Asian Male Rhinoplasty on Thick Skin. Rib Graft, DCF and Alar Base Reduction. - Beverly Hills, CA

On January 26th, I had my primary rhinoplasty with...

On January 26th, I had my primary rhinoplasty with Dr. Yoo. He was the 6th surgeon that I consulted within the past 2 years but left the best impression on me after our skype consultation. Coming into this, I didn't have any large expectations. The nose that I was born with did not really suit my face that well and I was just hoping for some improvement.

The day before surgery
I had an early pre-op appointment where I sat down and spoke with his assistant Cynthia about the pre-operative and post-operative duties. Later that day I sat down with Dr. Yoo for my pre-op so that he could discuss what he wanted to do with my nose. He morphed my nose into what he believe was possible for my nose but because of the limitations of computer imaging, the profile and the base were the only things that could be enhanced. This was just about the same answer from every surgeon I consulted with and its true that you can only morph pixels so much. I enjoyed the look of the new profile and the enhanced base of my nose but was deathly afraid of alar base reductions due to the fact that I am not a fan of small nostrils on a man. I have always been a fan of larger, elongated nostrils but I pulled the trigger and took the plunge because it seemed necessary to what I wanted to achieve.

The day of the surgery
I woke up at 8:00AM and was to arrive at the surgery center at 10AM. I arrived and started dressing for surgery. I remember initially discussing with the nurse about my career and then walking into the surgery room. I laid down and then I just drew a complete blank and woke up post-surgery. It was really that quick. Waking up from anesthesia was the absolute worst. By the time I got back, I was extremely nauseous and the vertigo was really hard to overcome. I took a glance in the mirror and liked what I saw. I then had to take the anti-nausea pills along with a xanax to fall asleep as quick as I could. It was pretty rough. I woke up 3 hours later to look at my face again and what do you know, the swelling comes in full effect and now my nose wasn't recognizable anymore.

Post-Op Day 1:
The anesthesia's side effects wore off and I was off to performing my post op instructions. 1:30PM was my next appointment and I made it to that just in time to talk about the rhinoplasty. I saw a few in surgery photos and with held judgement. Dr. Yoo discussed that my nose was primarily thick skin and not much cartilage to his surprise and that really worried me. He was able to enhance my dorsal bridge greatly and now I can finally say I have a profile but it seems that I might not get the tip that I always wanted due to the thick nasal skin. The alar base reduction will take some getting used to as well because I asked for a conservative reduction but it seemed to have been a little too reduced to my liking. I will have to reserve judgement until the swelling comes down a bit more. Coming back home, I had no issues eating or drinking. The only thing that might suck is the temporalis fascia incision spot stretches and hurts a bit when you open your jaw wide to eat. Yawning also really sucks. The painkillers are kind of a must.. Especially when its late at night and you try to get out of bed to urinate.. the horror of the rib pain.

Post-Op Day 2
Woke up at 8AM and performed my post-operative instructions. Nothing out of the ordinary except that the pain feels different than day 1. Everything feels more like a minor throbbing or stinging pain. The splints are also very uncomfortable as well as you can definitely feel it in your nostrils. Right now my nose looks a bit upturned but I'm expecting it to drop. The base has changed my look a lot and this was why I was so afraid of getting the alar base reduction but the flipside is that my face has become a lot more masculine looking since the surgery. Just the overall structure isn't very soft and round anymore. I'm pleased with how much slimmer it has made my face but theres still so much more healing to come.

Day 3 and Day 4

Post-Op Day 3 - 4
The meds are rough. They take a huge toll on your system and you feel extremely lethargic. I'm starting to question whether or not I even want to take them anymore. The side effects that it has on me are pretty tolling. Depression, Lethargy, Shortness of breath, Slight nausea. Mind you I don't feel any of those symptoms before I take the Medrol Dosepak and Bactrim DS. Without fail, every time I take a dose of either of those, it kicks in within an hour. I spend most of my day in the house and only step out to get food from a delivery driver. Its been pretty rough on my mental state but the xanax sure does help.
Cleaning has been a breeze and is pretty routine for me now. The post-nasal drip has minimized immensely to the point where its just like regular mucus dripping from your nose as if you were standing in the cold. I was also able to finally wash my hair of the betadine and it was the most relief i felt in days.
So far sleeping has gotten worst. Although I sleep elevated on three pillows, for some odd reason I'm always waking up in pain. I wake up with the inside of my nostrils feeling really cold and my throat feeling really dry. I'm not sure if its because I have a tendency to start highly elevated and slide my head lower on the pillow as the night goes by but whatever the reason is, I have to keep hydrocodone by my bed to alleviate the pain upon wakening. I never get a straight 8 hours of sleep. I'm always waking up sporadically throughout the night.

Recovery is brutal.

Day 5 and Day 6

It's happening!! And No I don't mean my cast removal. I mean the near end of the FREAKING MEDS. known as the antibiotic bactrim DS and the steroid Medrol dosepak. I finally finished my Medrol dosepak, the cause of so much misery during the initial healing stage. Seriously, that sides are absolutely terrible. You feel like a chemo patient on that stuff. I swore i lost more hair than usual those past few days as well. I still have 3 Bactrim DS pills to take still but so as soon as thats over, I'll finally feel healthy and functioning again.

Sad News! I was pushed two days ahead with my original removal day being the 6th day. Really sucks but who am I to argue. New Date is Feb 3rd at 11AM. At this point I'm more excited to breathe again than to see my nose. My cast has been slipping off each and every day even though I have been keeping it dry like instructed. Theres really nothing you can do about the sweat and oil build up and I have been experiencing a ton of that. It loosened up the tape immensley and I don't even know if the cast is securely set anymore. Besides that, I've observed and analyzed my nose day and night only to know that I'd probably wont be that surprised once the cast comes off.. Well maybe when I get to see the actual bridge that I wanted for years I'll be super ecstatic. Right now the tip is still the size of a tomato. Its round and ugly and shows no promise of a narrow tip :-( The roundness is what my old nose looked like and I am really expecting a really drastic reduction in bulbosity and width. I really do hope that underneath the cast shows something that I am totally not expecting. If I even see that the nose is taking the right direction in healing and forming a strong bridge with tip definition, I will go and praise Dr. Yoo anytime and any chance I get. Anyway here are some updated full frontal, profile and base shots with the cast on. As you can see, the cast slipped off quite a bit but all I can do as of right now is to keep it dry until Wednesday.

Heres to more healing!

Day 6 Photos

Comparison of Nostril shape changes Day 1 vs Day 6. Bummed out

I'm really bummed out about this. The shape was so perfect the first day and then it just seemed to take on a whole new shape. I don't know what the cause of this is and its making me depressed.

Cast Off, Splints Out! Day 8

Took an assortment of good angled photos today. I'm sure whoever is reading would like to see regular angles of the cast off pics but I just didn't feel like doing that today. Here's photos of me at the Urban Lights at LACMA and etc.

Anyway let me kick off this review with this clip!
true story.

So what I didn't mention in my previous posts was that I had a mild deviated septum that was diagnosed by Dr. Yoo in the pre-op appointment. I was due for a septoplasty as part of my rhinoplasty procedure. I never knew that my left septum was deviated a bit and there was no way for me to ever really know.. especially if its mild. I always thought my breathing was perfectly fine until today. I was anticipating the removal of the splints more than anything. The ability to breathe through my nose again, the lost of all that ear pressure, to smell again and to even fully experience the taste of food again. The moment Dr. Yoo took the splints out I took the biggest inhalation through my nose and experienced a new way of breathing. I'm now able to inhale much more air through my nostrils than before. The first thing I smelled in the room was the aroma of Cynthia's hair (Dr Yoo's medical assistant) and I'm glad that the first smell was good and not trash.. although i'd probably be happy that i can even smell trash at that point.

Now as far as the nose goes.. Theres some insane swelling. Enough that I had to be consoled by Vivian, Ana and Dr. Yoo. You hear about it so much but hearing about it is not experiencing it. It takes a huge toll on you and even though I was able to laugh off my eyelid surgery's swelling, its way different when it comes to the nose. I felt better by the end of Ana's talk with me but was reassured once again by Dr. Yoo himself. At the end of the day this is what I signed up for but hey its a normal reaction to the swelling. Nothing seems out of the ordinary and according to Dr. Yoo, the healing has gone according to his expectations so I have nothing to stress over.

So a big thanks to Dr. Yoo, Ana, Vivian and Cynthia for taking the time to talk about it. #tooblessedtobestressed

Day 14 Pictures.

Didn't get a chance to update due to the hectic traveling and etc. Here are the cast off pictures of real swelling on my week 2. Its rare to see actual swelling on this website as it seems that most are uncomfortable sharing the pictures of true swelling of cartoon like proportions.

My nose doesn't look like this anymore as I have had 2 kenalog injections in my nose since then but realistically this is what you could look like if you're a patient with thick skin. The swelling is much more pronounced and its coming down very slowly. I currently am still not presentable to my peers and coworkers but I have slowly been warming up to a few.

34 days since surgery, Week 5

So there hasn't been much change in my nose, the swelling is still persistent and very sporadic. I've resumed work but people who know that I had work done can tell when my nose contour loses shape throughout the day. The nose coming into work with freshly peeled tape will have a nice contoured shape like this /_ but throughout the day it'll swell back up and eventually takes a horrid parenthesis shape (_ .

The tip has dropped as expected and swelling has come down from the bridge but thats about it. I still don't like going into the public eye without hiding half of my face with a hat. I am still hoping for major de-swelling to happen around the supratip but it has't even come close to dropping in size yet. All of the de-swelling seems to be taking place on the bridge. No ones timeline has matched up to mine yet and I am fully expecting my recovery to take a lot longer than others.

Kenalog dying out?

This week has been a weird one. I was going to update again at 60 days and I still plan on doing so but I think the kenalog injection has been dying off. Normally my nose swelling is pretty sporadic and fickle with certain times of the day where its at its biggest and smallest. I one day noticed about a week and a half ago that it swelled up but even with taping it doesnt go down. My nose looks really bulbous/round again and my coworkers have now noticed and mention that I look different from 2 weeks ago when they saw me. Its drawing unnecessary attention to me. It really sucks that I don't have access to Dr. Yoo to get another steroid injection.

Day 60

Officially hit the 2 month mark. Nose is still pretty swollen. I don't have much of an opinion of it as it keeps fluctuating back and forth in swelling. So far I'm pretty indifferent and its still too round looking some days. What's odd is that when I was one month out, the profile actually looked a bit more defined when the tip was still up. Ever since it fully dropped, the overall nose and tip has been really round looking. I've included a picture of my nose on February 12th as well to give you a picture of what my nose looked like at its smallest.. I guess this is when the kenalog was still fully working before it died out a few weeks ago. Whats strange is that the February 12th pic frontal was actually still very swollen but seemed small on profile. Now the profile on the 60th day looks fat and round but the tip is actually smaller than the Feb 12th pic. Funny how that works.

Quick Side Snap

Hey guys, just wanted to provide a quick update to my nose. Its been a stressful month and my swelling has not been kind. That and acne has been fighting for a place on my nose to make it look even bigger. This is what my nose looks like as I am writing this update. It isnt so bad but this is not what it looks like a on a good day. I consider this a bad day photo but it really isn't as bad as it was in the previous month. Its getting better. I wish I could get another kenalog injection in my nose right now but I'm thousands of miles away from Dr. Yoo.
Beverly Hills Facial Plastic Surgeon

Awesome surgeon.

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