Rhinoplasty Surgery Including Cartlidge Grafts from the Ear and Chin Implant. - New Orleans, LA

When I was in high school, a friend and I were...

When I was in high school, a friend and I were leaving a party and were sitting in my car when I was attacked by another boy. As I sat, he punched me 3 times in my nose and mouth. My nose was fractured and septum was deviated by this. When I was 19, I had a septoplasty to relieve breathing problems but did not have a rhinoplasty at that time. Over the years I grew to dislike the crooked look of my nose. One week ago (I am now 37) I finally gathered the courage and underwent rhinoplasty.

Before surgery, the doctor suggested that I get a chin implant to improve the harmony of my particular facial features. Mainly, he said it would improve my profile to go ahead with the chin implant along with the rhinoplasty. He also let me know that due to the fact that I had a previous septoplasty, it might be necessary to take cartlidge from one of my ears and use it to help build up my nose.

It has only been seven days, so my ultimate final conclusion as to success is still down the road a bit. But so far, here are my opinions of the process:

I did a lot of research and saw 5 different plastic surgeons in three different ciities near me before ultimately choosing one. Strangely, the initial doctor I met acted like he could help me but then when I called to make an appointment, his assistant said he refused to operate on me. When I asked why she smply said, "He can't help you." To me this was bizarre. Maybe he thought I was asking too many questions or would be too picky with his results but if that was the case, he should have just told me this instead of having a receptionist reject me without any real explanation. In hindsight, this was probably a blessing because ultimately I ended up finding a much more qualified surgeon. 

The remaining 4 surgeons that I visited, all agreed that rhinoplasty could help me. I think that 2 of these 4 wanted to use a closed approach and the other 2 wanted to use an open approach to rhinoplasty. The cartlidge in my nose was both damaged and missing due to the previous septoplasty, so the surgeons had differing plans to deal with this issue. 1 surgeon wanted to use an artificial material (implant) in my nose, 1 surgeon wanted to use cadaver cartlidge in my nose, and 2 of the surgeons wanted to take cartlidge from my ear and put it in my nose.

I decided that there was no way I would allow cadaver cartlidge to be placed in my nose. The idea just "weirded" me out and I was worried about infection because that is a risk with both cadaver cartlidge and implants. Thus, I chose one of the surgeons who would use my own ear cartlidge to perform the surgery.

So I decided on the surgeon and went ahead and got the surgery last week. Basically, he worked on the bones, the septum and reconstructed the tip of my nose using the open approach to rhinoplasty. Lots of people told me that rhinoplasty was not very painful prior to me having surgery. When I asked the nurse the order of pain from most to least, she said that it would probably be ear, chin, and then nose. After surgery, my conclusion is that the chin hurt the worst, then the ear and then the nose.

My chin hurt so bad that I could barely eat for several days. In fact I have lost between 5 and 10 pounds in the seven days since my surgery. My chin still hurts on day 7 but is much less painful than it used to be. I am starting to look like santa claus because I still can't shave it for 3 more days.

When they took cartlidge from my ear they stitched it up and then stitched in a big waxy, medicated plug that I had to wear in my ear for 4 days. This was perhaps the worst part of the whole recovery process....not because of the pain but because of the irratation and itching. I couldn't sleep and felt like I was about to go out of my mind until they removed it.

As for my nose...i really didn't notice too much pain with it. I don't know if this is because it isn't all that painful or because I was so overwhelmed by the pain of my chin and and the irritation of my ear, that I just didn't notice the nose as much! The cast was removed yesterday (day 6) and my nose is very tender.

As to whether this whole process was worth it or not....the jury is still out as far as I am concerned. My nose is still crooked looking but this could be because I still have a lot of swelling. I am hoping that this is just uneven swelling and that when it ultimately subsides, my nose will look straighter. I can already tell that my profile looks better....especially the tip. But again, the main result I was hoping for had more to do with making my nose "straighter" so if it ends up looking more crooked instead, then I will view this as having been a failure. I think the chin will definately look better but I am just hoping that the residual pain will eventually subside and that I can get used to the weirdness of having something artificial in there. As for the the scarring on my ear, I am told that the scar will eventually be almost invisible. The only part of the ear that kind of grosses me out is when I felt the back of the ear and realized there were divots where hunks of cartlidge used to be. Other people cannot see this because it is on the back part of the ear, but it is something that I had not realized would be there and it grosses me out when I touch it or think about it. Hopefully over time I will get used to it and not think about it as much. But this has been no picnic and I think people contemplating having surgery need to know this. There is most definately pain involved. Perhaps I have a low pain tolerance, I don't know. My advice is be sure and think this through before taking the plunge. I would say that it will take a good six months for me to truly say whether I made the right decision when I decided to have the surgery.


also, plz message me and let me know the other docs u saw. I have an appt in 4 days for Revision consult and I really appreciate your opinions
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Sorry, I don't have before pics, only after. Other doctors I consulted were James Lanasa and John V Williams in Baton Rouge. I had no problems with Dr. Johnson to be just fine regarding bedside manner. I don't expect anyone to hold my hand, just do their job and he did just that. I am not easy to please. My issues were subtle but real. To me that made the job more difficult as far as providing me with satisfaction. He delivered because I have been satisfied.
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I have an appointment in BR with dr. perenak. if im not satisfied ill go next to Johnson. may I see your after pics plz? ty for your help!
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New Orleans Facial Plastic Surgeon

Very professional and has tons of experience. He is thought of as one of the best rhinoplasty surgeons in the country. He has a very friendly and available staff.

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