Heading to Glendale for a Rhinoplasty with Dr. Grigoryants

Hi Real Selfers,

I have followed the reviews on this site for two full years now trying to gain the courage to go through with a rhinoplasty and quell my fears of surgery and a less than positive outcome. In particular, I have followed reviews of Dr. G's work with interest because I almost always like his "afters." Unlike most of the young women in this forum, I am in my mid-50s. And I really wish I had done this years ago. But the older I get, the more I dislike how my nose looks and how it is aging me. I think a rhinoplasty will provide some facial rejuvenation and soften my look.

Can you RS'ers help me to compile a list as to what I should ask Dr. G to do to my nose? I want a sloped, feminine profile and a nose that does not droop. When I smile, my nose points down even more so. I know I need to ask that the tip be lifted (definitely!). Do you think I have a hump to shave down? I think I have a small hump, it's not as prominent as some noses I've seen, but it is still present. Do I need nostrils made smaller? And I was wondering if I should tell him my nose needs to be deprojected? I particularly don't like my 3/4 view nose. Should I also ask for the tip to be refined? I thought I would ask some of you experts that have had this done or are knowledgeable about the procedure because I only have one shot at this and want it done correctly.

Below are my objectives and goals that I think are important. Please let me know if you think I have nailed it or if I need to add/remove something.

Objectives:
1. Small, feminine nose
2. Put a little curve in the profile to make it look feminine, slight slope
3. Raise and lift tip, upturned
4. Refine tip
5. Reduce nostrils
6. Shorten the nose
7. Deproject the nose
8. Remove hump
9. Remove some of the excess tip/refine tip
10. Want a softer, less harsh (masculine) look to the face

Goals:
1. Sloped profile
2. Slight Supra tip break
3. 106 degree nasal-labial angle
4. Upturned but not piggy

Should I leave the columella alone? It really does not bother me one way or the other. I think my present nose would be classified as not having columella show.

I believe I may be a "thin skinned" patient. Is this a good or a bad thing?

Is there anything on this list that I should add or remove?

Also, is he likely to use grafts of any type (i.e. spreader grafts, etc.) and if so, which ones?

I have not consulted with Dr. G in person because I live all the way on the other side of the country and I think that is why I am nervous and looking for support. I will say that email communication with him has been very good so far. I am respectful of his time and have only reached out to him three times via email.

Thank you all for your support, compassion, and kindness.

When I had my email consultation with Dr. G two years ago, he responded as follows: "I agree with your goals and would suggest removing the bump, improving the width of the bones, raising/ refining the tip. I may need to reduce the size of the nostrils. I will open your airways at the same time if necessary. Surgery is done at the hospital which is safe and clean. Anesthesia is provided by experienced anesthesiologists. If you do blood tests in your area, you would be here one day before surgery to meet with me and stay here for about 8 days after surgery (if you are out of town). You will have a good result."

I have all my reservations made and we are planning on doing some sightseeing ahead of the procedure so that the trip is enjoyable.

Well, just about 1 month to go at this point. I'm arranging to make final payment on Monday. After that, I just have to have a surgical clearance and I'm good to go.

I've included a couple more before photos. I hate how my nose droops when I smile. I really need the tip lifted and refined.

I can't believe it's getting this close. Starting to get nervous but I think everyone does.