Brian Paul Kim, MD

Dr Brian Paul Kim of Irvine is am amazing surgeon. He is kind , caring and listens. He is a very talented and results oriented doctor. Dr Kim is current with medical trends always offers best practice advice. He is absolutely the best! If you are lucky enough to see Dr Kim you will be in great , talented hands

Saw my head and neck doctor Brian Paul Kim in hopes of identifying the cause of my chronic headaches. (15+ days a mo.) - I suspect that these are actually sinus headaches caused by my deviated septum. After the assessment, it is obvious (despite x-ray and previous opinions) that I do in fact have a severely deviated septum and the doctor has ordered surgery to fix my septum and straighten my nose. We think the deviated septum is causing sinus headaches. But I also suffer from restricted breathing which will be corrected without doubt.
Surgery is not yet scheduled, but will likely be scheduled in August when there is availability.
Before photos below. *I'm sick excuse the redness :)

Updated on 13 Sep 2018:
Went to my Pre-Op appt. with Dr. Kim today. It went well, he was very kind and asked me to tell him all of my questions with no hurry. He took some PreOp photos I hope to get from him soon to post here more officially. I learned we will be doing a septoplasty and turbinate reduction. While hes up there he will try to straighten my nose a bit and shave down some slight bumps I have on my nose. Low-key hoping this gets a little cosmetic and my nose looks great after! I'm a little worried about what my nose will look like after. One side has cartilidge showing and I actually prefer that side as it doesn't look as turned upward as the other. But the other looks normal in the nostril area. If I could just combine the two strengths! Surgery date is September 28th! I will be back for future updates.

Updated on 24 Sep 2018:
Talked briefly with my Anesthesiologist today for surgery this Friday!

I had to quit smoking and drinking 2 weeks before surgery. At least I managed the drinking. I smoked up until yesterday (5 days before surgery). And by smoking, I mean vaping. So here's hoping that doesn't madly effect the healing process or something.

Increasingly nervous about the potential of cosmetic changes to my nose during this surgery. As you can see in my left/right photos. One nostril has cartilage that really hangs down and is visible. Apparently that is going to be no longer there, according to my pre-op. But he also said I would look the same and he wasn't making any cosmetic changes... doesn't add up exactly but I'm trusting the process! I will update more photos and or videos the morning of and during recovery!

Pic is Pre-Op obvi :)

Updated on 27 Sep 2018:
I am now in full anxiety mode about how my nose might change appearance post op. The more I look at the left side the more I like how it comes down and dislike how the right side is more upward turned. Looking into nostrils is not cute and I'm so scared that is what this is going to become... despite the claims that this will not change my nose appearance I'm just not seeing how that could happen with all the work we're doing to straighten and make my breathing better.
I will take photos and videos as the days go by and be back to update as time goes on!

Updated on 28 Sep 2018:
Surgery complete.

This morning I met my doctor at 615 am and begun surgery at 730 am after meeting the team etc.

Surgery took about 4 hours altogether. Crazy. We were expecting 3 hours tops. When I woke I was very very dizzy. I've been under before and I've never been so dizzy upon waking. I also threw up for the first time after anesthesia. This was definitely a result of swallowing blood, because I was just throwing up blood. One minor complication im experiencing is urinary retention. For some reason I'm feeling the urge to pee without the ability to follow thru. I read it's a common side effect so I'll give it some more time before I start to panic.

Pain level - about 1-2 hours post op -
I'd give it a 6 or a 7. Idk how much pain meds I'm on so I imagine it worsens a bit with time. But I'm just ice packs right now. I've had headaches worse than this. Pain is nose obvi, forehead, throat. About to do cough drops to try to soothe the throat but the throat is not as bad as I was expecting based on what I read. Basically feels like I chain smoked all night.

Updated on 28 Sep 2018:
This morning was a bit of q blue understandably. The only thing I wasnt excited about was that I felt rushed through leaving the hospital. Not the doctors fault more so on behalf of my nurse who was otherwise lovely. I have no idea if its packing or splints in my nose. He may have to told me preop but being told later or having it on the paperwork would have been cool. I'm bleeding a ton and I'm concerned about how much is dropping from my nose. Other than that, I think under the swelling im going to like the results :)

Updated on 29 Sep 2018:
Okay lots of advice for you! First ill talk about night after surgery followed by this morning.

As expected, The pain worsened throughout the first night preop. It's important to note that get chronic migraines, almost every day, (part of why I had this surgery) So it might have been worse for me than the average joe. It also may have felt more manageable for me as I am used to this level pain. Itll really be up to you. I would suggest taking your meds at directed even if you don't feel the pain at first. I regretted not getting ahead of it. I Ended up taking my hydrocodone around 7 pm and icing a fair bit. Also the congestion and bleeding picked up quite a bit. Post op the first few hours I could still breathe through my nose a little. As night 1 progressed that became an unavailable option. This was to be expected, I was just hoping I'd get lucky ;)
The bleeding however was a lot around the same time and a little concerning for me who didnt know better. It was like a leaky faucet dripping virtually every 10 seconds before I could get the next gauze on. Bled a lot on my shirt, bedding etc. I'd definitely lay down a towel it will happen. I ran out of gauze the first night so I would recommend picking up an addl 100 to 200 pack pre op or the next few days so you dont have to go back out to get some. This is obviously advise for those who like me were not given packing but just a drip catcher that goes about your ears. Will post photo below. Last and most irritating symptom for me was trying to get some sleep. This was difficult for a number of reasons. I'm a stomach sleeper. And I hate hate dry mouth. So not being able to breathe thru your nose you HAVE to do so through your mouth. I woke up every hour or so to take a drink and wet my throat again. It's pretty annoying but once I got into a groove at least I got like 4 hours of sleep so I'm not getting too loopy.

1 day post op - AM
This morning my pain has greatly subsided. Generally my migraines come at night so that confirms my thoughts that I just had my usual migraine on top of the uncomofrtableness of surgery. I could be wrong tho so just expect a bad headache the first day and consider yourself blessed if it's not the case. Congestion at an all time high but it's cool I got over using my nose last night. I'll take some sudafed later to see if that helps at all. But the bleeding is significantly less. It had some time to scab up last night for sure. Throat is more dry than in pain, dont need cough drops this morning. Just feels a little bit raw at most which is awesome, I was pretty concerned about that pre op. Trying to drink a good amount of water because hydro can make you constipated if you dont stay super hydrated. which is also just a good thing to be when your nose is healing obvi. In addition, making sure I eat a ton of yogurt and probiotics this AM as I was given strong antibiotics which can do the opposite and give you diarrhea. So just remember to do those two things as well to make this process as easy on yourself as possible.

In terms of appearance, no bruising yet but sure to come. I'm told pineapple will help decrease this so I've sent my SO to go get some. Though the swelling so far is doing wonders for my sunken in under eyes;) silver lining. The only change I can really see because of the cast and swelling is the upward visual of my deviated septum. It's pretty clear in the photos that it no longer protrudes and that is awesome! One step to normalcy. cant wait to see what the rest looks like. Cast and splints to be removed in 1 week. I'll be back for updates as things change and of course on that day particularly.

Feel free to ask questions!

Updated on 29 Sep 2018:
I spoke too soon on the bruising. Moments after my last update I took a better look in the mirror. And I was def bruised. Now my face is swelling AND the bruising is spreading. Under my eyes and bridge of nose. To be expected. Heres hoping this all goes quickly.

Updated on 30 Sep 2018:
I figure I'll keep updating til I get the splints out. Night 2 much like night 1 sucked. Not in pain just in the miserable time I had trying to sleep sitting up. I couldnt do it. It was giving me a major migraine. So I laid down. I'm sure this made my swelling worse but it was worth getting a few hours of sleep and relieving the migraine. Again, I get chronic migraines and stress headaches so my guess is that was all me and not surgery. I just keep a little trash bag by me and tissues at this point. No sense in wearing the blood dropper thing. I can just use a tissue since it's not so constant.

This morning wake up. As I suspected my swelling has gone up up up. Fun photos to come. I did a saline rinse which felt great. One nostril is still super blocked idk if its gunk or stitches or what in there but I'm not gonna push it. The other nostril cleaned out enough for me to feel the rinse in my brain. I am eating yogurt about to take my antiobiotics here shortly. Throat doesnt hurt at all. Lips hurt bc the dryness causes them to stick together and RIP apart when you finally get something to wet your throat again. Use chapstick or vaseline liberallyyyy.

Despite all this, I'd still say it's a pretty easy experience. I feel better each day and thus far would def recommend the surgery. Just cant decide til the results are In!

Splints come out this upcoming Thursday!

Updated on 1 Oct 2018:
Okay so my surgery was Friday morning and it is now Monday morning. Making this day 3 post op.

Bruising and swelling was at its worst throughout day 2. Its not much better today but it's not getting progressively worse as it was yesterday. I have been doing saline rinses and have coughed up a gross amount of blood clots. And constantly clear out a ton of blood. (Hopefully that's not a bad thing?) still cant breathe, to be expected. I'm sore but it's all bearable. The only part that sucks is that I want to lay down to sleep and when I do the swelling gets worse and makes my eyes feel claustrophobic even. Have to stay sitting up and on ice despite being super tired.

Nothing else new to report. Heres a pic of me looking gross to brighten up your day.

Updated on 2 Oct 2018:
Good morning all.

Day 4 Post Op. Each day a little easier. I realize I've been aggravating my nose by blowing it a bit. I know you arent supposed to but when you feel gunk in the airway and dont do something it's super annoying. Anyway I'll try not to blow at all until I get these splints out. Otherwise I imagine I'll bleed a lot when the time comes. Nose is still sore. Surprise. Cant wait to get these dumb things out. I can really tell they are in my brain. Just consistently uncomfortable like everyone else says.

Slept not sitting up again. I cant help it. Its sleep or swelling and I choose sleep. So my eye lids are a little swollen in this photo I'm about to post. I'm sure with ice and walking around they will go down I'm just still in bed.

Updated on 3 Oct 2018:
Same old. Doing saline rinses 2 or 3 times a day getting some gnarly blood clots out. Cant wait to get the cast off tomorrow and get my sinuses cleaned out. New thing is that the top of my mouth is pretty sore. Didnt notice it before. Just before my uvula mostly on one side. I hear it can happen due to nerve damage from the procedure but its weird I'm noticing it right now. Hopefully it's not sign of any kind of infection.

Updated on 3 Oct 2018:
Post op day 5 photo. Forgot to add this to my last update. Looking at my before and after photos my nose is def super swollen. I am sure I'll freak out once the cast is off about how big it is. Heres hoping swelling subsides quickly and I can get back to pretty selfies.

Updated on 5 Oct 2018:
I think I missed a day. Perhaps that was yesterday. I had the cast and splints removed. It seemed much less dramatic than what I had seen in videos etc. It didnt hurt and was barely even that uncomfortable. The vacuuming out also wasnt nearly as crazy as I was expecting. Oddly enough the most painful part for me was when he cut the stitches. They are still in my nose and allegedly will come out over the next month. If not he will remove them on my month post op visit. That sounds scary and painful tbh. Heres hoping they come out on their own before then.

He put on some tape and showed me some massages to help straighten my nose as it's still not entirely perfectly straight. Hardly noticeable though I dont really mind considering how off it was before, but I'll try them anyway.

Some photos here for you before I had the tape put on as well as the icky inside pieces from my nose.

Keep in mind swelling takes several months to go down and up to a year to resolve entirely! I am actually pretty happy with my nose. The rest of my face could use some work especially in these pics... but I took one for the team, enjoy!

Updated on 17 Oct 2018:
3 weeks post op (almost). The stitches are finally starting to come out in big gross scabs. Thank God because the scabs are annoying and you find yourself with your fingers in your nose all the time picking at the stitches. Which hurts btw if they arent ready to come out. 10/10 do not recommend trying with tweezers lol. Breathing is great. Headaches continue but hey at least I look better and can breathe.
Swelling continues to go down. Nose is still sensitive to being bumped or otherwise booped. It feels dry but I continue the nasal rinses as I hear that helps less scar tissue to form internally. And the doctor said so. Follow up w him in a week or two here. If there are any remaining stitches hes gonna cut them out so I'm hoping they come out before then! That hurt!

Odd note. After doing saline rinses... it smells. My nose has a bad smell. Idk what this is but apparently common. Not the worst just like.. idk. Not pleasant. Probably a result of decaying stitches I'm guessing. Which is how your body gets rid of them.

Here are some 3 week post op pics to encourage you. I still recommend getting this surgery. Even just to help your breathing or appearance. My surgery was not cosmetic but it had cosmetic benefits!

Updated on 31 Oct 2018:
About a month post op now.
One thing I've noticed is that the tip of my nose is bigger. I understand there is still swelling to go down but I read an article saying no matter what you do to the cartilidge the tip will be bigger.. so not happy about that but it's not the worst ever so I guess I'll live.
Another thing is my nose is super oily. Apparently a post op thing. It's just been so gross and oily ever since the cast came off. Feel like washing my face more but then it gets dry and flakey and oily all at the same time. I hope my skin goes back to normal soon. I havent taken a post op selfie since surgery. Just not crazy about how it looks with the skin and the swelling. It's not the end of the world I'm told it looks way better. My portrait is better for sure. It's just the swelling and the skin. For the better I guess. Still got stitches up there to come out too.