No Longer Disappointed when I Look in the Mirror - Long Island, NY

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Ever since I was very young (around 7) I can...

Ever since I was very young (around 7) I can remember disliking the appearance of my nose from the side; specifically, the large hump that grows even larger when I smile. I grew increasingly more ambivalent towards a nose job as I got older. Sometimes I would absolutely decide to get one. Other times I would tell myself no, my future children won't look like me, I won't know who I am anymore, etc.

My dad had mirrors in his bathroom that could be adjusted in such a way so I could see myself the way other people saw me (instead of merely a mirror image). This was the summer of 2010 and I was horrified! My nose stuck out from my fase, curving to the right and ending in a downturn. That asymmetry is another aspect I've always detested--I believe I look completely different if my face is turned to the right or the left. I decided that the left side was the good side, so in every single picture my face was always turned to show this.

I finally decided to get the surgery in May '11 after watching the episode of Glee in which Rachel almost gets a nose job. Something Quinn said resonated with me: she got her surgery because she loved herself! That day I made an appointment for a consultation with the same doctor my friend's sister went to for her nose job. I left in June for Army Basic Combat Training. Someone said I looked like a bird--no one had ever made fun of my nose before. He was right, of course. When I found out the dates of my leave in December, I scheduled the surgery and paid the deposit.

In six months of training I managed to save half the cost of the surgery with my mom covering the other half. I wasn't nervous at all the day of--I completed trusted my doctor. It felt right; I had a good gut feeling. I was ready to say goodbye to my beak.

The first couple of days were the worst. I had a drip pad under my nose and I just sat on the couch and watched TV/movies. I slept on the couch too, sitting up, which was difficult. I don't think I left the couch for three days! My nose was completely blocked off so my mouth and lips got so dry during the night. I woke up every hour with a tongue that felt like sandpaper in my mouth. It didn't really hurt that much but the cast applied so much pressure that I had to take vicodin so I wouldn't feel it.

At first I thought my nose was too far upturned, but now I know I was just getting used to the difference. The doctor rotated my tip and shaved down the bump. My surgery was on a Monday, and on Friday I got my stitches out. I still had the cast on but I started going out in public on Friday anyway. The following Tuesday I got my cast off. By Thursday I was on a plane back to work!

My nose is still tender eighteen days post-op but I absolutely love it. At this point I can't believe I used to walk around all the time with my old nose on my face. Even though I kind of liked the left side, I really only had one good angle--this way is much better and I don't feel self-conscious if someone is standing on my side.

Today marks exactly one month since my rhinoplasty...

Today marks exactly one month since my rhinoplasty. The profile looks awesome from both sides and I can tell some swelling is subsiding.
But now it's like revenge of the crooked nose. A week ago I started looking in the mirror and thinking it was still slightly crooked. I dismissed these fears but I cannot any longer. My nose STILL veers slightly to the right like it did before! Granted, the tip looks a whole lot better, and this crookedness is not as pronounced as it was originally. But it remains.
The photograph I've uploaded to illustrate this was taken using Photobooth, so the image is reversed. But you can follow the line of light along the bridge of my nose and see how it curves to the right. You can also see more shading on the right alar base. I really hope this is just uneven swelling. When I press the sides of the bridge I definitely feel some give. I will update as time goes on.

Nearly six months post-op, and my nose is still...

Nearly six months post-op, and my nose is still very swollen and hard at the tip. When I press it right on the tip it's pretty much solid, it doesn't give way like a normal nose. All the pain is completely gone. Unfortunately, the left side is still my good side. The right side is still curved too much down. It appears as though the doctor removed the same amount from both sides of my nose, when really he should have removed more from the right side than from the left. I'm going home in December, so I'll see him then and see what he recommends. STILL, it is a vast improvement from the old nose! I may just leave it like this too. Who knows.

My nose has changed a lot. I'm not sure what to...

My nose has changed a lot. I'm not sure what to think anymore. A lot more swelling went down, so the curve to the right is even more pronounced. He didn't take enough from the left side of the bridge is what happened (not from the right as I had initially stated). Also there's a strange indent on the left side of the bridge at the very top, almost where my nose reaches my forehead. I've been looking at photos of people who went to other doctors in my area that cost half as much and have perfect noses and I'm wondering if I made the right choice. The tip has dropped but it's not too bad--it just looks like a completely different nose than one month after surgery. And I'm pretty sure it's still swollen in the tip too because it still looks pretty bulbous.

I'm getting a little worried now. Sixteen months...

I'm getting a little worried now. Sixteen months later and the swelling has gone down significantly in the bridge to the point where, front on, it looks almost identical to my before shot, minus the dorsal hump and downturned tip. When I visited my doctor in December he said the left side was very swollen and gave me cortisone shots. I just found out that excessive swelling can turn into scar tissue! I really hope this was just a case of a too-conservative nose job (like he didn't remove enough from the left side), rather a good one that I messed up by not addressing swelling sooner.

Revision at eighteen months!

I haven't mentioned this in any of my other posts, but for the past eighteen months I've noticed this odd congestion. A continuous post-nasal drip/mucous in the very back that I started noticing more and more after the surgery but that I could not necessarily pinpoint as a consequence of the surgery. I told my primary caregiver about my congestion and when Nasonex didn't really do anything she put me in for a consultation with an ENT specialist. Keep in mind this is all within the military healthcare system.

That specialist did something Dr Jacono never did: he looked inside my nose and discovered a band of scar tissue in one of the nostrils that was trapping mucous. He said we could do a surgery--and he would also revise the appearance! I was elated. He said shaving down the bump on the left side would be no problem, and he would also take a look at the left tip and try to make it even with the right. He wasn't sure it would even work because it might be all scar tissue but I wanted to go for it. Additionally he said he would straighten the septum, making this surgery a septorhinoplasty.

I got my cast off yesterday and I am very pleased thus far. It's swollen and huge but it looks straight. Immediately after my first surgery, I still noticed that the right side curved more and I preferred the view from the left. That is no longer! As of now I would feel comfortable being photographed from either angle.

I was right in my earlier assessment that Dr Jacono was too conservative with my first surgery. I don't know WHY, but he neglected to shave the bump on the left side, and he didn't remove enough cartilage from the tip. Yep, my new surgeon said that once he opened up the tip he saw that it was just cartilage on the left and no scar tissue and it wasn't a problem to remove some of the cartilage. I can't believe I almost considered not even having him go in there! He also used dissolvable stitches--amazing! The incision looks great and it's been just over a week.

I almost wish I had waited a little bit longer and gotten the first surgery done in the military. They would have done it because of my septum. But things happened the way they happened and I'm not going to waste time dwelling on what should have been.

Some additional notes. Dr Jacono and I sat in his office and he used a computer to digitally edit my nose into a desired result. He gave me a printout of the before and after, and I was able to see other work he had done, and look him up online. Not so for the military doctor. He took photos and we looked at them and discussed the issues but I got no morph of what to expect and they weren't allowed to show me pictures of other patients due to HIPAA. (They said no one else had ever asked, which I found odd.) When I looked up the military doc online I found a linkedin profile and that was about it.

I realize that I'm going to have to wait an additional eighteen months or even longer to see the final result and I am prepared for that. Now I know, firsthand, how much a nose can really change!

Seven Months Post-Op from the Second Surgery

Hello, again. Argh. How would I describe my nose at this point? Muddy. Lumpy, especially on the left side. No real defined lines. I tried to find a good photo to display it. I hope it is still slightly swollen.

I know that I will definitely have to go under again for the third time. The cartilage has collapsed in the front, impeding my breathing. If I have to close my mouth, it is very loud and labored. I can stick pens and other pointy objects inside my nostrils and move the cartilage out of the way to improve my breathing--otherwise, it stays down and blocks the airway. So frustrating.

One Year Post-Op, Third Surgery

This month marked the one year since my third surgery. I can breath much better now and as the swelling goes down I am satisfied with the appearance.

One Week Post Op, Fourth Surgery

How did I get to this point? I'm a week out from my fourth surgery. This one was a septoplasty and turbinate reduction, performed at the VA, by a third doctor.

I could breathe better after the third surgery but it was still so impeded that I was unable to sleep without Sleepright Intranasal Breathe Aids. The valve collapse was improved from surgery #2 but still not good enough. So I went under again.

This was my first closed surgery and while they didn't put a cast over the bridge I had to wear nasal stents for a week. Immediately after the surgery, once I woke up, I noted that my right airway was open while the left was completely shut. It is still shut. When I look inside the left nostril, the top inside of the nostril is touching the septum. If I pull the skin on my cheek away the left airway opens up.

I had my follow up today and they removed the stents, which greatly improved the right airway. But the left away is still completely shut and I'm worried the cartilage from my ear that they grafted in is visible (it is very white) or that the incision didn't stay shut so it's all just falling down onto the septum. It's uncomfortable and it feels like it is so stuffy with no way for reprieve. They told me to continue using saline soaks. Luckily the right airway is great and I can even breathe with my mouth shut. I'll probably be able to sleep too. But WTF? Do I need to go under for a fifth surgery to correct the valve collapse on the left airway?

They say it's swelling, but inside it looks nothing like the other side.

Why is this happening? I have such a beautiful nose now. Why won't it work?

I'm So Sad

I begged the VA all summer for this surgery, they canceled on me twice, and when I finally get it I'm even worse than before. Very soon I have to leave the state for military training for three months and I'm just dreading being around all those people and having to breathe through my mouth the entire time.

Last night was my first night back in bed. I had to sleep with my mouth open. I even tried putting my breathing aids in the right side, where the airway is a little more open, but it didn't help much.

So piecemeal. I had to have three separate surgeries just to fix the bridge of my nose, and now it will be three separate surgeries just to allow me to breathe again. I need another procedure just to fix the left side alone since the right side is actually so open I can breathe with my mouth shut (under the right conditions, and not while sleeping for now at least).

I've never had this feeling after a surgery before. I just feel sad. I contacted two nearby doctors that will probably cost a fortune but I'm loath to let the government touch my nose again.

Is it a swollen mucosa? External nasal valve collapse? And what the fuck is that visible white ridge sticking out?


I noticed a bump on my left nostril, the bad one. Today, I felt pressure there and mild pain. I think he just inartfully balled up the cartilage in there and didn't take care to ensure, when he stitched it up, that was definitely all in there and not falling out the bottom of the nostril and through to the inside. It is most certainly not opening up and I can't believe I will most likely have to spend a year feeling like one nostril is full of mucous before being faced with the decision to either go with another nobody military doctor or spend upwards of $20,000 or more on another surgeon. This is a nightmare.

I was right.

I was right any everything. I went to my second follow up today, three weeks post op. I saw a different doctor. He confirmed the my graft was misplaced, it is POKING OUT, and it is weighing down my nostril. Yes, it is visible and palpable from the outside. I'm getting it removed next Tuesday. I can't BELIEVE they told me two weeks ago that it was just swelling. This is so upsetting. I'm getting the graft removed in Tuesday and on Friday I have to drive twelve hours to South Carolina for military training. WTF.
Manhattan Facial Plastic Surgeon

Dr Jacono is very busy; the only times I saw him were for the initial consultation and right before the surgery. But his patient care coordinator responded to my emails for awhile and the nurses who removed my stitches and cast were friendly. He is expensive, and at least my issue is not enough work done, as opposed to too much. I edited this review to give him two stars as opposed to five because even though I needed a revision his surgery wasn't as bad as it could have been.

2 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
2 out of 5 stars Phone or email responsiveness
2 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
3 out of 5 stars Wait times
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