Risk too great-The Nose Makes the Face - Washington, DC

I was the pretty girl but with a wonky,...

I was the pretty girl but with a wonky, asymmetrical nose. But people that I know and don't know told me I was beautiful all the time. Still, I remember the first time I saw my nose profile. I was 12 years old and I was surprised. I had never really seen my profile. I had a hump develop after puberty. At 17, I would look at my nose in the mirror and see what I could change about it. At 21 I had my first consultation, but decided after I was shown the simulation "after" photos that the typical change performed by surgeons was too drastic. I searched until I came across a top surgeon that I decided had a conservative approach. I wanted minor tweaks. A less bulbous tip. a slight reduction of the hump. I wanted to wake up and look like me but better. I finally had my surgery at 25.

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.
Thank you for your honest feedback, it's good to get a realistic sense of all the emotions we feel when we look at a different face in the mirror every morning. I understand that a nose can throw off the entire familiarity of your face, and that must be a difficult thing to come to terms with. I fear I will feel exactly as you do, and I really dread that prospect. I'm already sick of myself for even thinking so much about this silly feature, and I would really hate to fixate even more about it afterwards. I hope you come to accept your new nose with each passing day, and it continues to 'grow' on you. With time, the swelling will definitely recede, and you'll feel a greater sense of relief to put it behind you. Stay active, go out and enjoy nature, meditate, listen to wonderful music, be thankful for the small things, don't let it get the best of you. We must forgive ourselves and not be so harsh--that's what get us in trouble in the first place. I'm sure you're a very pretty girl, and believe me, no one but you is paying attention to your nose! (everyone else is obsessing on their own issues :)
Reply
Minorwhite!! Thank you so much for your lovely message. I am working on forgiving myself and learning to adjust to my new nose. That said, I just saw the pictures you have added of your self. I am a stranger behind a screen, and I have nothing to gain in appeasing you or lying to you, if you had an ugly nose I'd be like, yeah, might be a good idea to get this done, but holy crap! you are incredibly BEAUTIFUL! PLEASE don't touch your nose! You don't have a hump that needs to be filed down, and your "wide tip" is not lacking definition (mine was just this round ball). I look at my face now and wish my tip wasn't narrowed so much. It fit my face better. The tip also gets really swollen even when no tip work is done, and you are so close to your wedding date. I really hope you don't go through with the surgery, but regardless, I wish you the best of luck and many congrats on your upcoming wedding.
Reply
Thank you for your cautionary tale. I'm sorry you aren't happier! Do you feel that you're obsessing about your nose now more than you did before your rhinoplasty?

I had different things done to my nose, but I have never regretted it for a moment. When all is said and done, I wish the same for you.
Reply

No one can tell a difference

I had only told two people before my surgery. Afterwards, not a single person noticed, including immediate family members who live with me and my own mother who couldn't tell anything was different over video chat.

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

:( I wish I'd never touched my tip and never gotten grafts. maybe others can't tell at all, but I did this to feel better and now I just feel worse. My nose looks so fake under florescent lighting and today I was at the store and they had that security camera where you self-checkout and I was horrified by my reflection. It looks SO FAKE. I am utterly devastated by the results and my decision to undergo a rhinoplasty. I will have to live with this for the rest of my life :(

Too straight

Another reason I am hating my new nose is because it no longer has curves. Its like a straight stick and it looks really odd.
I think your nose looks beautiful. Please try to learn to like it. At least you're not stuck with a big ol honker like me (15k and an open rhinoplasty later, and my nose is still big)
Reply
I just looked at when you had the procedure, you can judge the profile after the first month, but dont judge the front view till at least the 4th. Trust me when I say this nose did not reveal its self until at least the middle of month 3. It was HUGE. maybe three times as big and it was like a sausage in the middle of my face. Those were the hardest months of my life. Every time I would lie down it would swell up. It was miserable. It only stopped swelling up a few weeks ago.
Reply
Sorry to hear your in pain and stress. 4 months still leaves you a lot of time for improvement try to be patient. but I do understand what you're saying about running into people wondering what they think especially people who maybe threatened or maybe they were worried about how much better you would look and now you wonder are they snuggly glad but I don't look instantly perfect and so much better are they thinking what a fool what a mistake it's very hard to wonder what other people are thinking. I'm having mine done in a month and a half but remember you don't know what they were thinking before maybe they were thinking about the bump or how big my tip is. maybe not all that matters is you did this so you can feel happy with what you see in the mirror and in time I bet you will other people care mostly about themselves and they don't spend as much time thinking about us as we fear they do at the end of the day enjoy yourself enjoy your nose.
Reply

Botched tip

So at 5 months, I pretty much have come to the conclusion that my tip is botched. Here are some photos. I think the alar grafts are making it look even bulkier. I'm not even sure what to do at this point.
I don't see what you see. I like your nose.
Reply

Inverted V Deformity

So I am pretty sure I have an inverted V deformity, which was temporarily fixed by the filler, but also internal nasal valve collapse as my breathing is getting difficult. I've also had a bad smell from my nose for over a month now. This is all just so stressful.

If looking for subtle change, it's not worth it

I feel like I traded one problem for 10.

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.
I am regretting my own surgery due to complications and am sorry you are going through this. In hindsight--if I could do it again, I would never have artificial grafts puts in. Can he thin the bulky tip? (I think your nose looks nice, but I get the unhappiness; if it doesn't look natural to you, it doesn't matter.) All that said--you might find over the next 7 months the tissue softens/streamlines. I hope this improves, even if you ultimately decide to get the surgery.
Reply
I'm so sorry to hear this. I can relate, and know how painful all the regret is. I agree with you that unless you need a major major change, it's just not worth it. I also can relate when you say that it's toxic and makes you focus so much on your nose. It's crazy how something so minor becomes an obsessive focus of every day. The emotional impact is incredible and I never could have imagined. I will say, as I hope you're finding, it gets better with time (months and years) and once you learn to forgive yourself and focus on other areas of life, things start to fall in place again.
Reply
I'm sorry to hear you're so unhappy with your nose! I think that it looks beautiful personally, and you're five months in... there's still a ways to go!
Reply

To be fair...

I think the lateral crucal strut grafts are and the columnar graft are both causing a lot of swelling in my tip....I took pictures today because it looked like the swelling was down and it is a marked improvement. I had no idea grafts, even though they're from your own septum, cause so much swelling and delayed healing. I wish I had known that. I'd actually initially said NO to tip grafts then decided last minute after browsing through the Dr.'s galleries that they looked natural and maybe they're not such a bad idea. I should have done my research. I wish I'd known the columnar grafts makes your tip so stiff long term. I miss my squishy nose :( So will definitely be having it removed when I get my revision.

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.
Thanks for your message. I discussed with him removing the grafts when I have my revision. I think it will make a difference I just have to be patient for a few more months till I'm ready for round two of surgery, just the thought makes me so anxious. I can't imagine going through all this all over again. The swelling is miserable. so miserable. Are you considering a revision?
Reply
Yes..if you are getting a subtle surgery to improve imperfections that only you will notice, then maybe you ought to work on your self-image and invest that money in something that actually makes a difference. I only thought about my nose when I saw some pictures I didn't like and they made me self-conscious. Otherwise, I got complimented all the time. I felt pretty good about myself, and my nose was certainly NOT the focus of my life. I can't believe how much brain energy I have wasted over this nose of mine post surgery. It just makes me really sad. I keep looking a pre-op pictures and thinking, I looked fine! Yes, I have a pretty big nose, but I was still pretty. People always complimented my eyes and smile. I started thinking about all the girls and women I think are beautiful and realizing a lot of them have noses that don't fit the beauty ideal but they are still pretty darn gorgeous. I'm not caucasian so a small cute nose would not match me at all. I was just too self-critical and thought if only I could change it a little bit it would make me feel better about myself...but it didn't. I am starting to intentionally NOT think about my nose and distract myself because I am so tired of having developed this post surgery OCD and anxiety. Drs really need to discuss the emotional impact with patients before operating on them.
Reply

On preserving ethnic beauty...

A scooped nose does NOT look good on everyone, especially some ethnicities. I know women who looked STUNNING before a nose job, but once they got rid of their high bridge, they lost so much of their beauty and their faces appear washed out, childish, and less defined. I often browse through before and after pictures and it makes me sad that so many women think they'd look better with a "westernized" nose. A raised tip and a scooped bridge do not look good on all faces!!! Just my two cents.
Thank you!! Rhinoplasty really does test your patience like no other!
Reply
Im sorry kiwibird000 :(
Reply
Thank you for your kind comment
Reply

Too big of a risk

This is how I've come to think of it. If people tell you that you are pretty (strangers too) then you are probably seen as an attractive person. Let's think of it using a scale. You could go from an 8 to a 9 by having a successful rhinoplasty, but if something goes wrong, you could drop down to like a 4. The risk is not worth it! Rhinoplasty is one of the most difficult procedures and the results depend on so many factors. You could be in the hands of the best surgeon and something could still go wrong. Sure, my nose wasn't pretty, but my overall face was attractive, and I never got teased about about my nose.

Oh and...

the funny smell from my nose was due to an infection. The Dr. put me on antibiotics and now it's gone. I also went to him and I don't have nasal valve collapse...just a lot of internal swelling.
I see a lot of beautiful noses on here I would have loved to have, BEFORE they had surgery! I personally don't understand those who want a minor change because of the risks involved, but I don't judge them, everyone has to do what is right for them. I'm sorry to hear you had a weird smell in your nose, I keep getting weird smells but mine was from blood clots. They really are the worst! I'm glad to hear they found the infection and have begun treating it. About ethnic beauty, I am "mixed race" (I don't really like the term too much, because we are all one race, but can't think of any other way to describe it. I come from a family I am not proud of due to their horrific treatment of me. For me, I could care less about my 'heritage' or 'ancestry' because they are not me. I just want to look the way I feel... I want it to suit my face, yes, but I don't care if I look particularly like one of the races my parents were or not. If anything, I have gotten MORE confusion over "what I am" than anything, and people have guessed from around the world. Some people want to preserve their natural look, some people want to look like their family or 'race'... there are people who want to look like other people or other races... and then there are people like me... who didn't care about either and just wanted to be a more aesthetically version of me. A button nose would look horrific on my face to be sure, I think the problem some people have is that not all nose styles suit all faces, and they push for something that won't suit their facial features, etc.
Reply
U wrote it so well.. If people in general say u are attractive then u should just accept it, say thank u and not mess around with your face. The bridge of ur nose is so important to the look of your face and I totally agree that a scoop look does not suit all faces. I wish I hadve asked my surgeon more questions. I thought he understood what I wanted. I had an ethnic looking nose that gave me character and was a big part of my personality. What I've been left with doesn't suit me at all :((((( I feel for u.
Reply
I am, and I'm terrified not only of the swelling, but of a bad outcome. I don't want to go through it again either, but the thought of staring at what I have now for even another six months makes me feel hopeless. This rhinoplasty was honestly one the worst experiences my life when things seemed like they were going to turn out well; I wish I could take it all back and have really done better research. I wasn't careful enough.
Reply

Revision at 6 months

So I had initially wanted to wait till after summer to get the revision, but my nose is causing me so much frustration that I really really want to get the revision done in June and just put all this behind me.

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.
I'm sorry about the blood clots. I hope that got resolved. As for ethnic beauty, I guess what I meant to say is that a small "caucasian" nose doesnt fit all face types, especially ethnicities who tend to have bigger noses like persian, middle eastern, etc. They end up looking really odd. Its just not aesthetically pleasing.
Reply
The blood clots did resolve themselves... It was both incredibly disgusting and the world's biggest relief to find the source of the smell lol. I totally agree that it doesn't fit all face types.. It's too bad they don't have nose simulators like they have hair simulators huh? Except it's difficult to tell what is actually possible with the existing nose.
Reply
I'm so sorry :(
Reply

Lateral Crucal Grafts

These grafts are from hell...I absolutely abhor them.

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.
Have you gotten a second opinion? I'd definitely suggest you consider other surgeons before going with the same surgeon for a revision!
Reply

Revision in two weeks!

I saw Dr.Chaboki today, and I'll find out on Tuesday for sure if I could have my procedure in the first week of June. I am so nervous I feel sick to my stomach. I still trust him because ultimately the changes he made were so subtle no one noticed but me.

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.
I did and the other surgeon told me it'd be best to have my first surgeon do my revision. I still trust Dr. Chaboki so I am crossing my fingers and praying for the best.
Reply
Did you meet with just one other surgeon? I'd definitely meet with more, as if you find one you trust to give you the result you want, that may be the best avenue. I've also heard that you should wait at least a year after any fillers are used in the nose. I would just urge you to do lots of diligence and have multiple other consultations so you don't end up having to look at options for a third time around!
Reply
I met with two surgeons. I think you are right though, just to be sure, I am going to book a consult with Dr. Naderi. I had actually considered him before Dr. Chaboki, but he was more expensive..in retrospect, that was really dumb of me. I am now going to pay another 1200 for anesthesia and I'd have paid the same as Dr. Naderi's fee.
Reply

Lateral Crucal Strut grafts

Just wanted to show you guys how visible these grafts are. They are the two slanted lines running down the sides of my nose. I can also feel the edges on the inside of my nose. This picture was taken FOUR months after my procedure. it is a lot better now but they are still palpable and visible.

Lessons

I think I could categorize the last six months as one of the most anxiety-inducing periods of my life. The funny part is that no one really noticed I had a rhinoplasty except maybe one or two people, but I see all the changes, and though they are subtle, they made me look and feel worse.

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.
i love your last update! i wish i had read this before going into surgery. You put it into words so well.
Reply
Thanks! Are you planning on getting a revision?
Reply
No im too scared to get revision. I had filler put into my nose recently to try and make it look a bit better. Im not sure if i will ever be emotionally ready to get another surgery :(
Reply

Profile

I still don't even know if this is a saddle nose deformity or what.

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 would like to add that your nose post op is not bad either. I'm sure you are aware that revision rhino is more difficult than the primary. You would need a skilled surgeon to perform your revision. Also keep in mind that the outcome might not be perfect. Good luck if you decide on revision.
Reply
You didn't really need this surgery. Your nose was fine pre-surgery and you had a nice front view.
Reply
Thanks. I had a classic italian/greek nose. I did have a hump and a nose that drooped when I smiled so I had a reason to get a rhinoplasty, but I shouldn't have touched my nose tip. I do see a lot of women on here who have really nice noses and certainly have NO reason to get a rhinoplasty though but we are our own worst critics
Reply

Revision-Day 0

I thought a lot and prayed a lot about getting the revision done at 6 months. I met with the Dr yesterday to go over expectations and goals again. Today marks exactly six months since my primary surgery and I decided to go through with it.

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.
I wish you a speedy recovery and I hope you like the results this time! Looking forward to seeing your new nose!!
Reply
thank you Zooster! I hope you're recovery is going well and you are happy with your revision
Reply
good luck with everything. Cant wait to see your results. My thoughts and prayers are with you.
Reply

Revision-Day 2

I am still sleeping a lot but overall have minimal pain. I've had no bruising either, just some swelling in the face. Actually, the only pain I have is a stomach ache. Probably from all the narcotics and medications I've been having to take.

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.
So sorry to see another join the Not Worth It category. I also miss the natural curves of my nose among so many other things. Thanks very much for sharing with us. Take care and best of luck to you.
Reply
Mine was not an in-office surgery, but in the hospital setting. Since there are always risks involved with anesthesia, I was pleased to have a local. Everything worked out well. I don't believe the procedure was major so that is probably why they could use a local. Hope all is well.
Reply
Definitely not a saddle nose deformity. Mine is way worse of than yours and even I don't have one after suspecting I did. Good luck!
Reply

Revision-Day 3

I took a sneak peak to see my nose underneath the tape and, well, I have a straight profile, and the tip was deprojected. This is promising. But the problem with rhinoplasty is that many people end up with a nice profile view and a worse front view. My front is naturally extremely swollen at this point and based on my first experience I can't really judge it until at least 3 months post-op.

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.
How's it going? I hope the best for you, but I don't think it was a good idea to have your doctor take out all the grafts "at the risk of your nose collapsing"! Taking out the grafts is only going to make your nose look less natural and more pinched...
Reply
Thanks. They weren't there before, and were put in to prevent external valve collapse, but they would rub again my internal valves and I could feel the edges every time I smiled or inhaled deeply. They were also constantly swollen. Wish I'd never gotten them put in to begin with. Either way, time will tell. I know now that by getting ONE rhinoplasty to begin with, I have entered this rabbit hole, and in the back of my mind I know I may potentially need another procedure in the future. He really was concerned about the functional aspect which is why he did not want to perform osteotomy again. Right now my breathing is beautiful and better than before. I hope it lasts.
Reply
Thank you! Do you mind sharing what you had done? What most concerns you about the risks of anesthesia?
Reply

Revision-Day 5: Tape is off

Dr. was supposed to remove it tomorrow, but I've taken a few showers and the tape has sort of fallen off. My profile looks NORMAL, thank goodness, It is straight (for now). This is how it should have looked the first time around. I am scared to touch it but I gently went over it and it does not feel smooth. I think even if it stays bumpy, if it looks normal and no indentations show after the swelling subsides then I will live with it.

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

Here are the official before profile shots. The hump was more prominent on the left side, and it looked the worst when I smiled wide.
Hi. How is your nose after revision? We qould love to see photos.
Reply
100% relate. I am an asian. So i had bulbous tip. My Ps harvested nasal septum to increase the height and placed ear cartilage above it for projection. And he used goretex for bridge. Though the result is not that bad, better than my original nose actually but I dont know and cant understand myself bec i insanely miss my old nose and the natural me. Im dying to get it back. And also the tip grafts are sooooo unconfortable. Very stiff and hard that i cant hardly move my upper lip. This added to my depression. i cant wait for 6 months and in scheduled for removal next month. It will be just 2.5 months after my primary. Worst is i already had open rhino last time and seems like my PS only knows this approach so for removal my columnella will be opened again!!! im suffering and dying what will my nose look after removal! :(
Reply
If your new nose looks good, and as you say even better than your original, try to wait until the 6 month mark. Maybe you will like it and you will adjust to your new nose. Don't rush into another operation. If you PM me pictures I can give you feedback.
Reply

post-Revision pictures

As promised, profile pictures. As I expected I wish he'd taken off a little more of the top bony portion, but I can live with this, and for now it means a much shorter recovery since no bones were broken.

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 :)
im so happy for u pneonia! how i wish id feel like u after also my removal. :( i soo envy u that u can now live normaly again.. I hope even if u want to move on already and stop giving time to open your account i hope ul keep in touch and still give me feedbacks.:( please pray also for me. I know ul be a better person than before after all these experiences.:)
Reply
What a relief...I am so so happy you have a happy ending. Enjoy life! Your nose looks beautiful:)
Reply
I am glad it is over and you're happy with the results of your revision. Thank you for posting the photos. Your profile is lovely. Happy healing!
Reply

Disappointment

its been 4 days since I've updated and 11 days since my revision, which was minimally invasive so there was very little swelling.

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.
So sorry :(
Reply

Thoughts?

So I found a picture that is similar to my nose tip and how it was narrowed. Is it just me or does a wider tip suit this type of nose better? I feel like a narrowed tip makes the nose look longer and harsher? Am I crazy?

http://www.drlamperti.com/blog/post/how-else-to-refine-a-bulbous-nose
100% think a natural, wider tip looks better!
Reply
yes the narrowed tip with grafts looks harsher. but i dont like the bulbous tip either. why can't he refine the bulbous tip while keeping it looking soft and feminine, also short for the nostril show?
Reply
This is what I thought before my surgery, that he wouldnt narrow it too much, and he really didnt, but it still ended up looking horrible on my face (even though to almost everyone I look the same) but after reading about HOW the tip is narrowed I realized that the technique that is used will always end up looking harsh even without the grafts, unless you bring down the bridge a lot to soften the appearance. If you read the link, what they do is bring the two points of your natural cartilage inside your nose tip closer and sow them together. So even without the grafts I now can feel those two points.
Reply

Probably will be getting a revision.

So I just cried my eyes out because, yes, I will need a revision. It's really disappointing that my Dr was/is not meticulous with his work. I don't regret the "touchup" revision. It is a definite improvement, and the good thing is I won't need a filler in the meantime, which are unsafe in the nose. I will now start saving up and narrowing down a list of revision drs I will be consulting with.
I'm sure you feel cheated there's so many reviews on here where are the people come out with a nice lowered curved bridge I'm sorry for your experience . you should talk to Dr naderi for revision he's really good but is expensive
Reply
Thanks. I hope your surgery goes well. I'm looking forward to seeing your pictures! I am looking into revision Drs but it won't be for some time.
Reply
Yes especially for a long nose. I am so excited because I just found out you can reverse dome binding by cutting the sutures. Yes this wont return my tip back to how it was because that's not the only technique he used, but at least it wont be so narrow in comparison to my bridge. I'm going to bring this up with revision Dr.
Reply

Nasal Valve Collapse

So I am in the process of researching a revision Dr.
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.
Thank you so much for sharing your story. I am a month post-op and i don't think i am happy with the results as well :( Even tho my new nose is a def improvement from what i had and i asked for a "natural look", i feel that the change is not drastic enough. Now i need a decision to make: do i need a revision or do i just need to give up spending money and chasing "ideal" nose that i have in my head and might never get no matter what i do :( So tough
Reply
I can sympathize with your post op feelings. My nose, similiar to yours, was not a disastrous nose that really needed any surgery. I went in with the thought that this minor* touch up, refinement of a very small bulbous tip and a narrower nasal base, was going to make me feel amazing. I am roughly 7 weeks post op...and I still have tape on the tip of my nose because I cant stand looking at it. Im still hoping my tip will appear more natural...I wish you the best, and I hope we can both surpass this tough time.
Reply
I'm so sorry this has happened. I sincerely wish you the best and I just know that you'll be able to find the right surgeon to give you a nose you'll love. Good luck, we're all here for you! :)
Reply

problems that will need to be addressed

-internal valve collapse
- 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.
I'm sorry you are going through this. I too live with a really bad nose job so I really understand how you feel and how it is impacting your life. I never had a negative self image before (I wanted to do a minor alarplasty and septoplasty to improve my breathing) and now I am left with a mashed eggplant in the middle of my face. I don't think you are being "obsessive" with your nose. I feel the same was as you. I am angry with myself for doing a completely unnecessary surgery in the first place and secondly, trusting a surgeon who never explained anything or seemed to listen to what I asked him. Believe me, this is not in your 'head', I've been told that by my surgeon. They say that to discredit you and kind of shoo you away. Your pain is very real and justified. PERIOD. I hope you will be happy with your nose one day.
Reply
Thank you so much and I'm so sorry you too have suffered. It has truly impacted my life in ways I could have never imagined. I developed social anxiety and literally had nightmares about it. I can't even breathe properly when I work out anymore :( I am angry with myself as well for not realizing how big of a risk I was taking even if my surgeon seemed to have the proper qualifications, and for not being more diligent about researching the details of a rhinoplasty and asking more questions. I think what is done is done and we have to forgive ourselves, and see what can be done now. I am trying to get back to working out regularly like I used to although I have to wear breathing strips. I also am taking herbal supplements and vitamins to help with my mood, and just trying to see the light at the end of the tunnel. I will go on consults and see what my options are. I am impatient which makes this process soo difficult. I hope you too are looking into finding ways to correct what was done and will be happy with your nose.
Reply
You are so right; I'm actively working on forgiving myself for making the biggest mistake of my life. At the end of the day, I did my research and chose a seemingly top-notch (!) surgeon. But I did one thing wrong: I didn't listen to my inner voice that keep screaming at me to run for my life....These qualifications,Ivey-league, double-board, triple-board certified , etc. mean nothing when the surgeon doesn't listen to you and even worse, doesn't even care. My surgeon told me to stop looking at the mirror and that no one else is noticing that my nose is crooked but me unless they look at it very closely! That, to me, was representative of his lack of empathy and the fact that he just didn't care what he'd done. As long as the cheque was cashed, his responsibility stopped right there and then. The psychological abuse that I was subjected to in the hands of my surgeon was even worse than the actual disfigured nose. I am glad that you are talking about it now. It took me almost 3 years to even attempt to get out of this dark, deep, depressing hole I was living in and share my experience. By the way, thanks so much for sharing your photos.
Reply

The Assymetrical Nose

My tip used to be more bulbous on the left side than the left, which masked that my nose was crooked. So I've noticed that now that its been narrowed, my whole nose looks crooked to the right. Another issue is that with the hump gone, my nose looks longer, and I don' like it. Will be curious to see what solutions the Drs I'm consulting with will suggest.

Did a video comparison

Today was very emotional for me. I took some pictures and the dent in the nose is back completely..started crying in the car. It helps that some of the bony portion was filed down, so it doesn't look nearly as bad, but still enough to make me avoid pictures and to be self conscious of my profile around people (more so than pre-op, ha!) :( My alar retraction/droopy columella has gotten worse. The dent and retraction show more on my left side than my right. Yay for an asymmetrical nose. My left side was always my worse side. I think that may be part of the problem too...the bone needs to be filed down on one side more than the other. Overall, I now do regret getting the revision. It should have been a pretty simple fix, most Drs I've emailed/met have told me so. But I think if your problem post-rhinoplasty is not simply a "touch-up" to improve overall results ESPECIALLY if it's a tip problem you shouldn't get it fixed with the same surgeon. Just don't. Save up and find another surgeon.

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.
I am sorry to hear your troubles. I agree with the other posters -- I think your main issue is that your nose was really, really good pre-rhinoplasty (thin, symmetrical, the right length, etc.) and there was like, no way to actually improve it. I honestly don't think there *could* have been a satisfactory result -- I mean, it's like, if someone were to work on Angelina Jolie's nose, which is already ridiculously good -- what could they actually do to make it look better? Almost everything a surgeon could do would worsen it in some way. I actually went to your surgeon too a few years ago, but my nose was flat and thick, so the grafts helped with projection and support. I think in your case, you didn't need anything done, so the grafts look unnecessary. Again, my sympathies for your troubles. I go to Hopkins and they definitely have a great medical facility there, so good luck!
Reply
I feel like the pictures I posted are deceptive. I had a bulbous tip and a hump, and a nose that drooped when I smiled. I just wanted a straight profile and a smaller tip. Trust me, there was definitely room for improvement. I just had a less than satisfactory rhinoplasty performed, and that's been confirmed by more than one Dr. Thanks for your message and I'm glad you had a better experience
Reply
You have been through a lot.
Reply

Revision Consults Done

Hi Guys!

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!!!
Keep us updated!!
Reply
When is the surgery?
Reply
I have gone through similar issues with my own tip and just...going from a bad nose (yours was okay--mine was actually bad, due to scar tissue from a first, bad surgery, but it was a small amount of scar tissue) to a much, much worse nose. I've spent a year with it now. From the the month before surgery, when I made the mistake of choosing a surgeon I settled with because he did my primary, to today...this has been the worst two years of my life, so I feel for you so much. I hope the next year includes getting our self esteem back with successful surgeries.
Reply
Washington DC Facial Plastic Surgeon

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.

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