Revision Rhinoplasty: 4 Surgeons Consulted, 3 Different Recommendations. HELP! - London, GB

Hello all,

I hope you are all doing well.

I am a 30 yr old male who is looking to get revision Rhinoplasty but I am finding it quite difficult to pick a choice of who to pick. I need more correction on the bone and redo of my bridge. I went to see:

Dr. Charles East: Who really wanted to just push for the surgery but said he will use my ear

Dr. Basim Matti: Who was more engaging but wants to use my rib for graft

Dr. Iwo Gwanmesia: Very welcoming however he told me he will have to use a graft but then he needs to also scrape a bit of my bone. This is something I had not heard before from anyone else

Dr. Julian Da Silva: Again very understanding but mentioned to use cadaver graft. I am not sure the pros and cons.

I am now done with seeing people in UK. I just have one appointment with Dr.Palma in Milan.

If anyone has had Revision rhinoplasty which required graft, please can you share your experience or point me in the right direction.

Thanks

Dear all,

I have been researching to find someone who can do my Revision Rhinoplasty to fix my nose which is deviated from the top, while the cartilage in the middle was removed (barely any left) and that led to tip and bottom part of nose collapsing.

My journey started with visiting Charles East (over a year ago) who suggested an Ear graft but I did not feel he gave me the confidence.

The next in line was Basim Matti who suggested Rib graft. He showed me morphed images (so did Charles) but what strike me was the letter he posted after consultation where he mentioned that I have thick skin and all kinds of things which he never mentioned at the consultation. I felt that was a bit misleading and hence I decided to move on

Third doctor in line was Iwo Gwanmesia. He is very polite and super informative. My only issue with him was that he is not specialised for face. I felt for revision, this would be too much. I just didn’t feel it.

Following him, I met Julian Da Silva. I am not sure why (maybe he was super tired that day) but he felt like he was nodding but did not show interest. He also recommended donor graft which I was not comfortable with. He also mentioned that he would not show me photos. This made the decision for me for him. He was charging the most but did not make me feel I was in good hands

I decided to then move on to Europe and consulted Pietro Palma in Italy. He was very good in listening and took my photo. He told me that he will use Rib but really scared the life out of me about possible Lung Puncture. I still wanted to see him but then I emailed him about showing me some photos and what could the possible outcome be (since he refused to show me something to give an idea). The issue I found was that every email I sent him (about 4), regardless of whatever I asked him..He would come back to say you should be very sure about this surgery and consider this surgery as very risky. Now I know you have to be ethical and inform your patients but I did not understand why he would bring this up on every email. Anyway, I short listed him still.

The next was M.F.Noorman who again was very helpful and suggested Rib. The only issue was that he drew on my photo about what he wants to do but then he did say that I cannot confirm the outcome and I felt his age and few reviews I read online that put me off.

Then came Nolst Trenite. He was very calm and confident. He gave me a mirror and told me what I want but he suggested Ear graft. Now that is where I wasn’t sure (majority have said Rib). The other reason was that many people brought the age factor and hence I was a little put off.

Following that a friend recommended David Kim from US. He did morph images and said Rib. I would use him but then all this travel to US just to first see him in person (we had a video call) was something I would do if I was totally hopeless in Europe.

Finally, I met Lucian Ion (After 3 months wait just to see him). He showed me morphed images, told me he will use Rib but he was very calm and cool. I will have a video call with him in January. I asked him about Lung puncture issues but he was quite confident but at the same time said that it can happen. He said Rib is better for me than Ear as it’s a revision and result would be better.

I think after all this research and travelling all over, I guess it seems that he fits my checklist (i.e. images to give me an idea), is local (London) and also has amazing reviews. Plus, he has an ENT background.

Also, the score between Ear graft recommendation against Rib graft recommendation is in favour of Rib.

The next date he has in April 2017 for surgery. I will provisionally book it, but I would love it if anyone has any feedback.

I am obviously super nervous and my last surgery was in 2004 which did not go well.

Please if there is any advice or if you think I have missed a trick, let me know.

I am about to put my fate in Lucian’s hand. I just don’t know but compared to the rest, he seems to be balanced.

I also hope this provides you all some insight into the doctors around Europe.

Fingers crossed! Hope this time it will work out right and the doctor I have chosen will make it right (or close to right)