31 Years Old & Finally Bit the Bullet After Wanting to "Fix" my Nose Since 9th Grade! - Tarzana, CA

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*Treatment results may vary

I have had a love/hate relationship with my nose...

I have had a love/hate relationship with my nose since I was about 14. I have always valued "natural" beauty. Something inside me just didn't want to be "altered". However, my nose has been a source of really distressing self-confidence issues, and so many avoided photographs. I have wanted to change the appearance of my nose, and had intended to, but other family needs have taken precedence. I finally reached the point where my intention and ability to commit intersected and here I am!

Septorhinoplasty(closed)/turbinate reduction/alar rim reduction

Went to surgery center in Tarzana. The staff was awesome. Met briefly with the anesthesiologist & Dr. Grigoryants to go over the nose goals. I don't remember whole lot from day 1 - anesthesia side effect. Came out of surgery and had dark bruising show up within a couple hours. Absolutely ice your face. It's hard to position ice packs of any type. I found wetting and freezing dish towels/washcloths the most helpful. If you're like me, you'll go home with a hard cast and a "mustache" dressing (a piece of gauze suspended under your nose, attached by tape to both cheeks). I had a lot of bleeding and seepage, so I needed to change the mustache dressing hourly. When I took the dressing off, a splint on each side of my septum (inside my nose) was visible, as well as a plastic strut under my columnella. There were black and clear stitches visible, as well as some taping of my tip. I had alar rim reduction, as well, so there were small vertical cuts with clear sutures visible. I found that the mustache dressing gauze would actually dry stuck to my nose, or the tape, which is really painful, so I recommend buying Aquaphor, taking a dollop and smoothing it across your nostrils and upper lip whenever you change the dressing. The Aquaphor keeps your nostrils soft, the inside of your nose moist, and believe me it pays when you have everything removed.

Day after surgery -

Absolutely take your pain meds, around the clock - along with your antibiotics - for the first two or three days. I'm a champ with pain, and even though the "pain" was low/mod, the discomfort was incredible. I really blew up day 2 - the swelling and bruising was completely disfiguring. I slept upright, iced and pounded Arnica, but I was really surprised at how horrible I felt. Still had quite a bit of bleeding. Day 2 swelling was under eyes, high up on my cheeks, and at my radix/glabella. My glabella was the most sensitive part of my face - touching it immediately gave me a headache. Drink a lot of water & stay away from heavy foods (breads), no spicy food (dilates your blood vessels and encourages bleeding), and take it easy/avoid salty foods (increases fluid retention). My energy was super-low and I felt soooo congested. Get some soothing cough drops (nothing with mint fumes - it will make you feel like choking and will burn) like the herbal Ricolas. You will have been incubated, and will likely have a sore throat. On top of that, you'll have zero nose breathing ability and mouth breathing at night makes for a very dry mouth/throat. At night, I kept a bottled water (you need bendy straws too), pain med, antibiotic, cough drops, and Biotene dry mouth spray (at drug store in toothpaste aisle) at my bedside. It can be hard to remember you med/antibiotic times, so set an alarm on your phone for every 4 hours and take them every time it goes off.

Day 2, I looked frightening. As the day wore on, my bruising grew and darkened. Felt like my undereye lids were going to burst. I put Aquaphor on everything that was swollen - I feel it helped my skin as it ballooned - skin feels scarily taut otherwise - and it kept my skin feeling elastic as it was shrinking back down.

Don't look at yourself day 2 and think you see any part of the final result. Ignore the way you look and focus on making yourself comfortable. Your upper lip will be functioning weird also - if you attempt a smile, you'll look like the Joker from Batman.

Day 3

Horrendous!! I'd say this was the worst day of all. My top and bottom eyelids were swollen shut, my upper teeth were sore, my throat was sore, bruising was alllll over (my chin/jaws/forehead had a greenish cast), I had almost zero radix, I was swollen from my tear ducts to my nose, and I developed chipmunk cheeks to boot.

I was scared by the swelling and bruising. Really couldn't see how much more my skin could take. My eyes were so sore from the swelling around the tear ducts and they watered a lot.

I was feeling really punkish, and compared to other patients, I thought my reaction was fairly extreme. I called Dr. G's office and was reassured that it was normal. I hadn't seen a single woman on realself with a facial result like mine, and it worried me.

Turned out I did have a mild fever (100.4) but since I was on the antibiotics, the dr office wasn't concerned about an infection. My sore throat was originally from being incubated, but I think it continued into a "cold" sore throat. Major congestion is to be expected, but I was oozing mucous (just slightly pink-tinged), so I'm pretty sure it was a cold. Luckkkkyy.
Anyhow, if you get "sick", get the old school style little plastic squeeze bottles of generic sterile saline to wash up your nostrils. You don't want the ones that mist or spray - you want the ones with the single hole in the tip that you can shoot. Literally stand over a sink, don't put the tip inside your nostril though, and shoot. The saline probably won't get very far (this will change over the next few days) but it helps clean out whatever is in there. Do not take any over the counter cold medicines, ibuprofen/Advil or drink hot teas, or eat hot soups. Only acetaminophen (Tylenol) and lukewarm liquids.

Also, get anti-microbial Q-tips and hydrogen peroxide - pour a little peroxide on the Q-tip and trace the inside rim of each nostril to protect against germs or bacterias settling and traveling up into your nose or infecting your incisions. I would rinse the hydrogen off with saline afterward, put a dollop of Aquaphor, and stick my mustache back on.

Day 4

Day 4 was a liiiiiiitttle better. Swelling is not at its peak anymore and some dark purple/black bruising starting to turn reddish. Still feeling unwell, but glad cold is also to blame! First day I'm not tied to my mustache!!!

Day 5 - removing the cast!

So this is 4 days after surgery day. Not really nervous. I was so self-conscious about my nose for so long, that any degree of better, is good by me.

Keep in mind - extreme swelling still. I'm glad I had read somewhere that your new nose could resemble Avatar - because that's exactly what I saw. I looked like the love child of Avatar & Miss Piggy. Go in expecting that. It'll ease your mind. And honestly, look at it , be shocked, but then leave it alone. Avoid mirrors. Take some photos so you can see the daily changes. And forget about it.

My daughter and significant other were she'll-shocked to see me look so different. My SigO liked my old nose and is extremely supportive of what I wanted, but he teared up. That's the only thing that made me well up. You have to be ready to let go of your old face!! You'll see yourself come back, but beware for shocked faces from people who love you at first.

Day 6 - day after cast removal

Scared if his is my profile! Checked in with Dr. G because my radix is so high compared to pre-surgery and I have a ski slope profile - exactly what I did not want. All I can do is have faith in the process. There can be swelling in the tissues, of the bone, of the covering over the bone, inside the nasal passages... Patience. When in doubt, ask your doc!

Day 7 - two days post cast removal

Dr. G instructed me to tape my nose every night and to remove he tape during the day. My front view scares me a bit, so I feel better with the tape on for now. If your doc has you tape, you can keep it on all you want UNLESS you have a reaction to the tape itself. Tape tightly. And when removing, moisten the tape with isopropyl alcohol & hold your skin down with a q-tip as you peel. Don't pull the tape forward off your face! Go slowly and gently. The goal is to get your skin to shrink-wrap itself back to the underlying structures. Keep this in mind!!!!

One Week

Things are pretty much evening out. Your nose changes throughout the day. I'm keeping my tape on, cleaning my nostrils with peroxide, doing saline rinses (the saline is making it all the way up my passages now), and keeping Aquaphor on my nostrils (they're healing really well). Swelling fluctuates. My profile is really calming down, thank goodness. Starting to run errands and get out of the house - I was going stir crazy!!

Six weeks!!!

9 weeks out!

Everything's going okay, but I'm a bit frustrated at the moment. You've got to appreciate the possibility that asymmetries in your facial structure and nose prior to surgery may appear more pronounced following. I had a dent in my right nasal bone/upper cartilage area, and my right nostril also had more of a peak than my left ~ those two things are now driving me crazy and they can't be fixed yet. Not the fault of the surgeon. Just my anatomy. I thought I was done with creative makeup techniques!!!

10.5 weeks

Improvements happening :)

Before/10.5 weeks After

Her are some comparison photos

More comparisons -

Before & 10.5weeks After

Less and less satisfied.

Hello everyone. Sorry for the huge time lapses. Honestly, I'm disappointed about what I'm seeing, and I've wanted to give a fair amount of passing time before posting negatively. Pre-surgery, I had mentioned to Dr. G that I though I'd need a strut graft on the left middle 1/3 of my nose, because it looked like I had mild collapse. He said no. Now I truly have a collapsed middle vault. I also noticed my nose was crooked immediately when the cast was removed. Dr. said "swelling, swelling; wait for swelling to go down". I was right. My nose needs to be re-broken. My nostrils appeared much smaller for months, and now they seemed to have returned to looking to large and are really spreading/splaying/flaring when I smile. My tip has also lost its sharper shape. I feel like my nostrils are retracting and I have a notch in one. I'm almost 6 months. Just bummed. I'm in for a revision. I want to see other docs. Just damn.

Hating what's happening!!!!!!

Talking to Dr. G in a week. Profile pretty. Front view is heinous!!! My front view pre-surgery was better, and that's not saying much!! I've been patient & I believe Dr. G is amazing. I'm hoping he can fix this stuff, because I'm freaking inside. Really, really bummed. I've complained about these things for months, and while it was easy to attribute the asymmetries and concerns to "swelling", my nose is stable now. None of this is going to change without revisions. I'm very much hoping Dr. G will see what I'm seeing and feel confident that he can correct it all. I'm seeing:
1) bones between eyes not centered
2) dorsal lines asymmetrical - right one straight & left one concave - right one harsh and left one faint - bridge looks wide, instead of narrow peak and gentle dorsal aesthetic lines
3) left lateral nasal sidewall collapse - my bridge hangs over the sidewall, like a shelf
4) tip still bulbous - nose has hourglass shape - fullness even above nostrils - no triangular shape whatsoever
5) too much nostril show, even when face at rest - nostrils still flare too wide when I smile - nostrils pull up & nostrils face downward when I smile - left ala has a pointy peak
6) columella looks too long - hangs down - esp when I smile
I'll update soon ????

Revision Surgery in 8 months

Feeling relieved. Dr. G and I have a plan. My asymmetries are fixable.

1a) asymmetry in upper 2/3 of nose - distance from canthus (tear duct area) to bridge appears greater on the Right (left side in photos), and the Right Side has a concave shape, while the left is more straight.
1b) "bump" at inner corner of eye
2) right nostril collapse. Looks floppy and flattens when I smile.

Some asymmetries are "actual" (physically measurable distances, angles & slopes) and some "perceived" (contours & shadows). Every persons "midline" is immovable - it's a structural fact. Your midline is the straight line from the midsaggital plane to your nasal tip.

I have very visible facial asymmetry - my midline is not a straight line, my midline is deviated. This is creating the "uneven" appearance. So, in my case, to make my midline appear straight, we have to camouflage it by adding grafting material (ear cartilage) to the dorsum, and the upper lateral cartilage.

I also developed a bony overgrowth on the Right Side, near my tear duct, at the lacrimal bone. There's a little "hill" where there should be a "valley". It altered the slope, making my eye sockets appear asymmetrical. This has to be re-fractured.

As for my right nostril (left in photos), I need a small graft. My nostril collapsed, as a result of losing structural support because of the tip work. This creates a pseudo-notch - the "notch" is actually where the collapse is; the nostril is kind-of "folding" there.

I love Dr. G, and he truly wants to help. My irregularities are a result of pre-existing asymmetries and some healing issues. In order to "test out" the look of adding grafting material to my dorsum, he injected Juvederm. Immediately the appearance improves. Still need the bony growth and nostril fixed, but this is promising!

I'm visiting him again in 6 months, after Juvederm is about gone, to re-evaluate and schedule surgery.

(Pics of the bony growth over lacrimal bone)

This has to be re-broken.
Los Angeles Plastic Surgeon

I have been trolling the internet for the best rhinoplasty doctors since I was a teenager. I found Dr. Grigoryants in 2009, and was immediately drawn to his personal aesthetic. There are many internationally acclaimed surgeons with exceedingly impressive curriculum vitae, and years of extensive training and experience. While qualification is most important, there's no circumventing the value and influence of each individual surgeons personal aesthetic on the outcomes of their patients. Dr. Grigoryants is world-renowned, board certified, published; well-respected among colleagues and loved by his patients. It is patently clear that Dr. Grigoryants delivers consistently beautiful work. He is compassionate, listens, is kind and accessible. He is adept at translating patient desires. His calm demeanor and paced manner, allows for very pleasant communication. He is upfront about limitations and sets up reasonable expectations. Dr. Grigoryants office personnel and consultants are polite, clear, and deliver prompt service and correspondence. His practice is flexible and respectful of his patients time. The Glendale office is wheelchair accessible as well.

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