In the meantime - just wondering if anyone has had any luck finding travel insurance that covers elective surgery? The only one I've been able to find is upward of $500!
Revision rhinoplasty with Dr. Grigoryants
Exciting stuff! Have booked my revision...
In the meantime - just wondering if anyone has had any luck finding travel insurance that covers elective surgery? The only one I've been able to find is upward of $500!
Before photos and desired results
After the swelling went down and now that seven years have passed, asymmetries are present and the tip droops quite a bit when I smile. By no means do I expect a perfect nose and had my breathing been significantly improved the first time around, I probably wouldn't take the risk of a second operation. However I can only breathe about 30% through one nostril at all times, and I won't lie; aesthetically I am not completely happy.
Dr G. plans to shave the bridge down a little more, raise the tip and columella, reduce my nostril size and reduce my turbinates at the same time. He may have to take cartilage from my ear if my septum doesn't have enough (since I live in Australia, I have not been able to meet him in person yet). From his photos and many happy patients, I am quite confident he will give me the best results possible.
I am a little worried about the first couple of months of looking piggish, but from my primary I have learned that it drops quite a bit! So would rather look piggish for a few weeks and be happy for many years to come. :)
I also have many photos of Alena Shishkova and Megan Fox, not only because they are 1. drop dead gorgeous (kill me) but they have similar noses to mine and I believe their results are achievable. I pray Dr. G will agree with me!
Will not be continuing with this review - best of luck to everyone else and their journeys and I will continue to follow you all x
Turns out I was right, and my consultation went for approximately ten minutes. Dr. Grigoryants seemed nice and very to the point. He immediately asked what I disliked about my nose and got straight to what we would be doing, as well as a couple of before photos. I had brought a collage of a few noses I liked, including my own 'before and after' morphs - the one he liked best was my 'before' morph as he drew on it to show me what my result may look like.
I walked out feeling confident that he was a knowledgeable and experienced doctor, but a little unsure if he understood the aesthetics I liked. From a couple of reviews on Realself, it seemed that his unhappy patients were from a lack of communication. I wanted to assert myself in the room and come to an understanding of a vision we both liked, and I didn't feel I did that in ten minutes. That night I had butterflies in my stomach but assured myself that I chose this doctor based on his work, and not his interpersonal skills. I decided I would take some photos into the operation and try to chat with him for a few minutes beforehand.
I received a lovely good luck message from user "lenosestory", who has a beautiful nose by Dr. Grigoryants! I messaged her through the night and that morning and she eased my concerns, although it did turn out her consultation had been significantly longer. It was really nice to have someone to talk to who had been through this themselves - thank you "lenosestory"!
I went through to the day surgery centre at around 11am, where I had an IV put into my hand (eek) and some lovely nurses took me through my paperwork. I then proceeded to read magazines and message "lenosestory" for the next two hours, as my Australian friends were in a completely different timezone. By the time I was wheeled into pre-op around 1:30pm, I had had time to make a little collage of noses for Dr. Grigoryants with the help of a nurse and some scotch tape. Not even drugged up yet and I was making collages!
Dr. Grigoryants came in and we quickly went over what we had talked about the day before. He explained what he could and couldn't do for my nose, and I tried to communicate as much as I could in the thirty seconds I had with him before surgery. He seems like an extremely busy man from the amount of patients he had waiting, time spent with me, and lateness to surgery. Being the last of the day, I didn't mind. I would much prefer a surgeon running late, who takes his time to perfect things, rather than someone rushing. I then met with the anaesthesiologist who gave me a 'cocktail' and I started babbling but fell asleep quite soon after.
Upon waking, I was asked what my pain level was like. I think I replied a six, but it's hard to remember. All I can remember is that I had chosen not to buy the nausea pills or the norcos, but chose extra strength tylenol instead. As soon as my nurse arrived (I hired her to take me back to my friend's house and look after me for a couple of hours), I got her to pop down to the pharmacy and buy the norcos. There was no way I was putting up with this pain for a week!
Note: my first rhinoplasty I had absolutely no pain or nausea, which is why I chose not to buy all of the prescribed meds. The first surgeon removed the hump and broke the bones in, however nothing else was done. Dr. Grigoryants said he would not touch the bone, but must have gone to town on the other stuff. My surgery took two hours, I woke up in quite a bit of pain, and threw up blood three times that evening. I'm glad I didn't buy the nausea medication - I did not want that amount of blood in my stomach! It felt really good to get it out.
I told my nurses I was surprised that the doctor hadn't come to see me after the surgery but they reassured me that he had, and had said that my nose looks better than the photos I brought him. I hope I didn't say anything crazy on those meds, because I don't even remember seeing him!
The trip home felt like forever. I could barely keep my eyes open and the nurse didn't know her way to my friend's house, so it felt like a lifetime to get there. She was extremely sweet though and pulled over for me to vomit up blood, as well as changed my drip pad in the car. I was so thankful to have her there for a couple of hours as she taught me how to change my drip pad, arranged my meds, and basically reassured me everything was going to be okay. As soon as we got back to my friend's house I fell asleep and woke up about once an hour to change my drip pad (sooo much blood!). I set an alarm on my phone to take my antibiotic every six hours, then took a norco to knock me out.
More to come soon!
Day 1, 2, 3
I was really undecided whether to stay in a hotel for the first week or with a friend who offered to put me up - thank goodness I chose the friend! She was a lifesaver that first day. Stupid me, thinking this would be exactly like my previous rhinoplasty, bought a bunch of fresh food and thought I would be up and cooking straight away. Hell nooo. I barely had the energy to change my drip pad, let alone cook. She bought me some oats and some low-sodium soup to heat up and I have been living off them for the past three days.
Day 1 was by far the worst in terms of a nasal drip. Blood, so much blood. I was changing the drip pad once every hour for almost twenty four hours.
Day 2 I woke up bright and early with an overwhelming urge to sneeze and my nose dripping snot/bit of blood like a tap. I was so uncomfortable that I ended up messaging Dr. Grigoryants to ask if I could take an antihistamine, but ended up googling the medication names and popping one soon after anyway. (He did message back later that afternoon saying antihistamines are okay). Oh, and I also took a photo since my gauze stuck to dried blood and I pulled down the string that I believe my splints are attached to. He said everything looked fine. I now clean the stitches with a bit of hydrogen peroxide and lather a generous amount of Vaseline on before putting a new gauze pad on, this helps with the sticking. Day 2 was also the beginning of swelling for me - the dreaded 'Avatar' look.
Day 3 I woke up with a nice bruise under my right eye and still look like an Avatar. It's not terrible by any means, just uncomfortable and boring to be stuck inside. There is constant pressure under the cast and my mouth is always dry from not being able to breathe through my nose. There is still a constant drip, at times I actually feel snot bubbles coming out. I'm still wearing the drip pad 24/7. Right now it's mostly clear, though the drip pad is always stained with blood. Really looking forward to being able to walk around without it!
In regards to the nose so far - unfortunately I was not one of the lucky patients who received a photo in their email so I have absolutely no idea what it looks like. I get my cast off at Day 6, so we'll see!
Day 4, 5
Day 5 - today - I called the office and they have agreed to take my cast off this afternoon! While the cast is bearable, I think I've started coming down with something. I'm scared I won't be well enough to go in tomorrow so they have agreed to see me today - hurrah!
I had cartilage shaved down to deproject my nose, an alar base reduction to reduce nostril flare and make them smaller, spreader grafts put in to support the structure and make my nostrils rounder (before they were very narrow slits), a turbinate reduction, and septoplasty. I haven't gotten the better breathing benefits just yet - my nose is still full of crud that is too painful to clean out due to stitches.
Dr. Grigoryants was really personable in the last visit; much more so than my consultation and pre-op 30 seconds with him. I'm glad I trusted his surgical skills and not how much he sold me on it; in fact my previous surgeon was completely likeable, and didn't even put any grafts in (ending up in internal valve collapse). I did have my doubts when I was ushered out of my consult so quickly, but I guess how busy he is reflects how many noses he does, and in turn refining his craft.
I will still give it a few months to evaluate the final result, however I am feeling very positive at this stage (even though my friend refuses to take me anywhere for fear of looking like a domestic abuse victim). Looks like I'll be indoors a few more days!
I've added some photos from today (post op day 6, cast removal was day 5). Please excuse the blacked out eyes and mouth, whilst I am not hiding this procedure from any of my friends or family, you never know what job you will end in that may frown on this type of stuff. Therefore for privacy I will be blacking out all future photos - more to come with before primary and revision. :)
Just wanted to start off by saying thank you for the comments and support. It means a lot when going through the healing process!
I've attached some photos of my original nose and my nose after primary so you can see what Dr. Grigoryants was dealing with. My primary was done back in 2007 and whilst I was originally ecstatic with the results, some flaws developed over time. First, my breathing. I was mostly a mouth breather before my primary, but after I could only breathe about 30% through one nostril at all times. Now, at post op day 9, I am breathing about 40% through both nostrils. I am confident once all of the gunk comes out and swelling goes down this will improve!
The main reason for this revision was the aesthetics. I've included photos of my face resting as well as smiling, as this increases the nostril flare and droopiness. From the side, I felt my nose was too big for my face. I despised my long nostrils, and the hook that developed when I smiled. The front, I didn't mind too much. Yes, the tip hung down a bit and could stand to be raised, but I find a hanging columella quite charming tbh. The thing that bothered me most was from the 3/4 view. Due to not enough cartilage being shaved off and a slight C shape in my nose, it caused one side to look scooped, while the other side still looked like it had a hump. Finally, my nostrils were so thin they were like slits. My original surgeon never used grafts and this caused internal valve collapse, contributing to my terrible breathing. Luckily he left enough septum in my nose so that Dr. Grigoryants could use this for grafting, however I would have been happy to have cartilage taken from my ear if need be.
Currently at Day 9 post revision, it is much too early to tell what has been corrected and what hasn't. My nostrils are definitely smaller, cuter, and rounder, and my breathing has improved. My nose appears to have been deprojected and Dr. Grigoryants assured he gave me a supratip break, however due to swelling this isn't evident yet. There are still some asymmetries, and it's impossible to tell whether this is due to swelling or permanent. Either way, a nose will never be perfect and I'm confident Dr. Grigoryants made changes for the best.
The ugly side of healing and staying positive
In saying this, I know it can be scary to look in the mirror and see a bruised Mr. Potato Face staring back at you so I thought I would share my healing photos to show my very slow progress. I'm currently at Day 10 post op and still looking a bit scary from the front... The bruise under my right eye is very persistent and my nose looks like an unrefined blob. My left side seems to be less swollen than my right, so there is a bit of tip definition on one side but not on the other. I also still have a bump from certain angles and it's impossible to see the supratip break Dr. Grigoryants assured he gave me. I already love the nostrils, but the rest is up in the air for now. Will post again in a few days with updated healing photos for you all. Enjoy!
Also here is a great article I found about swelling, courtesy of Facial Plastic Surgery Miami.
"There are essentially two forms of swelling that take place after rhinoplasty. After a rhinoplasty surgery, there is the immediate swelling related to the trauma of the surgery and then there is swelling related to retention of fluid.
... This second type of swelling to which I am referring is related to fluid retention under the skin. At the time of a rhinoplasty, cartilages and bone are shaped, and grafts are used to reshape the nose to achieve the cosmetic outcome. The skin then simply has to “re-drape” over the new shape. The skin, in essence, has to mold itself over the new shape of the nose. In doing so, fluid is retained underneath the skin and over the cartilages. It can then take up to several months for this healing process to transpire. Gravity and your body’s fluid retention are the two main factors which control swelling at this point after surgery. You will notice that the upper part of the nose towards the bones is the first area where refinements are noted after surgery. The tip, being the most gravity dependent, is the last to show resolution of the swelling. These changes are normal and occur in every patient to some degree. There are factors which do influence the amount of this second type of swelling after surgery, the main one of which is the thickness of the skin: the greater the thickness of the skin the greater the degree of swelling. I counsel all my patients upon their consultation as to their noted skin thickness and try to prepare them for the expected amount of swelling that may be typical in their case. At this point in the surgery, in order to help resolve the prolonged swelling, I tell my patients to limit their amount of dietary salt intake. Since this second type of swelling is mostly due to fluid retention underneath the skin of the nose, I have noted that the reduction of salt from the diet helps. Regardless, this second type of skin swelling may take months to fully resolve and unveil the refinements made during the rhinoplasty." - Dr. Anthony Bared of Facial Plastic Surgery Miami
I still have that stubborn bruise under my right eye! Went to Sephora yesterday and got some Kat Von D tattoo concealer and powder which does the trick. My nose still looks really fat from the front, but a cute supratip break is really starting to appear on the left side. The right side still has no supratip break and a slight bump on it, but since this is the side with the massive bruise I'm confident that this is just swelling.
There is still constant pressure on my nose, almost like someone is pushing down on the bridge. It's not painful, just makes me very aware of my nose at all times. The only painful part is when I clean at times, as the internal stitches are super sensitive. I clean a couple of times a day switching between saline spray and hydrogen peroxide, followed by Vaseline for lubrication. No exaggeration; I go through about fifty Q-tips a day!
I still tape every night and try to sleep in a straight, sitting up position, but this has been gradually getting harder. I keep waking up on my side and having mini freakouts as I don't gravity to pull my nose to one side! With my primary, I actually started sleeping on my side with my cast still on and I still wonder to this day if that caused the C-shape deformity I had.
All in all, everything is going smoothly. I'll post some photos around the three week mark when (hopefully) some more changes are apparent. Good luck to everyone else who is in the healing process!
Over the last couple of days the tip has dropped significantly which unfortunately, I do not like. One of my biggest fears going into this was ending up with an over-rotated tip, but after seeing the slight upturn I kinda fell in love with it. Alas, it was not meant to be.
Now that the tip has dropped but the swelling has persisted, my nose looks very similar to the old nose, just slightly fatter. I know this is temporary and will shrink, but I'll admit I'm feeling a little down and impatience is taking over.
I did make some good progress on the nose cleaning tonight though (have been taking it super easy because the stitches are so sensitive to touch) - I got a bunch of massive boogers out with stitches in them and was naughty and pulled on a stitch end. This stitch felt like it went through the entire columella, I pulled one side and felt it on the other! Sorry to be so gross but it was so satisfying, lol. There are still some visible stitches in there but I'm sure I'll make more progress in the next few days :p
Now for this swelling and bruising to go away!
So not too much has changed in the last few days, or even couple of weeks... I think due to my own carelessness. I have been on holiday and drinking excessively - even tonight I've had a couple of wines! I'm seeing the doc tomorrow for the last time so I'll ask him about the impacts of alcohol. My swelling has been pretty consistent and I don't see too much of a change when I drink, but maybe that's because I've been drinking so much it doesn't have enough time to go down!
What I love: loving that my columella doesn't hang as much as before. Loving the cute nostrils. Loving that my tip doesn't droop when I smile anymore. Love the profile - I compared to the morphs I showed him and it is almost exact!
What I'm anxious about: The tip has dropped more than I anticipated and I really don't want it to drop anymore. The 3/4 view still looks super bulky. There's no visible supratip break.
Hopefully Dr. Grigoryants can let me know what to expect over the next coming months - what is swelling and what is permanent. In any case, there are improvements - especially in terms of function. I actually find myself breathing completely out of my nose at times - something that was unheard of before!
Day 23 continued
I forgot to mention in my previous post, I got a small stitch infection on my right alar base incision. There was a visible stitch under the skin and even though I cleaned daily with hydrogen peroxide, I developed a small white ball on top of it for a couple of days. Once it burst I used tweezers to pull the stitch out and it looks fine now. I told Dr. Grigoryants about this and he said irritation is common and not to worry, just to keep cleaning.
I also mentioned I was worried about the tip dropping further and he said mine has dropped fully. If this is the case, I will be super happy once the tip refines a bit!
My last concern was the 3/4 view and he assured me it will get better once the sides of my nose refine, and I will have tip definition. Praying I get that cute little supratip break he tells me he gave me!
All in all I am delighted with my results at this time. I can understand why so many people say their nose looks better in person the first few weeks - it really does look better in person than in the photos I posted. The subtle definition that is starting to come through really isn't evident on camera. I will wait to post my "worth it/not worth it" until at least six months, but for now I am very optimistic and already see a lot of improvements. :)
Back at work!
I chose not to tell anyone apart from close friends this time around. Unfortunately I'm notorious in my workplace for getting botox and fillers so one girl did ask me what I'd had done! No-one else noticed, and I honestly think that if no-one knew I had touched my face in the past, no-one would have said anything. The girl who approached me was certain I had my lips done, lol! I denied it all and she didn't guess once about the nose, she just said I looked different from the side and couldn't pick it. I feel like a naughty little schoolchild hehe.
So for those who are self conscious about going back to work and not wanting anyone to know: it is very doubtful that people will put a finger to it. They may notice you look slightly different or that proportions have changed, but no-one will guess the extremities of a nose job. They make think a different hairstyle, new makeup, or in my case lip injections as I've gotten them before :P
Good luck for those heading back to work soon :)
One month post
Not much has changed at one month post, hence no updated photos. Since I've been home I've been careful with my salt intake, no alcohol at all, drinking lots of water, cleaning religiously, and taping at night. I have been naughty and sleeping on my stomach though and I don't care! I love my sleep too much.
There are no physical changes whatsoever in photos, however I do see small fluctuations in person day to day. My nose looks it's best in tape, tbh. Second best is in the morning directly after the tape has been taken off, and third is with makeup on and some contouring. I can't wait for the swelling to go down more!
Still not loving the tip (it looks bulbous and slightly masculine) or the three quarter views, but I'm putting it down to swelling. It is definitely an improvement from my primary, and I think I could learn to love it just the way it is. However from my extensive reading I have found that revisions take longer for the swelling to go down so my original idea of 'one month and it will look great!' has now changed to three months. So I will re-evaluate at three months and let you all know how I feel about it then!
Until then - thank you for all the wonderful comments and sharing of experiences. I'll still be reading all of your updates and checking back regularly :)
1 year on!
It took about four months for my swelling to subside and for me to stop seeing changes. It's a bit straighter than I imagined (I didn't get the cute supra-tip break) and there are very slight asymmetries, but overall it's a huge improvement and I'm very happy.
I did get a small dent on one side, which I had seen in another review with Dr. G. It was a small divot that I could place my finger into. No-one else ever pointed it out to me but it bothered me, so I got 0.1ml of filler injected into it and now it's gone. I'm a little worried that it may mean something went wrong (that, along with my breathing not being perfect anymore) but overall I'm so happy with the look that I'm not too concerned. My breathing was immaculate when the surgery was first performed and slowly declined over the months. One nostril is perfect and the other, I can barely breathe out of. I may go and see someone later and check that everything is ok, but I highly doubt I would get a third surgery. The risks are simply too great.
My greatest advice would be that if you are considering surgery, make sure that:
1) You are so unhappy with your nose that you would rather have the potential risks happen to you (i.e. collapse, infection) than the current nose on your face. Surgery is no small undertaking.
2) Choose a surgeon whose style you like and who performs many. Who is open to questioning, can show you a lot of their work, and similar cases. Get it right the first time!
3) As well as you choose your surgeon, do not have this surgery unless you are prepared to accept that you may have to do it again.
So that's that! As for the photos – I apologise that you cannot see my nose in proportion to my face but it simply takes too much time to edit them that way. I hope you can at least see the improvements in the swelling. :)
A talented and confident surgeon with an artistic eye. Do not expect a salesman who will try to woo you with smooth talk in the consult; he's direct, straightforward and honest in what he can and cannot do for you. His work speaks for itself. I would have liked more time in the consultation to ease my nerves, however I understand that he is a busy man - this is what makes him the experienced and talented surgeon his is today. Dr. Grigoryants has incredibly long wait times for surgery, however I put five stars as I managed to get on the wait list and move my surgery up by five months. It is also a long wait in the office to speak to him, however this happens at almost every surgery centre I have been to. His staff are incredibly friendly and will do their best to get you in.