Extensive Revision Rhinoplasty - Beverly Hills, CA

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After a disappointing primary rhinoplasty, I was...

After a disappointing primary rhinoplasty, I was seeking to revise my unsatisfactory result. My first op was a closed procedure. I sought to reduce a dorsal hump, refine my tip, take care of a hanging columella and resolve some asymmetries. I was left with retracted alars, a wide bridge, and an inexplicable "lump" that protruded from the right side of my nose.

I underwent a pretty extensive revision rhinoplasty with Dr. Ghavami on Oct. 6, 2014. Not only was he able to correct the cosmetic issues that were my chief complaints, he was also able to identify the fact that although my previous surgeons (a father-some team of doctors) had said they'd given me a septoplasty, they had never touched my septum. This turned out to be a blessing in disguise since Dr. Ghavami was able to use 100% septum cartilage for my revision surgery without needing to harvest from my ears.

I'm about 2 months out from surgery now. The results are dramatic, and quite an improvement, but there is still a great deal of swelling (as is to be expected with a complex secondary surgery).

I have "good" nose days and "bad" nose days. The swelling in my case is asymmetrical (but corresponds to the areas which the Dr. indicated he worked on the most) so I'm fairly certain this is swelling and no a complication of healing.

Compliance and patience are important, with this type of surgery. It's really intense, and it's a smart thing to observe dietary changes (cutting out processed foods, sugar and sodium, taking supplements, drinking lots of water) and to follow your doc's instructions re: taping and massage (these things are more beneficial in some cases than in others. Pay close attention to your medical teams advice).

In all I'm very glad I chose to finally take the plunge. My trust was damaged severely in 2004 after my previous surgery, and my doctors' dismissal of my concerns as "the best I could hope for." It took me 10 years to build up the courage to search for surgeons to correct this, and Honestly my only regret is not doing this sooner!

Im going to post some photos of my "before," my "after," and my healing progress. Since I'm 2 months out, the only new pics you see going forward will be monthly updates, as not much happens at this point besides swelling resolution. If there's a specific view, angle, enlargement or type of pic you'd like to see, message me. Also, if you want to ask me any questions about my surgeon, or my procedure but don't want to ADRESS it on a thread, go ahead and message me for that too.

Thanks for reading! I sincerely hope that this helps you out if you're considering a revision rhinoplasty.

Some additional Pics

A few more photos from some different angles, before/after

And Two More

Oblique (3/4) View of my left side

Nostril Healing (swelling from the grafts used to fix my alars still evident, small incision scar still evident. Taken at 7weeks post)

Couple More Front-View Photos

Another Before/After, front view. This "Before" pic depicts the details of the deformities from my 1st. rhinoplasty pretty well. The After pic was taken at about 6 weeks post. I try to post things "all things equal" meaning: if I'm not wearing makeup or standing in flattering lighting for the "Before" I will not do so for the "After". Trying my best (with a cell phone camera) to present an HONEST and straight-forward example of revision rhinoplasty results for you guys. No filters, or editing.

Right Oblique

3/4 (oblique) photo of my right side, 2 months post. I have no "Before" pics of this angle. It was my worst angle before surgery and I deleted every pic of it that was taken, or I let my hair hang in my face.

Some Photos of Healing (graphic)

Hi RealSelfers :)

So, something I have neglected to share with you all are photos of my very VERY early recovery. I think it might be valuable to share them, even if they are a little bit gory. The idea behind sharing these is to provide you with some honesty, and as a sort of "counterpoint" to all these "Before/Afters" that kind of make a really serious surgery look a bit like an effortless, nifty little magic trick. For those of you who have had surgery and are concerned because right now you feel banged up and you can't picture a good result, this lets you know that you're not alone and your results are on the way!! For those of you thinking of a revision rhinoplasty, here's a closer look at the nitty-gritty of early recovery. As always, thank you guys so much for allowing me to share. And I really hope this helps someone who's thinking of revision rhinoplasty.

3 Months (and one week) Update

hi guys! I hope y'all are having a great start to 2015!!! I'm adding some pics of my healing-progress, 3 months post. The swelling is taking soon LONG to resolve, especially in the tip. I have a little hard "bump" on the right side of my radix, and my right nostril seems a little "puffer" than the left one, so I will address these issues with my surgeon when I see him next month. But for now? Everything is pretty uneventful. Oh, one very positive development: my husband says I no longer snore!

4 Months Post-Op

Monthly update. I'm including some photos showing a big 'ol wiiiide smile, since I have never done that before and I figured tgw RealSelfers might be interested in seeing how things look when I move my face....


Let's see if this works......

5 Months Post-Op

Here's my monthly post-op photo update. I met with the Dr. for a follow up this week. My healing is progressing as expected, my tip is the most swollen part of my nose, and I can expect my rim grafts, which are still a bit swollen, so completely flatten out and lie flush with the vestibular skin inside my nostril. Other than that, there isn't much to report; I go back at the end of Sept. for a follow up, at which point most of my swelling is expected to have dissipated.

Pre-Rhinoplasty Photos; Nose I was Born With

So, in order to give everyone reading a better understanding of what kinds of things have been surgically done to my nose over the course of two rhinoplasty operations, I am posting "before, before" photos. These are pictures of my natural nose, the one I was born with. I'm doing this so that you may have a visual representation of what "Aggressive Overdone Rhinoplasty" means in terms of tissue removal. As always, thanks for letting me share, and I welcome any questions/comments.

A couple more of my Original Born-Nose

A couple of different angles of my original nose. This makes clear exactly **how** aggressive my primary was, and how much tissue was removed.

6 Months Post--Pics

Updated pics for 6 months post-surgery. I'm suuuuper frustrated with the swelling. I don't have another follow up until the end of Sept, so I guess "time heals all wounds" will be my mantra....ugh

7 Months Post

A few pics of progress. This is 7 months post. I feel like they may be something to the idea that after 5 or 6 months the lymphatic and blood vessels are on the mend, because the last bits of healing seem to be moving a little faster.

After pic, with makeup

Almost 8 months post-revision. I'm wearing makeup in this one, and since that's a rare occurrence, I figured I'd post a progress shot. Frontal. Head tipped down slightly.

Exactly 8 Months Post-Op Today

...and as usual, here's my set of progress photos. I'm wearing makeup this time, but I do NOT do anything special to my nose. I'm not a makeup whiz. I basically try to cover up zits and dark circles and then blush and eyemakeup. But I don't "contour" or any of that. And I don't alter my photos for this site--the whole point is to have an **honest** depiction of what healing from revision rhinoplasty is like. I really do think Dr G is going to have to rasp down a small bony callus on the right side of my radix, lateral aspect. And I believe he will need to needle shave some cartilage in my right surpa-alar crease for symmetry reasons; that side seems a smidge "rounder" in a funky way.

A little over 9 months post-revision

Nothing much is going on. I still feel swollen: my nose feels numb at the tip in the mornings and it looks kind of more "bulbous" there too. But nothing noticeably big or misshapen. This takes a lot of time. An open revision with graft work and osteotomies? It takes A. Lot. Of. Time. To. Heal. .....Don't let anyone convince you that it doesn't. You need lots of patience and emotional support to heal from a revision

Random photos of my nose, almost 11 months post

Whew! It's been a while!!!! I got a new job and a new kitten and I kind of havent had the time to update and post and such.

So, I'm adding a few shots of my nose now, almost 11 months post. I have a follow up on Sept. 29.

One year (+) post surgery

My one year update:

At this point, I'm considered "healed" by the medical community. I've had a follow up with the Doctor, who wants to shave a bit of cartilage from my right-side, near the supra-alar crease. He says there's some scar tissue and the graft is a bit "bulky" and going the fluororacil-5 injection route is not for me because I have extremely thin skin with a tendency towards hyper pigmentation. My touch up is scheduled for Oct 26. One year and 20 days after my original surgery.

I'm including some pics of 1-year post healing.

Had the touch-up surgery Monday

So, I had some scar tissue and bulky cartilage removed from the lower-third of the right side of my nose (supra-alar crease area) in order to improve symmetry.

The doctor seemed extremely satisfied with the touch up and pleased that he resolved the issues. In fact, he even said "oh, THERE'S the offending culprit! We got it!" When he located and excised the tissue.

I felt nothing. I was numbed with a shot and even after the shot wore off I felt no more soreness than I would if, let's say, I squeezed a painful and large pimple in that area. I'm including a couple of pics here to document the recovery from this little procedure. I'm really swollen (because that's what I do--I SWELL like CRAZY).

4 months post-touch up

Hi everyone! Sorry I have been a bit AWOL!!! I moved from CA back to FL due to family issues.

Also, I wanted to update once the swelling went down. I'm a PRODIGIOUS "sweller" and, well, frankly I've said a TON already about "be patient" "swelling resolves" etc.

So I'm back to post new pics of my nose post-touch up. As you know from my review, I had a knot of scar tissue in my supra-alar crease on the right side that needed to be resolved with excision. The swelling is still not 100% resolved but the result of the removal of tissue is evident. I'm posting some Un retouched photos in daylight for the RS community to check out.

Frontal shot

Since I bothered to wear makeup today, haha!

I'm satisfied. Perfection wasn't my goal; improvement and a more normal, not-botched look was the goal

5 months post touch-up

To bring everyone up to speed:

My primary (botched) rhinoplasty was done in Miami in 2004.

My revision rhinoplasty (reviewed here) was performed in LA by Dr. Ghavami on Oct. 6, 2014.

Dr. Ghavami gave me a small touch-up to remove scar tissue from my right supra-alar region on Oct. 26, 2015.

I am now exactly 5 months out from the touch up, so I'm updating with a new series of pics.

A little bit about healing timeframes for revision rhinoplasty

Something I get asked a lot about this surgery is: "how long did it take to see final results?" That's a hard one to answer, honestly, because the operated nose looks very different one week, one month, one year, five years out. Hell, even noses that have never been touched change over time--just look at younger photos of someone in their 70s or 80s and you'll see what I mean. To give everyone a visual example of what healing looks like, I'm uploading a comparison of two after photos from my revision. The one on the left is 3 weeks (21 days) after my revision. The photo on the right is 18 months after my revision surgery. Don't judge anything by what you look like the first 3 months after rhinoplasty!!!! If I were to judge my rhinoplasty by the "3 weeks post" photo, I'd have been very dissatisfied with the shapeless blob of a tip, and the fat, wide bridge (especially in the radix area). I hope this helps to ease the anxiety of RealSelfers who comment 3 weeks or a month postoperatively saying that their nose is asymmetric, their tip is shapeless and blobby, they see imperfections, etc. Healing time is when you should be EXTRA kind to yourself not extra critical. Believe me, I understand how difficult it is to resist the urge to panic and nit-pick every detail, but try instead to things that make you feel empowered. Note your progress. Keep a journal of what you see. Show the progress photos and journal to your surgeon at your follow up appointments and ask questions. In time you'll realize the results you and your doctor worked so hard to achieve. And if you don't, you will feel empowered in your endeavor to correct the issues which persist because you kept diligent notes and photographic evidence. Be kind to yourself. Everything will work out in the end. If things aren't working out, well then it's not the end!! xoxoxoxo

20 months out from revision; 8 months after touchup

A couple of unretouched, no-makeup, no filter photos in different lighting conditions to show what this surgical result looks like almost 2 years later.


Today I'm exactly 2 years out from my revision. I'm posting some Before/Afters. One is of my profile--to show subtle changes over a two year period (most notably, tip dropping into place and columellar scar resolution) the other is a a front facing before-and-after that I think shows the extent of the damage and difficulty of the repair.

Almost 2.5 years later.........

Two and a half (almost) years post. Not much to see at all. Nothing anyone who isn't me wouldn't notice---just some residual swelling resolution.
Beverly Hills Plastic Surgeon

Dr. Ghavami is an outstanding surgeon who excels at rhinoplasty in particular. His consults are quick, to the point and concise. If you need a lot of drawn-out conversation about your feelings or broad topics, you might feel as though he's "rushing." I didn't feel that way at all. I appreciate his candor and professionalism more than ancillary conversation. As a patient of Dr. Ghavami, I have come to understand that his FIRST LOVE IS OPERATING. Even though he has time commitments with teaching, lecturing, symposiums and consultations, it's extremely clear that he isn't "rushing" these things; instead he prefers being in the O.R. Practicing his craft. He has a rare combination of skill, experience, and artistry that is tough to find. I consulted with surgeons who were older (and therefore more experienced), I consulted with surgeons who were every bit as skilled. But I couldn't find anyone whose skills and experience were teamed with an aesthetic sensibility that was as fine tuned and discerning as Dr. Ghavami.

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