Dr. Alejandro Nogueira accumulates 25 years experience as Senior Consultant in the field of Cosmetic and Aesthetic Plastic Surgery with more than 4.000 procedures performed by himself as leading and executing surgeon in his post-graduation practice as senior plastic surgeon.
I had a chin augmentation. Which was done with bone graft. Pre-op I knew something was wrong with my face so I decided to speak to a few doctors. Several gave their feedback on what they felt I needed, final Dr Nogueira called me. For me it’s obvious when you are speaking to someone who is passionate about what they do. And whilst you’d expect ever surgeon to be passionate, not came close to this doctor. He was specific and intentional in his language. Already just by the phone call, I knew this man was an expert in chins. We met shortly after in his clinic. Again his passion shone through. I was committed. From the phone call, but the face to face took it to another level. Post op: I’m one day post op, I love the result. This man was beyond skilled. And looking in the mirror I finally see in my reflection what I had wanted to see. A strong masculine chin, that fits the proportions of my face. This man was 100/10. I’m beyond happy. If you ever see this, thank you doctor. Pain: well, my hip hurts, but I expected that. It’s a pain well worth it for the final result.
Dr Nogueira did a fantastic job for my chin vertical enlargement procedure, using pelvic bone grafts. The procedure went smooth without any issues. I am over a year post op and could not be happier, the results look just like I dreamed they would, in my pre-op simulations. The first 2-3 days post were a bit tough with the pain at the leg when walking but it does improve every day. My suggestions for people planning to have such surgery : bring a food processor so that you can make an easy to eat, soft paste from any dish, for the first week of eating.
By far, the best doctor you can ever find. Dr Nogueria is professional, expert in his field, honest, methodological, critical, realistic and a humble human being which made me feel at ease. He genuinely cared about the results I was looking for and about my wellbeing, and for that I am extremely grateful. He spent plenty of time talking to me and answering all my questions. He even pointed out issues that the x-ray has revealed and has nothing to do with my surgery, and provided great advice on how I can manage them. He definitely goes the extra mile!. I was given a special one to one attention from the first consultation till the last post op meeting. I trust Dr. Nogueira 100% and I cannot recommend him and his team highly enough. Dr. Salmones, the anesthetist was so professional and a great person to talk to. She makes you feel you are in very good hands. And Yolanda answered all my emails and questions promptly and organized the operation very efficiently.
After failed rhinoplasty in Amsterdam I was desperate to fix it somewhere else. It took me months to do the research, I was anxious and scared of another disappointment. When I sent my pictures to Dr Alejandro he called me and pointed out everything that was bothering me. I decided to give it a shot even if, after my experience I didn’t know what the outcome will be. Now I’m only 3 weeks post op and I’m feeling relieved. My nose looks very good! I decided to share my experience to help people who need to fix what other doctors messed up!
Kind Doctor. I sent my postop ct scans (surgery was done by another surgeon) to him and after seeing the damage he just called me out of the blue and consoled me and gave me options to fix. He did not oversell either and told me he had not fixed a face like mine, but he was willing. I have not had surgery with him yet as im still consulting. If i do ill add another review.
Maravilloso. es una persona cercana, agradable y empática. Muchas gracias por su ayuda, ha sido un placer poder conocerle. Totalemente sincero y amable. Gran humanidad y un muy buen profesional, muy agradable
He tenido complejo con mis orejas desde pequeña y necesitaba reducirlas en tamaño o hacer algo por mejorarlas. De momento solamente puedo hablar del trato que he recibido por parte del doctor y todo el equipo, ya que la intervención ha sido hoy mismo pero aquí estoy, encontrándome genial, sin ningún dolor y escribiendo la reseña, que creo que es muy necesaria. He visto algunos comentarios en los que no dejan en muy buen lugar la forma de ser o de tratar a los pacientes del doctor. Yo solo puedo decir que el trato ha sido magnífico, me ha querido transmitir tranquilidad en todo momento, ha bromeado, me ha dicho todo con claridad y que pregunte lo que haga falta por muy "ridículas" que me puedan parecer mis dudas, que lo importante es que sepa todo y me quede tranquila. Por mi parte un 10. De la doctora Salmones igual, me ha tratado con un cariño inmenso, ha sido súper cuidadosa siempre conmigo y me ha transmitido mucha seguridad durante todo el proceso. Han resuelto ambos mis dudas en todo momento, y están disponibles para cualquier duda también desde el momento en que contacté por primera vez con ellos, y ofreciéndome seguimiento post cirugía. Cuando pase más tiempo y pueda hablar de los resultados haré otra reseña, pero necesitaba aclarar todo el tema del trato porque he visto comentarios que me han hecho estar más insegura, pero todo el equipo ha hecho que todas mis dudas al respecto se hayan aclarado y solo puedo agradecerles por lo bien que me han tratado. Muchas gracias a los dos, y a Yolanda y a los enfermeros del Hospital CERAM también.
Me operé de aumento de pecho con el dr Nogueira en el 2016. No puedo estar más contenta con el resultado, el tamaño adecuado, natural. Te resuelve todas tus dudas, con respuestas muy claras. Lo recomiendo sin dudar. Visite otras consultas pero cuando lo conocí sentí que debería ser el quien me operé y no me equivoque.
Outstanding! From first consultation to last post op meeting I felt special, was treated with absolute respect and kindness and owe a debt to gratitude to Doctors Nogeuria and Salmones. My sense of well-being is off the scale.
Wonderful work done on my eyelids! I had my lower eye lids done by Dr Nogueira to remobe massive eyebags and than another trip to this clinic for Dr Nogueira to treat my droopy upper eyelids and the results are amazing. From the start of my conversation with Yolanda to the end my operation and the post-op care everything was fantastic. I can't find the bestnwords to describe how happy I am with the results thanks to Dr Nogueira and his team.
First of all, yes the skin, the muscles and all facial soft tissues are going to shrink back satisfactorily, however there are nuances here. Make absolutely sure your surgeon has in mind, for the reversion procedure, to REATTACH the mentalis muscle tendon back onto the surface of the jaw; viewing the Xray you posted it is clear he'll have to fully dettach it to perform the reversal, normal and routinary, same normal and routinary than reattaching the mentalis; do discuss this thoroughly with him; should the mentalis muscle float free you'd get double chin, dislocation when expressing and lower lip incompetence, plus expression deformities; so not a trivial issue. Second, you did NOT get a sliding genioplasty, it was a technique with major shortcomings, the surgeon did a very conservative forwarding (which is essential what a sliding thing does), and instead of doing a sliding he angled down the chin fragment, living a tiny hair-thick line of contact between jaw and chin fragment, in what I believe was an intent to increase the vertical height... or just a mistake... did you request from him vertical increase of your chin? If the vertical increase was a feature and not a bug, this is not the method accepted, instead a osseous grafting taken from iliac bone is the correct method, because this linear contact between jaw and chin fragment are non sufficient to obtain good ossification and bone healing, leaving you with a glass jaw prone to break with minor impacts (no, the titanium plate does not prevent this, ludicrous to pretend so). I recommend you have a serious discussion with your surgeon and the real intentions he had when he angled down the chin fragment, which probably is the reason for your insatisfaction, was this an error or an intentional design? if intentional... why he did not supply bone grafting to create a solid assembly? if an error... maybe you need better hands and re-do the sliding.
You have to live with it and accept your face is asymmetrical, like happens to all of us humans. However, your lips are subject to some enhancements I recommend: -corner lip lift, pennant lift, etc, to create better looking corners of the mouth -a conservative (small) autologous lip augmentation, without injected fillers, only your own collagen taken from the dermal layer of the skin (donor site a previous scar or the groin)
We need to see your current situation with updated images, however a retouch after a major revision rhinoplasty SHOULD be delayed 10 to 18 months, no less, doing it at earlier stage is a guarantee of suboptimal results, complications or even a disaster. It is neither true that 3 months are needed to assess the result, it is as I said a much longer period, x3 or x4 longer. Seek other opinions if your revision is not successful.
I'd have a very serious and sincere conversation with your surgeon, in good tone and begging him to be equally sincere with you. Ask him if he feels capacitated and motivated to go beyond with your result; he did a good work on you, can it be improved? No doubts, there is a huge margin for that. Is it a poor result with plenty of technical fails? Not at all. It is a grey zone result, not calamitous, not brilliant, just better and hence good for you. I'll tell you what I'd do; first and above all I'd talk with myself, to ask to me (you): is this result good enought to live my life? are the costs and challenges of a revision worthy for me? can I overcome the fear to put my face again in human hands? do I accept the risk of another non brilliant result or even a worsening? If you conclude that you wish to get the revision, then ONLY a surgeon confident that he can reach at least 9/10 has to bear the responsibility, and his talent and skills have to be proven to you. Goals for such revision, to my knowledge and capacitation I'd focus on: -strong and well planned alar rim grafting to push the nostrils down to level closer with the columella -lateral crura grafting, tutoring, even replacement to align the tip and improve symmetry -polish the dorsum, you have a little "polly beak" or supratip prominence, very likely you may also need spacer grafts in that area -improve the overall result of the tip shape, location and lenght, a slight deprojection, reduce the bulbosity, tip grafting, etc These are the items you can discuss with your current surgeon, prompt him whethe he feels capacitated for this; should he express or transmit any doubts or vague words... then you'd better seek the help of a experienced revision surgeon.
Be realistic and use a fine eye on this image: it is not only the nostrils that are asymmetrical, it si the whole nose, the entire left side is hypoplastic (less developed) if compared with the right one, ala, nostril, sill, alar rim, hemi tip, hemi middle vault, etc. A good structure rhinoplasty surgeon may achieve a more symmetrical tripod support for the tip (lateral cruras at the sites and both medial cruras in the midline), by means of replacing the current structure; to which extent? You may expect between 60 to 80% reduction in asymmetry.