2013
- 26 days post
Hello hello! I realized I haven't posted in days but the truth is, there isn't too much more to report... Let's see, I'm still taping my nose at night. I try to leave the tape on for 12-16 hours. Sometimes I can't tell if the tape makes it more or less swollen. My nose definitely feels slightly more swollen and tender in the morning, but I think that's generally the case. I finally stopped sleeping upright (do NOT miss that!!) but I'm still sleeping on my back. I am still using Neosporin on the scars inside my nostrils, but only once a day now.
As far as getting my life back to normal, I feel pretty good. I just started doing yoga this week. BUT I am very careful. I also don't like to bend over, so I try to keep my head elevated as much as humanly possible during the positions. My nose starts to feel a little tingly when I exercise and a little swollen after, but it's totally manageable. I've gone hiking a few times but nothing too strenuous. Definitely not going to attempt running for a few more weeks, although I am DYING to really work out. I wear contacts during the day, so I tape my glasses to my forehead at night. It's a really great look...NOT! haha. No sunglasses, which is very tough in sunny California, especially now that summer is here. But, it's a small price to pay! :)
I did do quite a bit of drinking this past weekend at a mini-family reunion (just over 3 weeks post op). Wow, my tolerance has disappeared after not drinking for a month, haha! Anyway, my nose looked and felt pretty swollen on Sunday and Monday, but I think it's settling down now. Definitely worth it though :) Thankfully, I haven't experienced the crazy tingling or extreme swelling like I did a few weeks ago. Woo woo!
And finally, quick update on the way my nose looks! I am still incredibly happy with my results. I know it's still a little swollen, especially near the tip. I am reminding myself to be patient, since it hasn't even been a month. BUT, (there had to be a but, right?!) sometimes when I look in the mirror, I'm worried it looks like my nose is leaning to the left near the tip. It kind of swoops in and leans. It's not THAT noticeable, but it's consistently something I notice. I suppose it could be from residual swelling that's more intense on one side. I really hope that's the case! The alternative is that the nose is still settling in and it's going to be slightly crooked... for good. Eek! I try not to over-think it because it's only from that one angle.
Anyway, I posted some pictures from today. I hope it doesn't look MORE swollen than the pics from a few weeks ago! I have an appt with Dr. G on Saturday 5/25 (surgery was on 4/25 - time flies!), so I will post again after that. Thanks for reading everyone!!!
Just over a month post-op...
- 27 May 2013
- 1 month post
Almost 6 weeks post-op
- 3 Jun 2013
- 2 months post
In my last post, I said that things had pretty much returned to normal. That's true, except I haven't done any running yet. I've been hiking and doing yoga - nose feels completely fine with those activities. I guess I'm just a little worried about hard-core cardio. I still feel very "aware" of my nose, and I know this may last up to a year. I hope I feel safer to try running after a few more weeks...
I probably won't write too much more until my next doctor appt (in 6 weeks). I did add 2 more photos with this update. I don't want to bore you guys! Thank you again for reading my posts and for all your incredibly thoughtful compliments. Until next time!
Almost 7 weeks post-op
- 11 Jun 2013
- 2 months post
Next up, glasses and sunglasses! I've been taping my glasses at night. I think I'm going to wait until next weekend (8 weeks post-op) to rock my sunglasses again. Summer is here and it's time to bust out the shades!
Also, I wanted to thank everyone for all of the kind words and compliments. I really appreciate you taking the time to read this and share your thoughts. I feel incredibly lucky and really am so pleased with my results. If anyone is considering Dr. G for rhino, please feel free to message me! I can't recommend him enough.
Almost 2 months post-op
- 17 Jun 2013
- 2 months post
The skin on my nose also seems to be a little different. Sometimes it's greasy and seems to be more prone to breaking out. It's manageable, I just spend a little extra time on my face in the shower now, haha. I haven't worn any sunglasses or glasses yet. (Man do I miss sunglasses!)I've tried them on a few times, and it just felt weird. It looks like most surgeons on this site recommend waiting about 4-6 weeks to wear glasses. So I'm thinking I should be okay to wear this weekend (after 8 weeks). Maybe just not for long periods of time.
Great review?
My Doctor: Vladimir Grigoryants, MD






























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