I've had a few open surgeries and I'm content, but recently hit my nose in July and made the previous on the bridge stand out more. It looks to be either my septum or my rib spreader grafts. I have thin skin. A doc a visited mentioned that he can use a needle in office procedure to shave & smooth the piece down or we can do a closed procedure to shave and then add fascia. Obviously the needle sounds way less invasive and ideal to me but does that really work? Is it safe?
December 11, 2023
Answer: Simple solutions to complex problems I would be careful of simple solutions to complex problems. If this provider claims to have experience shaving Cartlidge, using a needle, then ask them to show you some before and after pictures. It may be possible to cut tissue using the sharp edge of a large needle, but how is the cartilage going to be removed? Simply slicing through the Cartlidge using a procedure that does not have good control sounds unpredictable and I don’t think you’ll be happy with the outcome. I think you need to ask yourself if this warrants, a revision rhinoplasty or not. You may be able to get some improvements using fillers. Each time someone has had previous surgery things become more difficult and complex. The threshold for surgical intervention should be higher based on having multiple previous procedures. Sometimes it’s better to leave good enough alone. Being in the hands of the most experienced and talented providers is probably the most important variable. Focus on choosing the most experienced provider and follow their guidelines. I generally always encourage people to have multiple in person consultations before scheduling any procedure and this is more true for complex operations like revision rhinoplasty. During each consultation, ask each provider to open up their portfolio and show you the entire collection of previous patients who’ve had similar procedures. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Highly experienced surgeons should have access to 100s or preferably thousands of before and after pictures. Seeing a handful of pre-selected images, representing only the best results of a providers career is insufficient to get a clear understanding of what average results look like, what your results are likely to look like or how many of these procedures anyone surgeon has actually done. You may very well be in the hands of a very talented provider, but Getting confirmation and vetting providers and comparing is always a good idea before committing to having surgery. I would err on the side of caution, considering the complexity of your previous surgery. Best, Mats Hagstrom, MD
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December 11, 2023
Answer: Simple solutions to complex problems I would be careful of simple solutions to complex problems. If this provider claims to have experience shaving Cartlidge, using a needle, then ask them to show you some before and after pictures. It may be possible to cut tissue using the sharp edge of a large needle, but how is the cartilage going to be removed? Simply slicing through the Cartlidge using a procedure that does not have good control sounds unpredictable and I don’t think you’ll be happy with the outcome. I think you need to ask yourself if this warrants, a revision rhinoplasty or not. You may be able to get some improvements using fillers. Each time someone has had previous surgery things become more difficult and complex. The threshold for surgical intervention should be higher based on having multiple previous procedures. Sometimes it’s better to leave good enough alone. Being in the hands of the most experienced and talented providers is probably the most important variable. Focus on choosing the most experienced provider and follow their guidelines. I generally always encourage people to have multiple in person consultations before scheduling any procedure and this is more true for complex operations like revision rhinoplasty. During each consultation, ask each provider to open up their portfolio and show you the entire collection of previous patients who’ve had similar procedures. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Highly experienced surgeons should have access to 100s or preferably thousands of before and after pictures. Seeing a handful of pre-selected images, representing only the best results of a providers career is insufficient to get a clear understanding of what average results look like, what your results are likely to look like or how many of these procedures anyone surgeon has actually done. You may very well be in the hands of a very talented provider, but Getting confirmation and vetting providers and comparing is always a good idea before committing to having surgery. I would err on the side of caution, considering the complexity of your previous surgery. Best, Mats Hagstrom, MD
Helpful