It's been two years since my revision rhinoplasty and I'm still unhappy. 1.my nose has a lot of irregularities, one side with deep depression mark, same side with the mark has a bad oder. 2. Nose looks masculine and huge! Bulky and round, I would like a nice smooth bridge with a smaller nose. I was told BOTH my nasal bones were gone so it was replaced with cadaver cartilage. Do cadaver cartilage last or will my nose collapse with time? Am I out of luck with no nasal bones? Is closed rhino better?
Answer: Revision Rhinoplasty Hi @LK19! I recommend seeing a revision rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. Rib harvesting is sometimes necessary in revisions if the septum and supporting cartilage of the nose have been weakened. This will give more strength and support to the nose. Rib harvesting is fairly simple and commonly used in revision procedures. Best wishes, Dr. Nima!
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Answer: Revision Rhinoplasty Hi @LK19! I recommend seeing a revision rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. Rib harvesting is sometimes necessary in revisions if the septum and supporting cartilage of the nose have been weakened. This will give more strength and support to the nose. Rib harvesting is fairly simple and commonly used in revision procedures. Best wishes, Dr. Nima!
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February 26, 2020
Answer: Hmm. Yes, you seem to have a prominent irregularity up at the top of the boney part of the bridge. More advice ... Really, more photos are needed to do a good online consultation like this. It's usually possible to improve those irregularities, but lots of different views would help in understanding what's going on there, and also, importantly, to see what other changes could be made, as you said, to make a smaller nose.I usually think that on revision, it's good to make a nose smaller if possible, because then any remaining bothersome asymmetries or irregularities reside on a smaller nose, and thus are smaller and less noticeable. Remember also that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations. Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs? And additional, full-face images would be needed for that.
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February 26, 2020
Answer: Hmm. Yes, you seem to have a prominent irregularity up at the top of the boney part of the bridge. More advice ... Really, more photos are needed to do a good online consultation like this. It's usually possible to improve those irregularities, but lots of different views would help in understanding what's going on there, and also, importantly, to see what other changes could be made, as you said, to make a smaller nose.I usually think that on revision, it's good to make a nose smaller if possible, because then any remaining bothersome asymmetries or irregularities reside on a smaller nose, and thus are smaller and less noticeable. Remember also that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations. Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs? And additional, full-face images would be needed for that.
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February 16, 2020
Answer: Irregularities and nose too large after cadaver cartilage Cadaver cartilage has been used duct in many patients but it’s long term outcomes are still unknown. I would be concerned about irregular absorption and so avoid it as an onlayngraft and only use for underlying support. Using your own rib should be a permanent solution. Rib grafts can look bulky, and there are solutions to avoid or correct that. The irregularities are fairly obvious and will get worse over the years in all likelihood. I would recommend a revision rhinoplasty with an experienced surgeon using your own rib cartilage and probably some fascia overlying your temporalis muscle which will not leave a visible scar.
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February 16, 2020
Answer: Irregularities and nose too large after cadaver cartilage Cadaver cartilage has been used duct in many patients but it’s long term outcomes are still unknown. I would be concerned about irregular absorption and so avoid it as an onlayngraft and only use for underlying support. Using your own rib should be a permanent solution. Rib grafts can look bulky, and there are solutions to avoid or correct that. The irregularities are fairly obvious and will get worse over the years in all likelihood. I would recommend a revision rhinoplasty with an experienced surgeon using your own rib cartilage and probably some fascia overlying your temporalis muscle which will not leave a visible scar.
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February 10, 2020
Answer: Nasal evaluation Hello, I would reach out to your surgeon or another experienced nasal surgeon to get a thorough evaluation. The aesthetic concerns can be readdressed with revision surgery, but I am more concerned about the bad odor you are smelling. Sometimes that can be from other concerns in the nose and sinuses like a persistent sinus infection. Cadaveric cartilage can be used with good longevity if utilized properly.I am unsure about how the cadveric cartilage was used to replace the nasal bones. As for closed versus open rhinoplasty, they are just techniques used in rhinoplasty. I wouldn't worry so much about which your surgeon uses, but what works best in his or her hands for your specific needs. Many of your concerns can be put to rest after a detailed in person examination by an experienced rhinoplasty surgeon. Best of Luck
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February 10, 2020
Answer: Nasal evaluation Hello, I would reach out to your surgeon or another experienced nasal surgeon to get a thorough evaluation. The aesthetic concerns can be readdressed with revision surgery, but I am more concerned about the bad odor you are smelling. Sometimes that can be from other concerns in the nose and sinuses like a persistent sinus infection. Cadaveric cartilage can be used with good longevity if utilized properly.I am unsure about how the cadveric cartilage was used to replace the nasal bones. As for closed versus open rhinoplasty, they are just techniques used in rhinoplasty. I wouldn't worry so much about which your surgeon uses, but what works best in his or her hands for your specific needs. Many of your concerns can be put to rest after a detailed in person examination by an experienced rhinoplasty surgeon. Best of Luck
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February 8, 2020
Answer: Permanent non-surgical nose job for bridge indentation. In all likelihood, the depression on your bridge may be filled with microdroplet Silikon-1000 for permanent improvement. However, that would not address the width of your nose. I'm not clear about your missing nasal bones being replaced with cadaver rib cartilage. The feasibility of another nasal surgery for narrowing would require a consultation and review of your previous operative reports and photos. Hope this helps. Dr Joseph
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February 8, 2020
Answer: Permanent non-surgical nose job for bridge indentation. In all likelihood, the depression on your bridge may be filled with microdroplet Silikon-1000 for permanent improvement. However, that would not address the width of your nose. I'm not clear about your missing nasal bones being replaced with cadaver rib cartilage. The feasibility of another nasal surgery for narrowing would require a consultation and review of your previous operative reports and photos. Hope this helps. Dr Joseph
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