33 Year Old Male, 7th Rhinoplasty Procedure Using Rib Graft

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Hello all, I'm a 33 year old Caucasian male who...

Hello all,

I'm a 33 year old Caucasian male who underwent my first rhinoplasty procedure aged just 17, as my nose had a large hump and was very out of proportion with my face. I was young and naive at the time and really didn't know what I was letting myself in for. I had it done through NHS and was referred to an ENT surgeon, who ended up allowing a registrar to operate on me without my knowledge. Of course, this was not a success and instead of going private I saw another surgeon on NHS called Dr Simon Withey. I had 4 further open rhinoplasty operations by him and 2 further closed operations. The last of which was 5 years ago.

I am still left with a very asymmetrical nose, poor nasal breathing and irregular misshapen nostril, despite numerous attempts to have this corrected. I also still have a drooping septum. In other words, it looks horrific! I have been unable to look at my face in its entirety for the past 7 years without feeling wholly depressed.

I saw Dr Lucian Ion in 24th December and felt very well informed and confident about what he felt he could do for me. I'd previously seen Dr Basim Matti and was wholly 'unimpressed' by him. He was also quoted £2,000 more for surgery. Lucian agreed that I had unsuccessful surgery in the past and was sympathetic. He took photos and showed me a morphed image of what he felt could be achieved. I am still deeply concerned (that due to large amount of scar tissue and little or no cartilage available to work with) that this will be my 7th umcsuccessful procedure, at a huge expense (£8,225). He seems confident about improving my breathing and overall symmetry of my nose, despite the previous surgeon's FAILED attempts at this.

Reading everyone's comments on here, it seems that I am one of the very few who has undergone so many procedures and it is very upsetting that I didn't find a site like this in the past or a surgeon like Lucian. I just hope that he can do something for me as it would make me feel happier than words can say.

Am booking surgery when his office reopens next week and will also have a second consultation to ask further question that I have.

I would love to hear from anyone who has experienced similar. Also, how long the waiting time for surgery is. I'm told it is 8-10 weeks.



Dr Uppal

Another Realself user has kindly mentioned Dr Rajan Uppal as a worthy consideration for revision rhinoplasty surgery, so have decided to arrange a consultation with him before committing to anything.

2nd Consultation

I was wondering whether anyone has seen Lucian for a 2nd consultation before committing to surgery, as normally the 2nd consultation is after booking in a date for surgery? Many thanks.

Rib Cartilage

I have done a little more research into the use of rib cartilage for rhinoplasty and the general consensus that I am getting is that it is the 3rd preferred use of cartilage after nasal and ear. I've also been informed that it can feel like 'wood' to the touch and has a tendency to warp or be reabsorbed into the body, creating an uneven look so am feeling very uncertain and nervous about it all.

Second Consultation

I can't believe it was back on December when I had my first consult with Lucian! I have finally got around to booking a second consultation with him in July so fingers crossed all goes well.

Dr Charles East

I am 99.8% certain that if I decide to proceed with surgery then I will have it done with Lician as I have complete faith in his ability. One thing he did mention though (in my first consult) was that an ENT surgeon would be better qualified to improve the issue I have with my breathing ( which is pretty bad!). This procedure would likely be done after I have my rhinoplasty op with Lucian but was wondering what people's thoughts were on Charles?

Having Second Thoughts

It is now 4 weeks until I have my second consultation with Mr Ion and since I last saw him in December I have shared experiences and thoughts with many other realselfers which has been both enlightening and imformative. As my consultation draws ever closer, I am starting to seriously question whether I should risk another procedure. I have been through so much physical and emotional scarring since I had my first procedure aged just 17 until now (aged 33). I am also wondering whether my nose has been tampered with so much that it is unlikely that I will achieve any real improvement or perhaps risk making things worse with another procedure. Ever since my first rhinoplasty operation, I have experienced disappointment and my biggest fear of all is to experience a further disappointment if I take the plunge once more. Ion was very optimistic that he could achieve close to his morphs (which looked great!), but unfortunately I find it difficult to share that optimism. Hope is what has got me this far but I am starting to feel as though hope is fading. Perhaps I should just accept that I am one of the unlucky ones and (try to) live with what I've got. I'm so confused and rather lost.

2nd Consultation

Hi All,

I have just had my 2nd consultation with Mr Ion. We discussed what he proposed to do and I expressed my concerns regarding the functional element of my nose, as I have severe breathing issues, partially due to deviated septum and partially due to scarring.

Whilst he felt confident that he could achieve close to the proposed morphs, he wasn't as confident about fully correcting my breathing. He said that I could arrange to have an ENT operate on me with him (at an additional expensive) but he felt confident enough to simply have a rhinoplasty now and see what the results are like with that. He also said that my case was borderline plastic surgery and ENT.

I also asked Ion whether he had performed many reconstructive cases and he said he had performed some but didn't give any indication as to how many. The pictures he showed me on his computer were not complex revision cases. Also, he said that a significant proportion of his cases are primary and secondary procedures which is understandable. That said, I get the impression that he hasn't performed many reconstructive cases like mine and this does worry me somewhat.

I was very open with Ion and told him that I had consuted with an ENT named Mr Charles East and he said that if I required any further work on breathing after my procedure with him that he would put me in touch with a good ENT who would not undo any of the work he had done.

I'm currently very confused. I knew I would be. I know it'll be a risk no matter what I do and I will inevitably need to bite the bullet and go with my gut. Problem is, my gut is equally as confused as my head. lol

I feel more reassured that East would be more well equipped to deal with the functional element of my nose but am also confident that Ion would achieve a nicer aesthetic, thus a nicer looking nose. Also, I saw East via NHS and he didn't provide any morphs (which is disconcerting) and also informed my that he would have a registrar with him who would help assist with surgery. I don't like this idea at all.

Ion is a lovely, honest man and I do trust him. It's because my case is functional as well as aesthetic, not to mention the amount of surgery I've already had, that makes this so much harder.

Any thoughts from anyone would be greatly appreciated. Perhaps if you are or have been in a similar situation to myself.

Thank you. :)

Surgery Booked

After much deliberation, I have finally decided to bite the bullet and proceed with surgery with Lucian Ion. The decision was not an easy one (given my current situation), but I am confident that Lucian will do what he can to best improve my nose.

I have booked to have surgery towards the end of the year and pray to God that this will be my last!

Wish me luck, eh. :)

6 Days Post Surgery.

After months and MONTHS of research and uncertainty about whether or not I should proceed with surgery, I finally did it! Man, it feels good to have it over with!!

So, how did it go? Well, it wasn't an easy procedure. Surgery lasted 3.5 hours but all went to plan and Lucian seemed to be pleased with the immediate outcome. He came to see me whilst I was still a bit groggy in the recovery room, then again briefly when I was recovering upstairs, before returning a 3rd time at around 10 o'clock at night for another check in on how I was doing and to discuss what he did in the procedure. The nurses were delightful and were in no hurry o discharge me from the hospital, even though I was meant to be a day case. Recovering from the anaesthetic was horrific and I had episodes when I felt hot and sweaty, disorientated and sick, not to mention a painful sore throat and rib. Not pretty! They provided me with ice cubes to suck on which helped ease the soreness in my throat and ploughed me with all the ice cream sorbet that my heart desired until I felt well enough to leave the hospital shortly after midnight.

I saw Lucian earlier today to have my dressings removed and have another chat about everything. He felt that I should leave my nose packs in a little longer (those tubular things inside the nose), so I am seeing him again on Saturday to have these removed (the poor man never stops working!).

I have attached a grainy selfie taken just now. There is still a massive amount of swelling, particularly around the bridge and tip, but the nose looks remarkably straighter (compared the how it was) and symmetrical which is a huge relief!

In terms of what Lucian did in the procedure...

The top part of my bridge was deviating to the right and lower part was deviating to the left so these both had to be reset. He used some rib to raise the bridge slightly and strengthen it, he also used some rib to strengthen the columella. He also tilted my nasal tip into a straighter position and narrowed the tip and bridge slightly. To improve the situation with my breathing, Lucian removed scar tissue from inside my nose, stitched up my collapsed valve as well as a couple of other things. Because I still have the nose packs in and it's still VERY early days, I have no idea how my breathing will be once the nose fully heals. I'm hoping it will be better.

On the whole, it's still way too early to tell about how the results will be. Finger crossed... :)

10 Days Post Op.

Hi Guys,

Hope you're all keeping well.

Just a wee but update and pic. I made the mistake of not having my eyebrows done before surgery so am now rocking some seriously bushy eyebrows lol. Anyway, vanity aside, swelling has gone down a lot more since my last post. There is still some noticeable swelling either side of my bridge and the area between my eyes which must still be a bit swollen as Lucian said that he narrowed it slightly although I can't see visual evidence of this yet.

Overall, I'm pleased with the overall straightness and symmetry. Lucian has done a far better job of this than I could ever have imagined. I'm also happy with the way in which he was able to lift/shorten my collemella and get rid of that god-awful hanging, twisted mess that I had before.

Unfortunately, Lucian hasn't been able to improve the situation with my nostril creases (which you can't really see in this pic) which were left in a total mess (dreadfully so!) by my previous surgeon. He never said that he would be able to do anything about it so I didn't expect a miracle! Some things are permanent and unfortunately the previous surgeon cut and diced my nose in ways which can't be undone. It is a shame though as my nose would 'ideal' had it not been for is (breathing issues aside). But hey, I can now look in the mirror instead of constantly having to cover my nose with my hand. I had been doing this for many years.

Concerning my breathing, I still feel rather blocked on both sides, mainly the right (which had the collapsing valve). I have been using the sinus rinse recommended by Lucian which has helped slightly but to be honest I'm worried about how well I will be able to breath after things settle down properly, particularly through my right nostril. This was always an uncertainty going into this, which is why I dithered for so long as to whether or not I should have an ENT or Cosmetic Surgeon work on me. I suppose time will tell....

Also, I can't smell a thing, is this normal 10 days after surgery? I know I still have swelling and am blocked etc. but it is a tad little scary not to be able to smell anything. Apparently if someone has work done on their septum or turbinates this can contribute to prolonged loss of smell whilst the nose heals itself. Has anyone else experienced this from past rhinoplasty's?

D x

5 Month Post Op

Hi Guys,

I just wanted to give you a quick update on how things are with me.

Overall, I'm still very pleased with the result and feel that Lucian has surpassed my expectations with what he has been able to achieve.

While there is still some swelling, much of it has settled down nicely. My nose was straightened, overhanging columella lifted and tip and bridge narrowed. My breathing is also much improved since pre op.

I last saw Lucian back in Feb and I expressed how delighted I was but felt that there was still some overprojection of the tip. He ageeed that this would probably need deprojecting slightly and could be done under a local anaesthetic in his surgery. He also said that he would be in a better position to identify whether there are any other slight alterations needed when the nose has settled down fully later in the year.

I apologise for not replying to comments / personal messages on here. Please don't think they've been ignored - I simply haven't had a chance to read them or sign on here due to some recent events in my life which are ongoing.

I will be seeing Lucian again in September and will update on how things are then. I'm afraid I won't be uploading any pictures for the time being. I know how useful pictures are for other realselfers but I don't feel comfortable uploading them just yet. Sorry.

Take care x

6 Months Post Op

Hi All,

Much of the swelling has now gone down and I have more definition around the tip. I still feel that some deprojecipn of the tip is needed, so will see what Lucian says in September. Overall, he has hugely surpassed what I thought him capable of. Amazingly talented surgeon.

Hope you're all well x
London Plastic Surgeon

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