I was the pretty girl but with a wonky,...
The past 4 months have literally been horrible. I have thick skin, so the swelling was ridiculous. I looked absolutely hideous the first month. The swelling in the tip was really really bad. I didn't even recognize myself until I hit the 2 month mark. I became obsessed with taking pictures and trying to see progress. It was a big shapeless blob. Then as it started taking on its new shape, I realized how so many things change with a nose job: how you look in pictures, pictures with flash (I look worse in those at the moment), how you look under different lighting, how it can look natural under certain lighting but the "operated" look is definitely visible under others. More so, my dorsum was slightly over-resected, so I had the option of filing down the hump some more (which I did not want to do because, again, I did not want a drastic change in how I look, and the profile is usually the more obvious change) so I just had a restylane filler to fill the dip in the meantime until I can undergo a procedure to build the cartilage back up. Also, with my tip made less bulbous, my nostrils appear flared when I smile and highlighted my asymmetrical nostrils. I also developed indentations on the sides of my nose. It has brought too much negativity into my life, I became obsessive about every aspect of my nose, and it literally consumed my thoughts. I've avoided so many social gatherings because I have been so self-conscious. I don't think it's obvious to most people that I've had a nose job, and it's by no means an ugly looking nose or deformed in anyway. I just like my before nose better. I wish I had done LESS. If I could do it again, I would definitely NOT getting any tip grafts put in. I would just file down the hump and cut the muscle that makes my nose turn down when I smile. I realize how much I liked my nose and how it added to the beauty of my face rather than detracted. I also realize that with a new nose, there will be aspects you don't like about it, just like your old nose. There are too many risks involved and your nose can drastically change your appearance. If something goes wrong, you have to wait AT LEAST 6 months to do anything about it. A revision surgery is just added expense and has a longer recovery time. Also, when you make your nose smaller, you lose a lot of definition that can take a long time to return as the skin shrinks to the new shape. I don't know how I will feel about it in a few months from now, especially since the swelling is still dissipating and it's looking better each week, but I still feel that if I could do it again, I probably wouldn't.
No one can tell a difference
This past week, I decided to specifically ask two of my best friends whom I hadn't told before. Both have known me for at least a decade. Both said that I look exactly the same to them.
I have realized how much a cosmetic procedure messes with your head. I don't think I have ever looked at my nose as much as I have since my procedure. It is really toxic and for that reason alone if I could redo all this, I would not get ANY tip work done.
I also just saw my before and after pictures at the doctor's office. I am happy that I got rid of my hump, but I think my front profile looked better before :( I still have swelling, and I hope I will be happy with my results at the one year mark, but again, I wish I hadn't gotten any tip work done. It just wasn't worth it for me, especially now that it has brought more attention to my nostrils, which flare a little bit when I smile ( I had NEVER noticed my nostrils before my tip was narrowed).
I still think Dr. Chaboki is a fantastic surgeon and is the right choice for conservative surgery.
But, is all this pain really worth it for a change so minor? definitely debatable.
All tip jobs look fake
Inverted V Deformity
If looking for subtle change, it's not worth it
My smile is still not 100% the same
my tip feels stiff as porcelain. I miss my squishy tip. Its painful thinking I won't be able to squish my face into my future husbands face like I used to. Thinking of getting the columnar graft removed.
The lateral crural strut grafts for breathing are STILL causing swelling and are hard as rock :(
I can feel the fracture line on one side
My alar creases are more visible and defined.
I HATE the way I look under florescent light...makes me sick to my stomach.
I still have to go in for surgery to rebuild the cartilage.
I'll take my hump and bulbous tip back in a heart beat.
To be fair...
I think the fact that my bridge was over resected in the wrong spot set a really bad tone for how I feel about all this. It really did look odd before the filler (will add pictures soon)....I think they say something like beauty is a matter of millimeters. Dr. Chaboki told me he had taken off less than one mm, but it was significant enough that the whole nose looked off and made me look really different in comparison to my pre-op. I really love my high bridge, I just wanted the hump filed down.
On preserving ethnic beauty...
Too big of a risk
Revision at 6 months
My mom is scared, said if there was a mistake the first time, how do you know the Dr. won't make another mistake and you'll come out with a worse looking nose?
Yes, I am really nervous. Before going into surgery I was actually pretty confident and completely trusted my dr that nothing would go wrong, but this time, I'm scared. I really need to get the bridge fixed. Pretty much my nose looks worse because the tip was narrowed and projected, while the top portion of the bridge wasn't filed down enough (and there is a dip in the middle that is temporarily camouflaged with a filler) so I have a really harsh looking nose and it makes me so sad when I look in the mirror. I emailed the Dr. and he said he would rather wait, but I have read that 6 months in enough time. I am not refining the tip so its bridge work and removing the collumellar strut graft. I told him I really, really want to get it done at the 6 month mark, so I am waiting on his reply.
Lateral Crucal Grafts
They have caused so much of the swelling in my tip and mid nose. I am SIX months post-op and they still show up in flash pictures.
I can still feel them and they are hard as rock
They exert pressure on the inside and are VERY uncomfortable, especially when working out.
hate.hate.hate them. I can't wait to have them out. I see most surgeons say they should not be visible...well, they are :( think twice before agreeing to them.
Revision in two weeks!
We discussed filing down the hump some more..I am actually now worried that he may not file down enough the second time around and I'll still be left with the hump. I'd be really, really disappointed. We also discussed removing the grafts that are making my nose look bulkier, and if possible removing the strut graft (which is difficult to remove with the closed approach so he may just trim it down).
I just still believe that finesse rhinoplasty is not worth it. Its not worth the price, risk or the recovery process. Obviously I wouldnt be saying this if I didn't need a revision...but so many people end up needing a revision after rhinoplasty, so again, there is that risk factor, and we're talking about the center of your face here.
Also, how come I can't edit what my previous posts? Can anyone tell me if thats simply not an option. Some of my earlier posts were typed when I was highly emotional and I'd like to edit them.
Lateral Crucal Strut grafts
Hindsight is 20/20, but here's what I took from all this:
1. make sure you really dislike your nose. Make sure you don't have a love/hate relationship with it because you may not like your results and will miss your nose. I thought I looked decent when I looked in the mirror, but I hated pictures of myself. I also miss a lot of the quirks about my nose. I ESPECIALLY miss having a squishy tip. I would give anything to have that back.
2. Which brings me to my second point. IMO, a subtle rhinoplasty is NOT worth it. By subtle, I don't mean natural. Everyone wants natural results (ok, most people), but like, if it's a difference so minor, like oh, my tip is slightly higher on the right side, and I want to make it symmetrical, it's not worth the risk, cost, or recovery. I think a big part of why I wanted a super subtle rhinoplasty was because I was scared of of a cookie-cutter nose, but I was also scared of being judged. If you really don't like your nose, go to a surgeon with an artistic vision who will show you what would look good on you.
3. Understand that if you change one aspect of the nose, you gotta change everything else so that it will be in harmony with each other. I only wanted to get rid of my hump but wanted to keep a high bridge, but I also wanted to reduce my bulbous tip. Having a smaller tip along with the high bridge made my nose look less soft and more harsh if that makes sense. My bulbous tip sort of broke up my nose into different parts but when it was narrowed it made my nose look longer.
4. Research, research, research. Read about the details of a how a rhinoplasty is performed. Research all potential complications. I had no idea what any of these deformities were until I became paranoid about my nose after surgery: inverted v, a pollybeak deformity, a step-off, saddle nose, open roof, internal valve collapse, etc. Know all of this and be prepared.
5. Choose a double certified plastic surgeon who is also an ENT, preferably. Make sure your surgeon specializes in FACE surgery. He may have excellent ratings but he may be really good at breast enhancement, for example, as opposed to rhinoplasty. This won't guarantee that you won't need a revision.
6. Ask for a computer simulation. Make sure you are completely satisfied with the simulation. Discuss every little detail. Ask lots of questions. I should have asked more questions about the grafts I was getting and potential complications. They left me with a lumpy nose and LOTS of swelling. Discuss the revision policy.
7. The recovery is NOT the same for everyone. I read so many positive reviews before I got my own surgery of how people were thrilled when they had their cast taken off, or even just a month post-op. I looked like a got hit by a truck when my cast came off. I had bruising for nearly two weeks. My tip was numb for weeks. My smile looked scary, and did not look natural for a while. The swelling was bad for months.Every time I would lie down I could feel my nose swell up. This lasted for 4 months. It was sooooo miserable.
8. Be prepared to possibly not recognize yourself. This was the most disorienting and the scariest part of this experience. The swelling just makes it all that much worse.
9. Your nose will become the center of your world and will consume your thoughts for a while. You will look in the mirror more than you have looked in the mirror all of your life. lol.
10. Have enough saved for potential complications. What if you're one of the 15-30% who needs a revision? Never thought I'd be getting a revision.
These after pictures were taken a little over one month post-op. It looks fine now because I had Restylane injected to fill the dip, and the swelling in the tip has gone down dramatically, but you can see why this caused me so much anxiety. Pretty much I was left with a much worse looking profile, a hump that looked more prominent, and a tip that was projected which just compounded how bad the dip in the middle of my nose looked.
I was extremely nervous and had to take sedatives for a few nights before surgery. I went in at 6am and surgery started at approximately 7:40am. I woke up from anesthesia around 2 hours later. The pain was around a level 4-5, so I was given some pain medicine. I fell asleep but woke up shortly afterwards because the pain was back, so I was given another dose, and quickly fell asleep.
I went home and slept for about 4 hours. I woke up feeling great. I have had minimal pain and no nausea. I have been able to eat normally, walk around, talk, etc. I have no bruising yet. the bone was rasped but not broken. I don't have any packing and my breathing is amazing. It's even better than it was yesterday before the procedure. So this is really promising. I remember my breathing was difficult and stuffy for a good month the first time around.
- The lateral crucal strut graft and the columellar strut graft were both removed. I hated how the former bulked my nose and the latter made my nose projected. It wasn't unnaturally projected at all, but because I have a long nose to begin with, I just preferred my natural projection better and thought the strut graft was extremely uncomfortable. I wish I had done my research about it the first time and stuck with no tip grafts.
The Dr was worried about collapse after removing the lateral strut grafts. I guess time will tell, but they were extremely uncomfortable so I elected to have them removed.
-The hump was rasped down some more but osteotomy was not performed.
- He did have to build up my middle bridge with crushed graft. This is what I am most worried about.
I do not have a cast, which is also nice. I guess now I just have to wait and see till it is removed in a week's time, and then wait for the healing process to reveal this nose.
Sometimes I wake up and think, is this really my life? I cannot believe I had to get a revision rhinoplasty. I pray that it is my final surgery because this is all emotionally exhausting.
I am completely regretting this whole saga. No one ever teased me about my nose. It just happened to be my biggest insecurity. I look at some of my pictures and think, well, I did have a reason to be insecure about it. It wasn't all in my head. But all I wanted was a one-time "finesse" rhinoplasty.
Now I am deathly scared that the cartilage that was used to build my bridge will show, warp, reabsorb, etc. I am scared of finding out down the road that I have an open roof deformity. It really feels like I have opened a can of worms.
I could not live with my post-rhinoplasty nose for another few years. Without the filler, it looked deformed. I had been reading about fillers and the damage they could potentially cause and did not feel comfortable getting re-injected. (please see this link http://deantoriumi.com/issue1-1.asp )
Yes, I took a leap by going with the same surgeon, and I am praying to God that I don't regret it. I do not have the funds to finance a revision, and my doctor was a facial plastic surgeon and an otolaryngologist and that was not a guarantee that I would not need a revision. I wouldn't even know where to start when looking for a revision PS considering I felt that I did my research the first time around in choosing a Dr. He worked with me and was willing to perform the procedure, so I went through with it. I am just praying so much that I won't need a third procedure. This all just saddens me so much.
I just wish I could rewind time.
Revision-Day 5: Tape is off
I am pretty scared of how the front will heal. I do not have high hopes or expectations. I asked him to address the visible fracture line (it's so ugly), but I think it will still be there since he did not break the bones. I am also expecting marks/indentations in my skin where the lateral crucal strut grafts were taken out.
Overall, I still feel pretty sh*tty. I can see how rhinoplasty can do wonders for someone's self-esteem, but it seems like a hit or miss. It's a huge gamble. And I feel so unlucky that I am in the miss category.
It took two surgeries to come out with a hump-less normal looking nose (for now).
Now the long recovery process begins. In the back of my mind, I know that I may need a revision sometime down the road, but for now I will live with this nose and its flaws, just like I lived with my biological nose for 25 years. I think they will be flaws I can live with, as opposed to the nose after my primary.
Will post pics soon.
This is why I was insecure
Yes, my Dr is really conservative. I just went through all this crap to look 99.8% the same? lol
I saw the Dr today who told me that my nose was completely straight when he finished the procedure, and that the bumpiness is where the cartilage is swollen right now but it should come down.
I am pleasantly surprised by how little swelling I have :) Really, really happy. I am only 7 days post-op and I look presentable and quite good even to myself!
My first recovery experience has really scarred me and I am just so happy I don't have to go through that again.
Most of the swelling is in the sides where the lateral crucal strut grafts were removed. Really, they make me so angry. I will now have scar tissue because of them. They are intended for functional purposes to prevent external valve collapse, but I don't think they should be used in a primary unless you already have bad collapse. I am so mad at how much they really prolonged my healing, were uncomfortable, and had visible edges on the inside and outside, and also it kept getting crusty inside my nose where they were inserted. Seems like some PS love to use them and say they will "refine" a bulbous tip. I guess I'm one of those people who had a bad experience with them.
Overall, while this experience has really caused me so much depression (even people with no need for a revision often suffer post-op depression), I am SO grateful because it could have been so much worse. I would rather have a PS who took too little than too much.
Though ideally, we all just want to have ONE procedure.
What I appreciate about my Dr is that he really respects and wants to maintain/improve the functional integrity of the nose, so he really is concerned about your breathing ability more than the cosmetic portion, which is why he is a great ENT. I can breathe at night, no post-nasal drip, no tonsil stones (he removed my tonsils-worst recovery but best decision of all the surgeries I've had), so for those things I have to remind myself to be grateful and just move on.
Now that the revision is over with, I am looking forward to finally being a normal person whose life isn't revolved around her nose :)
My swelling is almost 90% gone, which is the bright side of things I guess. Its also a huge relief that the grafts are out.
I am sorry to say that I am disappointed :( There is still a slight dip above my tip :( I was hoping I would be completely satisfied but was half expecting something like this to happen, but I wanted to at least have an improved nose until I could save up to go to another Dr for a revision if need be. It's definitely a big improvement over that deformed- looking profile I had post-primary...looking back, I cannot believe I did not get a second opinion and waited 4 months to get a filler (and paid for it), but then again I was going crazy and I literally did not see anyone until after I had the filler injected :(
I also never mentioned that I've had a really swollen columella since my primary. I don't know if this will improve with time.
I have requested the operative notes and will be scheduling a consult in a few months.
I may, however, end up choosing not to get a revision at all. It definitely won't be happening for a while if I do.
So there it is, $7600 total down the drain along with my natural nose and self-esteem.
Probably will be getting a revision.
Nasal Valve Collapse
I emailed one revision Dr and sent him my post-primary pictures and he replied saying:
"the change in nose position is classic for valve collapse"
This pretty much confirms what I thought before. I do believe I still have it after the touchup revision. My breathing gets really, really difficult when I exercise.
I look in the mirror or at pictures of myself and I get this feeling that I just want the earth to open up and swallow me. I went from a nose I mildly disliked to a nose I absolutely hate. Its funny because I pine for my old nose now. I look at pictures and think "My God, your nose suited your features so well! What were you thinking!" I really don't know how I took the plunge and trusted a surgeon with my face, and despite his qualifications as a facial surgeon and ENT I still ended up with all these complications.
Add to that that I have a hanging columella and retracted nostrils.
This is definitely my biggest life regret and my most expensive mistake.
problems that will need to be addressed
- droopy columella and Alar retraction
- I want the dome binding sutures cut to partially restore my tip
- visible fracture lines
- residual hump
Do you guys have any suggestions on important questions to ask a revision Dr? I have consults scheduled for the end of July and one in the beginning of August.
I had very mixed feeling about my surgeon initially because I kept getting told that swelling was to blame and I did not know what half of these issues were and only after much research was I able to pinpoint why I hated my results so much. It is very clear I had very lousy results due to lack of skill on his part. Really upsetting and life changing.
The Assymetrical Nose
Did a video comparison
I emailed my Dr. telling him I was really upset and he called and left a VM and replied to my email saying he gets upset when one of his patients is upset, which is really nice of him. I think a lot surgeons just flip on you and lose that positive attitude once you tell them you're unhappy. But again I still have this problem that is my nose and it's taking a toll on my emotional well-being.
I took a video today and compared it to one pre-op. I *think* my tip looks better. Yay for something positive. I say *think* because I still don't like how it looks under certain lighting. My nose was more of an /\ shape and now it's a || shape, but my nose is too long for an || shape. I'm still not sure if I will have it shortened. Also, it took a REALLY long time for my brain to adjust to the new tip. Probably because the swelling was out of control in the beginning. There is still something weird about the dome-binding technique that I don't like. It looks strange under certain lighting. Honestly, comparing the videos, I don't know how no one noticed, but I realize now that most people don't memorize what your features look like, and unless you go from a big nose to a little nose, they won't even notice you had anything done.
I also realize how I have so few videos of myself pre-op. Like maybe 5 total. I did take a lot of pictures but it's not the same. It's so much easier to see the difference via video.
If you plan on getting an operation make sure you take some videos of yourself and under different lighting too.
Just overall I have very conflicting, confusing feelings. The love/hate relationship I had with my face is very confusing for me. The operation definitely negatively impacted my self-perception and brought to surface a lot of insecurities. There is a reason that I hated people taking candid photos of me, yet at the same time, I was pretty confident overall, felt pretty a lot of times, got complimented often, never had a problem dating etc...It's almost a schizophrenic self-image. I still can't wrap my head around it.
Revision Consults Done
Consults are done :)
I have a residual hump/unevenly shaved bridge, a droopy columella, my tip is slanted to the right, and I have shadows from my fracture lines. This has been confirmed by the Drs I consulted. I have consulted with a total of 6 doctors either in person or by phone+email.
To correct what I had said previously at one point, I don't have an inverted V deformity. Just an unevenly shaved bridge. My alas did go up, by they are not considered "notched" and are "within reasonable distance". Reducing tip size can bring them up, that's just a trade-off with rhinoplasty. I do have a droopy columella though, which makes them look worse, so once that is fixed it will look much better.
I have spent a ridiculous amount of time educating myself on rhinoplasty and know that I am taking a risk yet again. Please do the same before going in for your primary because a revision is just so much more complicated and more expensive. Please choose a reputable surgeon with many reviews by actual patients.
I just booked my revision surgery. I hope and pray that my gut has guided me to the right surgeon. I won't post who I chose until the surgery is done. I will write and post pictures once the cast is off in a few months :) Wish me luck!!!
He is professional & answers questions promptly and I never have to wait more than 5 minutes to see him at his office. He saw me the day after surgery and gave me a call in the evening. He replies to my emails within 24 hours and his attitude has not changed post-surgery. He still takes his time to talk to me. HOWEVER I am VERY unhappy with the results. My top concerns: My middle nose was over-resected, so I had a dip in the middle of my nose, causing nasal valve collapse, which I had to get restylane filler for until I get a revision, while the top bony part was not filed down enough. I have a huge droopy columella and alar retraction. I also have a visible fracture line. The lateral crucal grafts made my nose bulkier. Overall I was left with a much worse looking nose. I had a revision with him 6 months post-op..made the profile somewhat better, took out the grafts, still left with 70% of the problems that need to be addressed.