Bad Revision Rhinoplasty & good genioplasty - Dr Bart van de Ven

Hi everyone, Here's my story... like so many of...

Hi everyone,

Here's my story... like so many of us, I too stood in the back of the line when they were handing out chins and noses ;-) Got teased a lot about my nose as a teenager. People can be cruel, especially 14 year olds! As soon as I managed to muster up the courage, I let my mom make an appointment with a surgeon; I was 17 at the time. Unfortunately, the doctor was a bad choice, as he wasn't a plastic surgeon but a nose-ear-throat specialist. Either way, the guy was cheap and who knew things could go horribly wrong? After the cast was removed, my nose instantly looked great. it was exactly what I wanted. After a few months the swelling subsided and it became apparent that I had a big dent in my nose where my nasal valve collapsed. For years I figured I shouldn't be splitting hairs and just accept the situation. It wasn't like people were pointing at me in the street anymore...

The last couple of years though, it has become increasingly difficult to look the other way. I want to be pretty too! :-( So I made an appointment with dr Bart van de Ven in Belgium. For some reason I started to consider a genioplasty as well, to balance out my features. The doctor was very professional and kind and made many good suggestions. My operation is booked for the 16th and I'm freaking out. I have difficulty trusting people and I would have liked to have spent more time talking to the doctor to explain in detail what I am looking for :-) I'm a little neurotic that way!

I've taken a few weeks off from work and haven't told anyone what I'm up to. Hopefully the changes will be very subtle and no one will notice. Idle hope perhaps but we'll cross that bridge when we get to it!

So that's kind of the background. I'll be posting throughout the recovery period. All your stories helped me so much so I want to give a little back :-)

Thanks for reading!!!!

The day before tomorrow

I am sh*tting myself right now! Evening before my surgery. I'm slowly but surely going crazy with fear. Had my pre op consult today and the doctor made a simulation of my nose and chin. I looked at it and it was like i didn t even recognize the person in the picture! So it finally hit me like a ton of bricks that this is really happening and there's a chance i'll hate the outcome. It took a lot from me not to storm out of the office and flee home to hide under my bed.

I was looking forward to this soooo much and now i'm only seeing the risks. When everything is still abstract and far in the future, you kind of downplay anything that could go wrong. All i could think of was how i'd finally feel good about myself (best case) and what a relief it would be that i wouldn't have to hide my "bad" angles anymore.

Today i'm obsessing about how they will break my nose and slice through the bone of my chin. Feeling guilty that i'll be putting my body through this while it's perfectly healthy and in no need of surgery.

Guess everyone feels that way the day before surgery?

Done

Worst thing i ever been through. I'm in pain, caughing up blood and my nose looks terrible. Am i crazy or do i have the katie holmes look right now?

4 days post op

I'm feeling a bit better today so I'll explain what's happened in the last few days.

So I went into surgery on Tuesday. Took some Lorazepam in the morning, and in the clinic they gave me some valium. I have to say the details are a bit blurry but I do remeber some bits & pieces. The anaesthesist came to introduce himself and was very nice. I asked him "please make sure I don't wake up in the middle of the surgery!". He said I shouldn't worry and he'd be monitoring my vitals the whole time

They walked with me to the OR and got me to lie down on the bed. I remember seeing some pics of myself on the wall, including the simulation they made the day before. Next thing I know, the anaesthesist put the needle in my vein, (very skilfully I must say ;-)) I told him my arm was feeling hot and that's the last thing I remember.

I woke up perfectly alert without any shakes or vomitting. My boyfriend was in the recovery room wearing scrubs for some reason but it was very nice to have a familiar face there. I spent the next couple of hours caughing up blood and trying to breathe. Swallowing hurt and I couldn't open my mouth over 1 cm. It wasn't the best experience ever i have to say. I must have called the nurse about ten times that night. I was wearing an automated icepack that cooled every 20 mins so couldn't get up to go to the bathroom on my own. She had to come with me and stayed in the room with me. I gotta say, feeling that bad, you quickly shed all feelings of shame! Either way, I didn't get any sleep that night and was happy to see the morning light finally.

The doctor came over at about 11:30 and discharged me from the clinic rather abruptly. I'm wearing a nose "moulder" type of thing, which can easily be removed, so he got me in front of the mirror and showed me my nose; I was shocked!! The damn thing didn't look one bit as expected. I have a big dent under my eyebrows where the moulder begins, my nose looked tiny and weirdly Eastern Europe.?? I hate it, hate it hate it!! So anyway, standing in front of that mirror I started to feel sick and was seeing black spots in front of my eyes. I had to be taken to the bed to keep me from falling. On the up side, my chin only got a little advancement and I think it'll be fine.

I must say there has been some pain, which was manageable with painkillers. I slept a lot, rested a lot. The hardest thing for me was really the caughing up blood. I convinced myself I was gonna choke in it, you know how that goes when you drive yourself crazy ;-)

We're on day four now and I'm feeling a lot better. Still weak, but the pain is a lot less and I can move around a bit more. Went to the doctor this morning for my first check up and he says my nose will look a lot better when the moulder is off and the swelling subsides. God I hope he's right or I won't ever go into public again....

I asked them to take some pics right after the surgery. I'll attach them but I have to say, the nose doesn't look ANYTHING like the pics right now....

Will keep you updated!

9 days post op

Getting more and more depressed. My nostrils still look awfully asymmetric and kind of masculine. I feel like a monster. Don't even have the courage to face my family right now and can't stop crying. Still very swollen all over my face. God what have i done... I have to go back to work in 9 days!

Just sent an email to my surgeon, basically pleading with him to help me. I hope the result will be better when the swelling comes down... Can't imagine that right now...

My genioplasty went fine really. Stll a lot of swelling but i can tell it's gonna end up great. No complaints there.

Sorry this is such a negative post. But please people, incorporate a worst case scenario in your plan. I wish i did...

18 days post op

I'm starting to recognize myself in the mirror again; Still don't look good, but at least the swelling has gone down quite a bit in my cheecks and jaw. So I'm almost looking human again!

My chin is still quite stiff and numb; but I can move my lips and people understand me when I speak now. I think when the swelling goes down a bit more, my chin will look good. I think the doctor did an excellent job on that one. Still experiencing a bit of dull pain on one side but it's very minimal.

My nose is a different story... I'm still happy with the bridge, it looks quite delicate and straight. My tip is still too long and pointing slightly downward. There's still a lot of asymmetry in the nostrils, which is really too bad cause I finally wanted to look the same on both sides obviously. I am slowly coming to accept that it's just not my desired outcome and it will have to be corrected later on. Just have to figure out how to get through the rest of this year...

I emailed my doctor with my concerns and requested for him to see me to discuss the early outcome and perhaps talk about any corrective actions (like taping or something). Unfortunately I got the reply back that he cannot be convinced to see me again before the 4 month threshold. This really disappointed me to say the least. After care should be a normal part of such procedures, no? I understand he can't operate right away and I'll have to respect the healing period, but I'd really liked to have seen him, if only for some reassurance.

Feel like I'm on my own going through this...

3,5 weeks post op

So the swelling in my face seems to be going down but i still need to sleep upright it seems, or the balloon face reappears.... Chin is still numb but the movement in my lips is getting better every day. Happy with the genioplasty overall, i think it will look good in a few weeks.
Still VERY worried about the nose. Had a bit of a panic reaction and had to take some more time off work. Just couldn't eat or sleep for a while there and feeling very weak. Can't believe this happened to me.... What are the odds... So yeah, feeling sorry for myself quite a bit. Emailed my doctor again, no reply up till now. Guess he's either very busy or pretending i don't exist :-)

Nose is still crooked in the tip and nostrils, long, and i feel some hard "knuckles" sticking out the tip in different places. Found a site that calls this bossae and i wonder if that's what it is. Sure looks and feels like it.

But ok, let's wait a few more months and see if it improves. Will keep you posted.

New pics! 7 weeks post op

Hi, some new pics i took today. Still not happy with the nose but it's looking a little better every day. I love the chin though. Glad i went through with it! :-)

New pics, 9 weeks post op

My swelling has disappeared for the most part. Especially in the evening you can pretty much see what my final result will be. I'm not expecting any more drastic changes... So it's still a mess, and it will remain a mess. I'm going about my daily business, ever aware of the crooked, embarrassing thing in the middle of my face. It could not look more unnatural. Ever seen a natural nose with columella bulging out over a thick red scar? Well i sure haven't. My nostrils are still asymmetric and the tip seems to be angling more to the right every day. I'll keep on posting pictures. If i can spare one more person of the hell i'm going through, it will be worth it.

Advice needed!!!

I had a consultation with a respected plastic surgeon in Belgium today. I won't name him here because I don't want to cause a war between surgeons... He said, and I quote: "Dr Bart van de Ven is a BAD surgeon with no patient ethics whatsoever". He said they'd clashed in the past and there was still a lot of negativity towards him.

Whatever I did, I should not let that man touch my nose again. I kinda figured that anyway but ok... This doctor said my nose was too scooped out and screamed "rhinoplasty" from a mile away. I think he even used the word "ugly" to describe it. A bit forward maybe but I'll accept any advice I can get.

He said my retracted nostril would be almost impossible to correct. What he suggested, and this is where I need your advice; is to reconstruct my nose. So raise the bridge instead of scooping out more. I don't like "straight" noses most of the time. I'm a ski-slope fan. My idea was really to scoop a little more off the bridge and raise the tip.

I'd appreciate you looking at the images and giving your opinions. I'd really like to get as many views as possible! At this point I'm so confused and disillusioned that I don't know what to do anymore. So the pic shows the "now" situation, then the doctor's suggestion, and then my own simulation of what I thought was the way to go.

Please leave any comment you like!

Thanks so much in advance!!!

4 months post op

Given all the turmoil on this site the last couple of days, i figured i should post a small update.

I kind of regret the way this post turned out. I wanted to write an objective review to help others in their decision, but somewhere along the line I let my state of panic get the better of me. This has been such an emotional journey with ups, downs, and everything in between.

I'll try to summarize how i feel now, four months out of surgery.

My chin still looks fine to me. I am happy with it. Although it's not perfect, i think it's a massive improvement and pretty much how i pictured it, going into the surgery.

I am not happy with my nose. In some ways it improved, but the tip, nostrils and columella still bother me a lot. Some people might disagree and say it looks ok, but it's my face, and I don't like it. No it's not horrible, it didn't collapse, i still have full breating ability and yes it could be worse. I am convinced though, that it also could have been a lot better. Especially the retracted nostril makes me flinch when i look in the mirror.

All these mixed emotions toward dr Bart still exist, but i'm trying to put them in perspective. I still feel that he and his team could have made more of an effort to reassure me when i was at my lowest. I do understand that an intervention wasn't possible at the time, but when a person becomes desperate with anxiety, things can spin out of control rapidly. Perhaps doctors don't always feel responsible for the patient's state of mind, i disagree with that.

Here's the most recent pictures, make what you will of them.

Post op consult

Went to my post op consult this week. I told the doctor that I'm thrilled with my chin, but very unhappy with my nose. He genuinely seemed to feel bad about it and assured me that all my remaining issues could be corrected with some small in office tweaks. He offered to book me an appointment one month from now, free of charge.

I expressed my reservations towards him and his clinic because my earlier requests for help were not taken seriously. He apologized for it, stating it had been incredibly busy.

I'm grateful that he apologized and offered to fix the problems, but I'm reluctant to take him up on it. I've had my nose cut open twice now, both times with questionable outcomes. My gut is telling me to go see a revision specialist for this. I find it hard to believe that everything can be solved in a one-hour prcedure with local anaesthetic.

Either way, I think I'm a lot better informed now than I was six months ago. I'll leave my nose alone for another six months to see how it evolves. I'll be consulting with at least five top surgeons before having anyone touch me again.

Consult with Dr Oelbrandt (Belgium)

Hi all, just keeping you posted on my journey as I'm "interviewing" surgeons to save my nose. I met with Dr Oelbrandt in Beveren, near Antwerp. He prioritized some other patient ahead of my appointment so I ended up waiting for an hour and fifteen minutes. I was so excited to finally be there that I didn't make a fuss though. Finally the Dr saw me and he was really nice. We went over my concerns and he said he could probably improve things but I shouldn't expect perfection. yes I realize that. So he wants to open up my tip again and basically rearrange all the cartilage. Also he wants to take cartilage from my ear and put it across the lining of my retracted nostril. The simulation showed a super tiny nose which is a little too optimistic I thought. We did get into the topic of the nose being "the most psychologically challenging" and he said he was very cautious as to who he'd operate on. The delicate cases are sometimes passed to his older colleague dr vd Dussen to avoid career-devastating internet wars. I understood where he was coming from but it didn't exactly fill me with confidence. With this kind of approach, it's fairly easy to have a www with great reviews. He did mention that they could also do the surgery together. This might be my best chance, no? Since it's only tip work, they can do it under twilight anaesthesia.

I still want to see Dr Lucian Ion and Dr Julian da Silva in the UK. M

So sick of this terrible nose!!!!!!!!!

Consult with dr Noorman van der Dussen (belgium)

Met with dr VdD today. He is dr Oelbrandts mentor and operates from the same clinic. Again there was a waiting time of about 30 minutes. Dr VdD is the nicest guy in the world. He makes you feel super comfortable. He went straight to the "i would do's" and told me that I needed a piece of bone shaved down where the nose 'starts' right below the forehead. Then he wants to use cartilage to correct my open roof deformity. He said he'd try to rebuild the tip but couldn't really promise much improvement, although he'd try to make it as symmetrical as humanly possible. It's again very clear that this will be a difficult operation.

I heard this a few times now, which makes me wonder if my previous surgeon even went to medical school at all... According to him, it would be a one hour small procedure under local anaesthetic... The mind boggles...

Anyway, dr VdD made some scetches and made very sure I knew exactly what he could and couldn't do. He seemed very very knowledgeable. I didn't get that level of detail from any other PS I ever spoke to. It's also very clear that he really has an eye for aesthetics. Pointing out some things that I never noticed before, which made me feel quite confident in his opinions.

There was no rushing of any kind. I could come back any time to talk about it again, free of charge. He told me to think long and hard and to come back after a few months if I wanted to.

Conclusion, up till now, I think I'd probably trust him with my nose more than any doctor that I've seen so far. The only things that bother me are his age, and the fact that he didn't make a simulation.

Next stop is Dr Lucian Ion in London who will do a 3D simulation.

The search continues....

Consult with Dr Lucian Ion - London

I went to see dr Ion in Harley street. Waiting time was about 45 minutes. This man is kind and professional. He made a point of me understanding exactly what he could do. First he asked me about my history, and then about what I'd like to change about my nose. He inspected the inside of my nose carefully and pointed out that he could help my breathing too. He took some pictures, including ones for the 3d simulation. We then spent about half an hour morphing the pictures. What I really liked was that he made the morphs entirely from what I said bothered me. Most surgeons will simply tell you what they can do and that is more or less it. Anyway, he made my nose very tiny in the pics and I thought that was only wishful thinking. Dr Ion seemed pretty confident though, that he could come close to that result. The plan is to take away some bone at the top of my nose, then add some cartilage in the middle. He would reduce the bump I have near the tip and straighten the nose out. Best news is that he can improve my nostrils a little.
Gosh this really got my hopes up. Can anyone here tell me about your experiences with this surgeon?

From 4 doctors i've seen so far, he really sticks out in terms of experience, aesthetics and confidence. Only problem is that he quoted me over 8000£. That's about 11500€! This is excluding transportation, hotel, food etc. Quite a lot of money without any solid guarantees. The best Belgian doctor I found charges 4500€. What a difference...

Can you take a look at my pics and tell me which morphs you like best? The middle pic is the actual situation now. Left is dr Ions morph, right is my own. Please give me any feedback or advice that you can!

Sorry bout the camouflage ????

Thanks so much :-)

Surgery needed for genioplasty plate removal

My chin was of no real concern to me after my operation. It looked fine to me and healed pretty well.

For a week now, I have been having this stabbing pain when I eat. Whenever I chew A certain way. Since it didn't seem to go away on its own, I decided to book an appointment with a jaw surgeon In a hospital near my home. They took some xrays (or whatever) and advised to have the plate taken out. This thing is apparently positioned too close to my teeth anyway, and also, it looks like the screws are coming loose...

Don't know if drBart is to be blamed for this... Still it's concerning that I need more surgery on my nose AND chin now.

Beware people...

No refund from dr Van de Ven!

So after the one year PO mark, I emailed Dr Bart with recent pictures and asked for a refund for the "work" he did on my nose. I didn't get a reply for a week.

After I'd sent a reminder, his secretary answered that they will not refund my surgery fee because results can't be guaranteed and I'm welcome to take the doctor's offer for a revision,

NOT IN A MILLION YEARS!

Absolutely no ethics. I am appalled.

Consult with Julian da Silva in Londen

Dr Da silva was lovely really. Very (very) calm, cautious, caring. He carefully inspected my nose, took his time for it also, and listened to my concerns. I did find the setup of the appointment quite strange. I first met with his office manager, a lovely lady bytheway, who discussed my history etc. Then dr Da Silva came in and did the nose inspection. He took some pictures and we went into his office. The message was not so great unfortunately. He said my nose was challenging and repeated it several times. He mentioned the need for grafting to build up my nose, as was expected of course. Unfortunately, the dr does not want to use rib cartilage because of two reasons. He feels the harvesting poses unnecessary risks, and this cartilage has a tendency to warp. He only works with septal, or treated cartilage wich is imported from the US. Of course this means an extra cost and a waiting list. He didn't do a simulation, which was unfortunate. The dr didn't seem too keen on operating on my nose, as he felt only a 50% improvement would be possible. He didn't say it was impossible though. Afterwards, the office manager joined us and sort of moved in the opposite direction. Saying the cartilage was readily available and really stressing that dr Da Silva was very modest about his abilities. So there would be a good chance of the result being better than expected. The whole thing felt a little bad cop/good cop to be honest :-) It's a great sales strategy I think, whether it's intentional or not. Hence all the great reviews perhaps? Anyway, I do believe the doctor knows what he's talking about and genuinely cares. At the very least it's given me something to think about. Would it be worth going through the operation for a 50% improvement? How risky is the use of rib cartilage? What are my expectations really? The cost of the surgey and complete aftercare would be close to 10.000£. I will need to sell a kidney so if anyone is interested...? ;-)

Second consult with Lucian Ion - London

I met with dr Ion again and remain impressed with his kind, yet professional nature. We spent another 45 mins looking at morphs and he was very patient with me, even though I couldn't really put my finger on what it is I want exactly... It's weird because all doctors I've seen so far just kind of "inform" you of what they can possibly, maybe, perhaps achieve, with reservations. Dr Ion seems to custom make your nose, completely tailored to your needs and preferences. It seems too good to be true but I'm sooooo hoping it is! As soon as I can arrange it with work, I will book my surgery with him. Just worried he might reject me as a patient after all cause I'm so difficult :-) I'm trying to act normal but I'm just so excited! :-)
Dr. Bart van de Ven

This doctor seems to be the go-to guy for FFS. He seems a genius when it comes to genioplasty, trachea shaving, forehead recontouring and so on. I know he has a long list of happy patients. Unfortunately for me, I think rhinoplasty is not his area of expertise and i found out the hard way. My nose improved in some ways, but my tip and nostrils got butchered in my opinion. In the first consultation, I got 30 mins for 50€. The doctor's demeanor was very calm, reassuring and informative. He doesn't take phonecalls preoperatively so if I wanted to talk to him, I needed to schedule another appointment. Email is picked up by the assistant mostly. I did get answers to my emails, but they were quite short and not all of my questions got answered. Everything is arranged quite well I have to say. Very structured, but perhaps a bit impersonal in my opinion. All ok if the results are good. The worst of all in my experience is that I feel I got a bad result, and wasn't taken seriously. I'm going through a rough time, trying to pick up the pieces and survive for a year till I can get a revision. I'm very disappointed that there is no follow up and the doctor simply refuses to see me before the four month mark. I hope to get my money back for the nose job when i see him for my check up in april. I still have mixed feelings because i'm very happy with the genioplasty he performed on me. Don't understand how one procedure can turn out so good, and the other so bad... My advice to anyone seeking surgery is to be VERY clear about what you want to achieve. Show pictures, do drawings, make them explain what they can and can't do. Ask about their experience. Talk to ex patients. Be sure you understand exactly what's going to happen; Really SHOW what it is that you want and ask them to be honest about their abilities. If you have any doubt, any doubt at all, go elsewhere! I blame myself for not following my gut;

2 out of 5 stars Overall rating
2 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
2 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
3 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
4 out of 5 stars Wait times
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