Bad revision

I am now 15 months post revision rhinoplasty with Ion Lucian and things are getting worse and becoming more obvious.

Following my surgery my left side wall caved and curved in and this was my concern initially but then I developed polly beak deformity which I already had after my first surgery and my revision was meant to correct this. This has not improved despite recurrent monthly steroid injections which has caused some changes to the nasal skin including small white pale tiny areas (This is a well known side effect of steroid injections), my polly beak has not responded to 5FU and hyaluronidase enzyme as well. I was surprised that he was still adamant that this is likely swelling and I questioned him many times that I am reaching the 12 months mark, could this not be a structural problem and thats why the skin is not settling?

Anyhow at my 14 months mark, he then told me that ( Oh probably the dorsum is too low and thats why the skin is not settling)!! Finally!! But he advised to inject me more and wait. Then I asked him about my left side wall collapse and his answer was ( I am afraid in my hands things are not always perfect and trying to go back to perfect things might leave more irregularities).

I was not happy after I left his office as thought he is a perfectionist and would want to achieve the best possible results! My collapsed wall is not just a small irregularity as it is different to the other side and gives an obvious shadow in photos.

I then thought let me be positive and follow his instructions.

I am nearly 16 months post op now and developed difficulty breathing more on the collapsed side. I am really worried I might have inverted V deformity but not sure!!!All the consultant I visited prior to my surgery advised I would need spreader graft but Lucian disagreed and here we go now difficulty breathing and blocked nose and caved in side wall!

Overall I am very depressed and disappointed.

It is not acceptable for such a reputable surgeon with expensive fees to do such a mistake and over reduce the dorsum!!!!! This is fatal mistake!!!!

In summary, after surgery with Lucian I eded up with collapsed left internal valve/probably collapsed external valve as well as the nostril on that side is notched. Over reduced dorsum with polly beak deformity and difficulty breathing. How would you rate this outcome???RUBISHHHHHH

I forgot to mention that he has been avoiding to put my pics on the computer to discuss results together!!! All surgoens do this when they know they missed up!My first surgeon was sharing pics with me till the moment I started to develop complications!!!

I am seeing him again soon and see what plan he has got to correct this!I can't afford to pay another surgery!!! After reflection, I feel I regret I went ahead with Lucian for my revision. A lot of people here ended up with some complications after they were initially happy and rated him very high. I also noticed he does the same nose to all his patients and this is very clear here and on his website. I have also realised he might be good for primary surgeries but not complex revision. He has been in private for less than 10 years and all his work in the NHS was on skin cancer!!! They do not do nose surgeries in the NHS!!! He might has some very good results and lot of happy patients but he does not have extensive experience especially in revision rhinoplasty! Also, Every time I saw him during my FU he used to say something different to me. Basically till now he can't diagnose me and he is puzzled with my nose, to the degree I will take some photos from the web for collapsed internal valve and inverted v deformity and ask him in my next visit to put my pics on screen and then show him the examples to show him that this is what I have!

If you need a complex revision think twice before considering Lucian.

My over all rating for my results is only 2.5 stars.

For some reason my first review was deleted after I updated it. I had to re-write everything again.

My first rhinoplasty was 2 years ago in Manchester. I chose this surgeon carefully after reading lot of good reviews about him here on realself! Unfortunately the outcome was terrible. I ended up with open rood deformity, collapsed left external valve, crooked nose, polly peak deformity, hanging columella, droopy tip. Basically, all complications in 1 nose! I then started my research journey trying to find an excellent surgeon to correct this mess. Dr Lucian came across very confident and I felt very confident with him. I had few consultations with different surgeon before him and most of them told me I will need a spreader graft and batten graft using ear cartilage. However, Dr Lucian thought I will only need grafts for the tip cartilage from my septum. I was very happy to know that I will not need any graft from my ear or rib.
I had my surgery in July last year and after cast removal I was over the moon. My nose looked straight, shorter, nicely projected. However this happiness did not last that long as within days of cast removal my left side caved in. I contacted Dr Lucian and emailed him few photos and he got back to me promptly. He asked to see me in clinic. He examined me and agreed that my external valve has slightly collapsed/caved in. He informed me that this might need to be addressed again in another revision :(. He asked to keep massaging the nostril from inside with a cotton bud to help push it back in place. He also injected steroid injection and asked to come back at 3 months.

It was really depressing to find out I might need another revision as waited a full year for this surgery and then to find out that my nose collapsed again within few days!

Any way at 3 months mark, I was not happy as my nose looked crooked/caved in and asymmetrical from the front view. At that time he injected me with dermal filler to help me feel better about it.

At 6 months mark, the filler effect started to go down and my nose started to look crooked and caved in from the left side in all photos. In addition to that I have very mild breathing restriction on that side.

Overall started to feel disappointed as started to think that I might have needed a batten graft or spreader graft in the first place!

8-9 months review:

I had a follow up review with Dr Lucian few weeks ago. He examined me but then it was me that pointed out I'm still not very happy with the front view. He had a another look and took photos and then he agreed that the left external valve is very very slightly caved in compared to the right side. On the other hand the right side wall and external valve looks fuller. He believes the the crooked look is due to the slight collapse of one side and possible persistent swelling or fullness of the right side which gives an asymmetrical appearance and an impression of crookedness. He asked me which side I prefer? I said I kind of prefer the slight caved side from the profile but not sure which side I like from the front. He then told me that as I am still not fully healed we need to wait till I reach the 12 months mark. He injected me this time with 5FU combined wit steroids to the fuller side. At 12 months we will decide what to do. If it is still asymmetrical the options I have:
1- Leave it as it is as it is more obvious in photos and certain lights rather than in person.
2-Shave more from the fuller side (right side)-Will need open approach.
3- Reposition of the right external valve +/- adding a small cartilage from ear for support- will need open approach as well.

For some reason he did not put the photos on screen to have a look at them together. I do not know if this is what most surgeons do once they are themselves not very satisfied with the results!

He does not think I need a spreader graft and that my mild intermittent breathing restriction ( Which I currently can live with and not a big deal) is most likely due to the mild caving of the external valve but he will decide intra-operatively if needed incase I go ahead with revision.

I will do admit that few days after the injection the swelling on the right side has gone down slightly but still looks fuller.

I'm a bit confused now as I prefer the profile of the collapsed side as it looks more refined but I hate the asymmetrical front view. I'm worried that if I add cartilage to the more refined side my nose will look fuller and will have a wider nose but at same time if I shave more from the other side my breathing might get affected!
I think I have no option other than to wait few months more and see what happens.

Any one reading this review with a skin slightly on the thicker side! Did your nose continued to changed beyond 12 months? Did it become more refined? Did the skin become more tight? Some of my friends who know I had surgery do not think my front view changed massively. They think it only narrowed a bit! Anyone to share experience?

Also anyone had asymmetrical healing up to 9 months and then things improved after that?

I had a follow up review with Dr Lucian few weeks ago. He examined me but then it was me that pointed out I'm not very happy with the front view. He had a another look and took photos and then he agreed that the left external valve is very very slightly caved in compared to the right side. On the other hand the right side wall and external valve looks fuller. He believes the the crooked look is due to the slight collapse of one side and possible persistent swelling or fullness of the right side which gives an asymmetrical appearance and an impression of crookedness. He asked me which side I prefer? I said I kind of prefer the slight caved side from the profile but not sure which side I like from the front. He then told me that as I am still not fully healed we need to wait till I reach the 12 months mark. He injected me this time with 5FU combined wit steroids to the fuller side. At 12 months we will decide what to do. If it is still asymmetrical the options I have:
1- Leave it as it is as it is more obvious in photos and certain lights rather than in person.
2-Shave more from the fuller side (right side)-Will need open approach
3- Reposition of the right external valve +/- adding a small cartilage from ear for support- will need open approach as well.

For some reason he did not put the photos on screen to have a look at them together. I do not know if this is what most surgeons do once they are themselves not very satisfied with the results!

He does not think I need a spreader graft and that my mild intermittent breathing restriction ( Which I currently can live with and not a big deal) is most likely due to the mild caving of the external valve but he will decide intra-operatively if needed incase I go ahead with revision.

I will do admit that few days after the injection the swelling on the right side has gone down slightly but still looks fuller.

I'm a bit confused now as I prefer the profile of the collapsed side as it looks more refined but I hate the asymmetrical front view. I'm worried that if I add cartilage to the more refined side my nose will look fuller and will have a wider nose but at same time if I shave more from the other side my breathing might get affected!

I think I have no option other than to wait few months more and see what happens.

Any one reading this review with a skin slightly on the thicker side! Did your nose continued to changed beyond 12 months? Did it become more refined? Did the skin become more tight? Some of my friends who know I had surgery do not think my front view changed massively. They think it only narrowed a bit! Anyone to share experience?

Also anyone had asymmetrical healing up to 9 months and then things improved after that?