Dr. Grigoryants is the best!-Revision Journey

I had what was supposed to be a finesse...

I had what was supposed to be a finesse rhinoplasty in December 2013 with a double certified Dr. (see my previous review). What was to follow was nothing I ever expected or imagined.

It has turned into a long, emotional, painful ordeal that I wish upon no one. When the cast came off, I nearly passed out from how swollen and hideous my nose looked. Instead, I went numb and my brain could not process that I was looking at myself. The nurse asked me what I thought and I remember telling her: "I look scary."

The following months were emotionally the hardest thing I have ever had to deal with, and I have been through a lot in my life. I had my first revision with the same doctor, which I have come to regret now. I should have saved money and gone to a revision Dr and had all my issues addressed in one shot. While the profile was improved, I was left with retracted nostrils and a persistent hump, a slight depression, along with a visible fracture line that did not go away. To make matters worse, a surgery that was supposed to help my breathing has made it worse. It is difficult for me to work out now, something that used to be my therapy.

My nose is not a "botch job", but what I walked out with was much worse than what I walked in with. I get really sad every time I look in the mirror or see my reflection. I am more self conscious of the nose I have now than I ever was of my biological nose. I know people live with bad nose jobs for years before they address it, probably out of fear that another surgery will make matters worse, but I cannot imagine continuing to look in the mirror at this nose for years to come. I hope to find the right revision Dr. I have consulted with two so far and both said I could have my revision 5-6 months after my last procedure since no bones were broken and my tip was not altered. This will document my journey of finding the right Dr for me.

No surgeon has a perfect record

If I knew then what I know now, I would have never touched my nose. Having a rhinoplasty IMO is opening a can of worms. In the last 8 months I have spent countless hours and days researching this procedure and speaking to patients. The amount of people who suffer from a bad rhinoplasty is scary. There are so many who suffer silently, ashamed to post about their experience. Even the most renowned surgeons have some very unhappy patients with bad results because the nose is very delicate and Drs are not perfect. It is really scary. A bad nose surgery is not something you can hide and forget about. It is in the middle of your face for you and all to see daily. Reading and researching Drs has led me to realize that this is a huge $$$ making industry and a lot of Drs resort to shady, unethical, and deceitful tactics. There are so many fake reviews out there that you just don't know which ones to trust. Some Drs have negative reviews completely removed from certain sites. That fact alone breaks my heart. Drs lie about the number of surgeries they perform, their revision %, and even whether a patient really needs an actual procedure such a septoplasty or not since insurance pays $$$ for those things.

Anyway, the point is, it astonishes me when I see so many people who have perfectly nice noses and still take this huge risk for little reward. People DON'T focus on your nose unless it's huge. They see your face as a whole. So many people who have very low self-esteem, BDD (Body dysmorphic disorder), depression/anxiety, and start obsessing over their noses thinking that fixing it will cure their warped self-image. Of course I'm not discounting the experiences of those who had noses where we can objectively say, yes, a nose job could really help, and a nose-job does in fact give them a self-esteem boost.

For me at this point, I'm as miserable as can be with my results, so I'm taking a risk again, but I am doing my due diligence and researching as much as possible. There is the possibility that I won't be happy with my results, and that worries me, but I want my life back!!!

Consults so far

I have spoken with a few surgeons so far and met with 2 in person.

Of all surgeons I have emailed, Dr. Lamperti in Seattle has been the most helpful in his responses. He reviewed my pictures, answered ALL my questions thoroughly, explained different techniques to me, etc. If he wasn't all the way across the country, he'd be at the top of my list.

Meanwhile, I drove 2 hours to see another well-known Dr who I will not name, and he would not give me ANY feedback. It was a 10 minute useless consult where I was told: come back in a few months. Really? Things like a hump or nostril notching aren't going to magically fix themselves. I am tired of surgeons blaming swelling for everything. While some things do resolve themselves with swelling, there are others that DO NOT and are known not to.

I also met with Dr. Boahene in MD. I was really excited to meet him and he did not disappoint. He was such a sweet, cheerful man. I was so grateful that he took pictures, created morphs, and told me while my nose does not look bad, he can see why it bothers me. I think the only thing was he did not agree with me that I had a droopy columella, and told me that my nose now leaning to the right was just an illusion, although my fiance (without me ever mentioning it) pointed it out. Another concern I had was his replies to my emails were a bit slow, I'm not really sure what the norm is in terms of responsiveness amongst other well-known surgeons is, so maybe I am just impatient.

I have considered Dr. Eric Joseph in NJ but don't like the fact that he really advocates permanent fillers which are completely unsafe. I want to feel that I can trust my surgeon.

I'm also considering Dr. Le in MD, he fixed penelopenose's completely botched nose and he is known for his revisions, but there are others who have had really unusual encounters with him. I think I will find out for myself by scheduling a consult.

Finally, I am scheduled to see Dr. Zuliani in Michigan. I am seeing him because he had a lot of experience with thick skinned patients/ethnic noses. I personally spoke to three of his patients who are very happy with their results, one being a major revision. He would not respond to any of my questions via email though. My only concern is that he is a young Dr with less experience than some others.

OMG It's done!

I made it to the other side and back! I'm still holding off on telling you guys who I picked as my surgeon because I want to do an honest assessment without getting any backlash or hostility. In total, I spoke to 6 surgeons before making a decision. So I'll talk more about why I picked him and meeting him in person in another post.

I had my revision surgery yesterday. I flew out to have it and had to come by myself. I think that's the hardest part about it so far, not having the emotional support, and I could use some assistance.

Unfortunately, I'm not sure if I was given too much anesthesia or what, but I woke up feeling awful. I was hallucinating!! no joke, and then I was in so much pain. My nurse was really rude and started saying things like "you are whining like you're dying! you are not dying!" Wow...I just told her "I know I am not dying but I'm in a lot of pain!!!" she then told me "hun, you've been through this before, you should know what it's like!" I could not believe her! Literally the meanest nurse I've ever had! I started crying and only then did she call the Dr who told her to give me some morphine, which helped so much. I then got my period while I was in recovery, omg, what? just great!

I had arranged with a nurse assistant to take me to my hotel, and she was supposed to spend 4 hours with me. Unfortunately the nurses at the hospital told her to come too early so she ended up waiting there for 2 hours :( She wheeled me back to my room and helped me a bit then had to leave, and I wished she'd stayed longer :(

I ended up throwing six times that night. It was so bad because all that pressure made blood gush out of my nose. I also could not stomach anything so I couldn't eat, which meant I couldn't take any pain meds. I'd feel so much better after throwing up, fall asleep, probably swallow some blood coming down from my nose, then wake up and vomit again. It was a really rough 6 hours.

I've been sleeping in increments of 1-2 hours, waking up with a really dry mouth, drinking some water, then dozing off again. The pain is very manageable now and I have been able to do without the narcotics I was prescribed. My eyes are nearly swelled shut. I am having nightmares about my nose when I fall asleep..it feels like I have PTSD. I really cannot handle another disappointment. He told me because it was a revision it wont be perfect but it will be an improvement. I am just scared, not sure what to expect.

Oh!! And I am so lucky that he ended up not needing any ear cartilage! I am so glad he found enough septum to work with. I didn't need any grafting except for spreader grafts. yay!

Will try to update until the cast comes off!

5-6 days post-op

I am 5-6 days post-op and feel so much better now. The swelling is dissipating and the bruising is shifting. My entire face swelled up and I even have bluish bruises down my laugh lines where my cheeks got stretched from the swelling. The inside corners of both of my eyes got bloody and overall I look like a total disaster. I am still stuffy and congested, but overall I feel much better than I look. Yesterday I was able to go out and walk around the city which was a nice break and such a relief from being stuck in the hotel room. I had a moment where I saw my columella (which he tucked in) and freaked out, started crying, because my tip looked so piggish. Then I had to remind myself that I am still incredibly swollen and haven't even seen my nose yet lol

Tomorrow, the cast comes off in the morning, then I fly back home. Till then!

I'm a believer!!! Crying!!!

Okay, you guys, my surgeon was Dr. Grigoryants, and you know what? he is the best! I am so so so happy I chose him for my revision! (More on why later)

I got a call from Dr. G's office saying he has time between surgery to get my cast off today since my apt tomorrow would be cutting it close to my flight time. He was really busy and had to rush so it was a quick 15 minute meeting. But you know what, I'm okay with a Dr. who doesn't have time for chit chat but who delivers and gives me a beautiful nose. My last surgeon spent so much time meeting with me, had a great demeanor and personality and was very sweet, but that didn't give me results.

You guys, I have no words to describe what I am feeling right now. Ahhhhh!!!

He removed the stents and stitches and put some brown tape on my nose. He handed me a mirror and let me see my profile.

As swollen as my nose is (my tip is huge) it still somehow looks amazing! Perfect profile, just perfect!! columella was lifted, no weird nostril show, my nostril size was reduced, and my nose is straight!!!!!!!!! I literally cried (tears of joy) after he walked out. Just writing this out makes me tear up a little bit.

I am soooo grateful and relieved this nightmare is over. My first rhinoplasty stole so much from me my social life, my happiness, and peace of mind. Dr. G gave it back to me in 2 hours just 5 days ago. I know the swelling will take much longer this time around because it was a revision (he said 2-3 years for all swelling to resolve) and I will have to hide out for another 2 weeks or so before I look presentable, but I am just elated :D

akljdflkjaadfljadg SO SO HAPPY!!!!

Traveling Home

I flew back home yesterday and frankly I looked like a train-wreck. It was embarrassing and makeup didn't provide the best camo since my bruises were dark purplish black. I also had bloodshot eye corners and 3 people asked me "what happened?" One lady said "Jesus!" and one girl asked me for my surgeons name lol! My nose got super dry on the flight and overall I was just exhausted. If it wasn't so close to Thanksgiving and I had more funds I would have stayed an extra few days before travelling back home.

I've been taking hot steamy showers and then applying coconut or olive oil for 3 days now. The hot water feels good and I feel that it's helped a lot with the swelling. Honestly, the arnica montana and bromelain (I started bromelain supplements a few weeks before the surgery) have no visible impact on swelling or bruising for me.

I love my tucked in columella from the side, but not so much from the front. I feel like it has created more space between my lip and nose, and my tip is a little high right now so it adds to that. I asked Dr. G about lip injections and he said "why would you mess with your pretty lips" I wish my upper lip was a little fuller that's it :)

My SO jokingly said "there is still a dip in your profile" and I freaked out. I remembered how it took a few days for the swelling to go away and show my true profile, and now I'm like omg, I got excited way too soon. Don't get me wrong its already absolutely a big improvement but I have to mentally prepare myself for less than perfect results. It's squishy where the residual hump was shaved so I just have to wait and see. But, there is NO WAY I'm doing anything to my nose after this. NO WAY!

Happy Thanksgiving y'all!

Why I chose Dr. G

I spent hours and hours reading everything I could find about revision surgery from actual patients, to the point that it became my life. It's how I spent all my free time. Based on my own experience, I decided that Dr. G has the best approach with some of the best results. Here is why:

1. He always does closed rhinoplasty. Closed causes less trauma to the nose and less inflammation as a result. Overall, I personally think it is the better technique. Visibility is not an issue if the surgeon is skilled.
Unless you are a revision case, then Dr. G might use the open approach. Thankfully, because my previous surgeries were closed, and my tip wasn't stiff, he decided on closed.

2. He does not use unecessary grafts. My first surgeon put in Lower Lateral Cartilage grafts, rim grafts in my nostrils, and a strut graft in my columella. They were all a disaster, felt awful, hurt a lot, were quite visible, and made for a ridiculously swollen nose. I did not need any of those grafts since it was a primary rhinoplasty. The LLC grafts made my breathing worse and scratched the inside of my nose, the rim grafts did not prevent notching and the one on the right side showed up in flash pictures, and the strut graft made my columella droop down and felt soooo stiff.
I ended up having all of them removed.

The only grafting I SHOULD have gotten but didn't were spreader grafts. From my research, I think its wise to choose a surgeon who uses them . They prevent certain breathing problems and make your nose streamlined. Dr. G generally always puts in spreader grafts. I also haven't heard a single complaint about them, most of his patients don't even realize they have them.

It seems to me that other kinds of grafting can cause a lot of problems and can move, protrude, warp, etc. I did not want to have to deal with that headache. I also had a surgeon tell me he may need to use rib graft. I did not need my nose built up, so no way in hell! I also read the only time you should get a strut graft is when you have an open procedure. Personally, it feels so awful, so I insisted to Dr. G that I did not want one.

3. He does beautiful noses AND beautiful revisions. I think of 100+ before and afters, I only didn't like 1 or 2.

4. There are people who are dissatisfied, because again, no surgeon can please every single patient, but none of them are horrible results.

5. Yes, there is a lot of hype around him, but it's well deserved, and there are many girls who have posted their pictures on here. They are obviously not fake reviewers.

And to the people who say he does cookie cutter noses, yeah, you could say he has a "style", but you know, after my horrible first experience, I'd rather have a surgeon who has mastered that one approach that works for most people's faces.

6. Finally, when I met Dr. G, he was a no-frills Dr who surprised me with how humble he is. He does not have a God complex at all like many plastic surgeons. He is very kind, straight-forward, and to the point. He does not push you to consider procedures you are not interested in and is frank with you in cases where he could make $$ but elects not to. While our meeting was brief, I felt comfortable moving forward with the surgery.

On the day I met him, I ran into two ladies who were there to have their casts removed. One of them flew all the way from Norway by herself! I got to see the Norwegian girl's nose after her cast was removed and it was so pretty. She said it was a big improvement and showed me what her nose looked like before. This was really reassuring!

Still bruised

I have been avoiding meeting people and going out because I am still bruised and have blood around the rims of my iris in both eyes. I actually didn't have any blood in my eyeballs until maybe day 3 which then slowly seeped forward. I went out grocery shopping yesterday and the clerk asked me what happened to my face and if I had gotten into an accident. I really hope that by Wednesday (2 week mark) the bruising will be gone or at least that I'll be able to cover what's left of it with concealer. It's also been really embarrassing with family who want to video chat as I've been coming up with a bunch of excuses and they're like....Okay??!!! I tried to reschedule my surg so it wasn't around Thanksgiving but there were no other available dates.

I am attaching a picture of Day 5 when the cast came off.
I am still very swollen so I do not know if I will be completely happy with it, but for now, I already can see that it's a big improvement. I am a little worried about the profile, whether it will be straight when the swelling recedes...only time will tell.

I will work on creating a collage so you all can see the difference side by side.

Almost 3 weeks out

Day 17: the bruising finally completely cleared up, but I have very dark hollows around my eyes. I also have very small traces of blood around my iris that aren't noticeable. Today was the first day I let my S.O see my nose w/o the tape because we were invited to my brother's house for dinner. I was very self conscious but he told me overall the swelling is only noticeable because he knows I've had surgery, but to me it looked like I had a tomato in the center of my face :( It was also the first time my family would see me since the surgery: my brothers, dad and sister in law. No one said anything...and I'm pretty sure the men didn't notice anything because they couldnt even tell I had anything done after my first surgery despite knowing I was having surgery, they just didn't know it was partially cosmetic. I wonder if my sister-in-law could tell but she wasn't staring weirdly so I presume not. Its actually funny because my younger brother noticed the hollows around my eyes but not the nose, and asked me if I've been getting enough sleep haha.

Day 19: I still have nightmares about my nose and still worry what it will look like with time, some days I get high anxiety about it, but I keep reminding myself how much of an improvement it is already. I did a video comparison and wow the difference is very evident and makes me so glad I got this done. The only thing bothering me is my 3/4th angle from the right side. It's the angle that bothered me most before this revision and I wish I pointed it out to Dr. G. I just assumed by telling him to get rid of the residual hump it would take care of it, but I think the bone is uneven and should have been shaved a bit more on one side more than the other. It still looks way better, as of now its just a minor flaw.

I would say Dr. G achieved nearly everything I asked him to and was honest with me about what he couldn't change.
He said the one thing he couldn't get rid of was the osteotomy shadow on the left side of my bridge. My first doctor made the break too close and it left an ugly shadow :(

My tip is very swollen but I know it will look much better as the swelling goes down.

I still have dissolvable stitches, and I have not resumed working out. I plan on starting around day 23-25 depending on how my body feels.

4 weeks update

I am still really happy with my results. I no longer feel like a freak show going out in public even with all the tip swelling. My left profile is near perfect. My right has a tiny bit of left over unshaved bone. The 3/4 angle as I've mentioned before is not completely even because of the small residual hump. I would lie if I say it doesn't bother me at all, but its just a small annoyance, sort of a damper on how thrilled I am with the results overall since I can't say "Its perfect". It's really not noticeable to the casual observer and only shows up in pictures under outdoor lighting but not indoors. I am still taping and hoping it will go down but from my first experience the profile doesn't change much after 4-6 weeks. I emailed Dr. G about it just so that I keep him posted on my recovery progress. Of course I got the standard wait 1 year reply which I am fully aware of.

I was reading how sometimes, when you have had 1 bad surgery, you become hyper-focused on the details and every flaw is a reminder of the fact that the first surgery didn't go well. I am trying to zoom out and look at the bigger picture.

I have no regrets in having gotten this surgery and feel much more confident now. I honestly feel like I got my life back, even though I still have nightmares about my nose.

I still have stitches inside my nose. I actually just pulled out a LONG one today and it felt so weird haha. I try to clean my nose out with saline spray 2 to 3x a day. I also rub in neosporine at least once a day. As for my breathing. I can breathe a lot better out of my right nostril than my left, but there is also a lot more swelling on the left side so I'm waiting to see whether my breathing gets better as the swelling goes down.

I have not started working out again but felt good enough to start on day 23. The dark circles around my eyes are getting much much better but are definitely still there. A little bit of foundation does the trick :)

A week ago a friend called me and she said "your voice sounds different". That's happened with my first surgery but I was surprised to hear it, being in week 3 of recovery. I have no idea if my voice permanently changed but I did read a study that slimming your nasal bones does have a slight effect on your voice, but I'm not a singer so it's not a big deal :)

Let me know what you guys think!
Los Angeles Plastic Surgeon

A truly talented Dr. with an artistic eye. Wish I had my primary with him, so glad I found him for my revision. He's really busy but he delivers and that's what matters.

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