African American Rhinoplasty - Revision Rhinoplasty - Jason Hamilton. Los Angeles, CA

I have had 1 rhinoplasty surgery in 2009 by...

I have had 1 rhinoplasty surgery in 2009 by another plastic surgeon who wasn't a facial plastics specialty: I had a tip grafted/refined and a bridge built via osteotomies. I also had narrowing of nostrils. The surgeon narrowed the nostrils too much, but I knew going into my revision nothing can be done about that; once the nostrils are excised they are gone forever... Save yourself the pain, and get this done post-surg under local anesthesia if you have the slightest uncertainty. My main concern is hanging columnella and nostril retraction (V shape) and pinched look (gave me a very operated look).. I still was not crazy about the bulbous tip as my nose still looked bulbous after my rhinoplasty, but I felt I could live with it. I hate how my nose hairs are always hanging and seeing up my nose. I also disliked that when I smiled, that my nose drooped to almost my lip.

For surgery me and Dr. Hamilton agreed that this is what we would *improve*
1. Pinched nostrils
2. Tip drooping, so adding support
3. Refining tip to give less bulbous look
4. Improving the retracted alar/nostril

Overall, I was very pleased with the result so far and I just had my cast taken off today (which is 6 days post op).

I no longer have the pinching at all. Completely fixed. 100% happy :)

At the time of review, I can't judge my tip. It's so swollen and hard as well as the columnella so I can't even tell you any review honestly.. All I know is that it's the same size as it was pre surgery.. So I'm 100% sure in the next 6 months it will refine and shape up nicely and I can give a better review... I know true results may take 2 years :(

The droop is not as evident when I smile now, it has definitely decreased a few mm already but due to swelling of tip I don't have 100% result to report. Definitely better, and less droop!

The nostrils retracting/columnella hanging/... On a scale of 0 to 10, I'm about a 5 happy... it's definitely better.. But now that I see that it got this good, how about we aim for the perfect 10!!! Lol... I will see how much swelling goes down between now and my 1 month post op... And address bringing the rim down a little more... I heard of the columnella tuck, but he didn't cut mine... And he didn't use an alar rim graft... I'm not sure specifically what he used, but there is a improvement. If i'm not happy once the swelling subsides, I will seek other options and go for something more aggressive. But I do see some improvement but I'm not 100% happy just yet. I also feel like I have a better result on my left nostril, then my right nostril... But my right nostril was worse, so it makes sense... Swelling and time will make a difference on my final opinion on this part.

Time will tell, but I'm very pleased with results so far and it's only been 6 days post surgery.

Pre-Op and Day of Surgery

Pre-op was on a Monday. I was scheduled to arrive at noon, but my flight was delayed and didn't arrive until 3. Due to my delay, I didn't have time to get my mani/pedi as wanted and do my running around in LA. My preop appt was at 4 pm, so I met Dr. Hamilton in person. We was welcoming and warm. His staff was polite. Very quiet office. He asked my 3 biggest concerns then he weighed in and agreed that the things I pointed out were the same thing that pointed out. I let him talk, and I listened. I wanted to see if we were truly on the same page. It was maybe 45 minute visit. Finished paperwork and took pictures with the nurse.

On the day of surgery, Tuesday, I was 30 minutes late. So unacceptable. But the staff or Dr. H wasn't scolding me for my tardiness to the party. I advise to stay really close, less than 4 miles, cause the freeway is beyond crazy. Firstly, Dr. Hamilton took more pictures today himself. He took his precious little time and I'm definitely wasn't complaining. He actually caught something on camera that wasn't previously seen with my collumnella and that would need addressing. After answering a couple questions, the nurse took me back and got vitals and got an IV started. Last questions with Dr. H and verifying consents were good, I also asked last minute for a scar revision. The CRNA gave me Versed, and that was the last I remembered. About 4-5 hours later I woke up, no sickness just a little *drunk*. My mom had been in the waiting room so sometime after surgery Dr. H had informed her of the surgery ending and the results. Afterwards, she got the car and the nurse wheeled me to the car and we were on our way. First stop, Whole Foods!!! Yes. I felt fine, but I don't recommend to anyone lol. We walked around 30-45 minutes. Of course slowly. I pushed the basket for support. The minute we finished chasing out, I started feeling nauseous/dizzy. We got to the car, got a little air on and I was fine. We went straight to our hotel. We chilled and talked. I may have took a nap for an hour but not much. The PA and CRNA called in and checked on me, but I was fine. All I wanted was sushi and my life would be complete, but instead I only did liquids and light soups as suggested by the nurse to prevent nausea. I love those Odwalla Mo-Beta drinks anytime I sick, so I bought enough to last me a few days. Sleeping was horrific, I had packing in my nose to prevent hematoma to couldn't breath. The dry mouth breathing was horrible. I took no pain meds. I suggest a cool humidifier. I started the Bromelain and Arnica immediately and continued until after surgery. No pain, just discomfort. The felt my nose was being a stretched and upwards and pulling my lip. Uncomfortable.

Day after surgery - 1 day post op

I went in to have the packing removed by Dr. H. The receptionist welcomed us and was surprised how great my spirits were, she said most people usually come in pretty drowsy from the surgery. Went into the room, and Dr. H went over the surgery and he assured I was going great. He took the packing out and left the gel foam in. It would slowly come out over the days. My breathing went from 100% blocked, to the right nostril staying 100% and the left being 50% blocked. Ughhh. :( I still had a cast on despite not doing an work to my bridge. I asked surgery questions, then we (him, mom, me) chatted up for the next 30 minutes about a book, and what's next in life, just everything, kids, family, marriage.. lol.. My moms ADD was in full blown action, as she is the biggest chatter box ever. We scheduled my next appt for Monday to remove the cast and stitches. I was originally scheduled for another post-op appt on Friday but he stated I was doing so well that we didn't need it.

Pictures from 1 day post-1

Day 2-5

I literally chilled and watched TV all day. No changes. Rhinoplasty blues kicked in. I felt my nostrils were showing too much from the front, the nose felt upturned and pulled up. Miss Piggy :( this is something I didn't want and had expressed to Dr. H presurgery. No nostril show. I became obsessed with RealSelf reviews and found the piggy look was very common after surgery and that sometimes the tip is taped up to help with swelling. Or that it's over corrected so that when it drops after surgery it will be the ideal position and not droop. I later found out this was the case for me, it was actually just tape pulling my nose up. I literally freaked out for days worrying. The gel foam coming out on day 4 and 5 was weird, one slowly came out the day before the other. I actually gave my foam extra assistance and used tweezers that were sterile. I don't advise this, but I just finished nursing school so I figured Id be a guinea pig. That stuff was so weird coming out but I could finally breath. I originally thought it was only going to be jelly, like petroleum jelly, coming out so I was surprised. I actually thought it was a septal hematoma forming, as it looked like blisters in my nose and the nose felt obstructed.. Lol.. The mind will make you think the worse. I seriously was going loco. I had a decreased appetite because I couldn't breath and eating with your nose plugged is a struggle. I now am checked out my hotel and staying a friend. I'm so thankful as hotel bills add up. Day 2 and 3 no outside activity. Day 4, walked .5 miles to Whole Foods that evening to get more Odwalla mo-beta drinks. The walk was so refreshing, it felt great getting out the house. Being cooped up will drive you crazy. My friend stayed in west hollywood so everything essentially needed was close by. Smart water and Bromelain and Arnica and Keflex and Odwalla were in constant rotation during these days. Day 5, I stayed inside.

Day 6 - cast removal

I used Uber car/taxi service to get to my appt. Same polite staff and same Dr. H. Stitches came out. He stated it would feel like mosquito bites when he pulled then out. Well some felt like bee stings lol. He then put something like liquid stitches on the columnella to aid with healing. He slowly took cast and tape off. He put two pieces of tape on my nose and suggested continuing tape for a week. He forgot to give me the mirror to see my results, so we took a look. I wasn't in horror! That was my only concern. With my first surgery, I looked horrific. The swelling and the butchering of my nostrils were depressing. I noticed an improvement in my alar retraction, still had hanging columnella from profile, tip didn't have significant change (which was good since I know there is so much swelling). I then asked questions regarding scar tissue since he said he found a good bit during surgery. He didn't remove it, he just worked around it. He only used septal cartilage, I had enough. We chatted more. Then scheduled my 1 month post op. I thanked him.

I wasn't overly excited because true results take a long time, but I was very content cause with the results of cast removal I knew it would get better each day. The results of the alar retraction are unknown, i do see slight improvements for sure; some pics are better than others and the columnella feels so swollen so I'm hoping that it will rise and less nostril show will be visible from the profile. I'm concerned about this area, as it was my primary concern, so I really wanted more drastic result. But time will tell and nothing can be done but waiting on the swelling to subside. The pinching is gone, so that's a big plus. My friend immediately noticed this improvement when I returned back to her place cause that really gave me an operated look. I know one nostril is bigger than the other from the front , it was this way presurgery but it's way more evident now. I will wait until swelling subsides over the year and if we need to address, I will have him equal them out.

Having anxiety about wanting fast results will drive you crazy, so I won't post anymore pictures until 1 month post op :) swelling is fluctuating each day, depending on how I sleep and other factors. I will continue sleeping at least 45 degrees. I will continue Bromelain and arnica until the bottle is gone. I can't vouch that it has helped but I bought them so I might as well finish the bottle.

Please let me know if you have questions.

Two weeks

Hey guys!!! So I'm doing fine!! Swelling going down slowly.. Can't wait until my 1 month post op on nov. 6 so he can tell me how things are looking.. Right now my nose is really dry on the inside so that's annoying... Dr. Hamilton gave me some gel saline nasal ointment.. It helps.. It's just annoying putting it on... Lol.. The tip is no longer sore when I'm just chilling. It doesn't hurt on facial expression and smiling anymore. When I touch it's very slightly sore .. It's def hard adjusting to the "new nose".: getting use to it.. I'm obsessed with everytime I use the restroom that the mirror is in my face... I look at it like 8 times a day like it's gonna change... Lol...

I slacked off on the Bromelain for 5 days or so, but now I'm back on it..

I forgot to mention this in my original post, but my smile was messed up from the swelling and soreness.. I looked soooo weird... Literally when I smile, you couldn't see my top teeth at all.. My lip was struggling to move up... Well now My smile is about 1/2 way back and it's been two weeks... It's only my top lip that isn't normal.. At first you couldn't see any teeth when I smiled, not I'm about halfway on the teeth.. I have a big smile naturally, all teeth showing lol.. I can't wait until the swelling subsidies more, so that I don't look so weird when I smile.. LoL.. Hoping by 1 month it's all back! :)

Right now still concerned about my alar/nostril retraction results not being dramatic enough and the side profile still showing too much nostril... Being patient until my 1 month... Not sure how much the swelling affects that!

Will keep you posted then.. Still no pics until 1 month!! Makes it easier emotionally.. ;)

Fyi!! I wish I would have got a facial a few days before my surgery. Cause right now I need one baaaaaad!!! And of course I can't., :( so yeah, I suggest everyone get a facial before surgery lol

2 months post op - forgot to mention

*Clarify* the change is not causing an extremely hard time to adjust... It's just a don't have the droop as much when I smile, it just sits there... I'm use to seeing the droop all my life, so it's the norm.. Just takes time to get use to it.. And the swelling just makes the tip, like blah! Just sitting there... I can't see dramatic improvement but I feel can feel new shale when I touch that's it's more refined.. Of course swelling takes time, so I know this is normal.. Patience, patience, patience!!!!

Also, my nose no longer throbs. It use to throb especially when I get up fast, or lean forward too much, or do thinks that normally raise your blood pressure.

Almost 4 months...

Hi all!! Everything is going well... I had my 1 month followup in November and he said everything looked great.. I was eager to know if my swelling had at least decreased by 25%, he said absolutely not and that I was still very swollen and be patient. Overall, I'm happy with my results.. I'm just inpatient! LoL.. The nostril side that I felt still allowed for columnella show is still the same. As time passes, it honestly doesn't bother me as much. It's improved from presurgery but I still wanted that perfection. He acknowledged my concern and noticed the difference, but stated he wouldn't touch it for 18-24 months if it still bothered me. The thing that bothers me the most is that my smile hasn't returned!!!! My top lip can no longer lift up like it use to.. My barely have any top teeth showing when I smile.. And this sucks because I was always complimented on my beautiful smile.. I've spoke to others and I understand this is due to swelling from the columnella work and it will just take time! I'm praying to God it hurries.. I didn't know this was a risk beforehand, so it really threw me for a loop.. I look like someone's grandma when I smile lol... And it's definitely noticeable..

I won't be updating until 6 months.. I'm praying by then my smile would have returned fully. :)
Los Angeles Facial Plastic Surgeon

Dr. Hamilton was very pleasant, down to earth, funny, knowledgeable, and honest. From the start, we shared a common interest of just improving the things I wasn't happy with. He gave an honest opinion on what was fixable and what was not. I literally found him on RealSelf from other ladies hearing of him but no reviews, so then I did more research on google. I didn't have 100s of reviews to go on, I literally went with a gut feeling after our phone consult plus I researched his credentials and experience. I saw Facial plastics/reconstructive fellowship and a head/neck fellowship, surgeon at cedar-Sinai, and teacher in their facial reconstructive dept, and he's written journals about other non-related head and neck. My other surgeon wasn't facial plastics, so this was important to find someone who only deals with the face. During the phone consult and preop consult, he answered questions thoroughly. As RealSelfer @jaedessi said, "He also gave me his thoughts on why some African Americans end up with undesirable/botched nose jobs. He explained how he believes part of it is from surgeons using the same techniques used on Caucasian noses onto ethnic noses, how there's a disconnect between what the patient wants/expresses and what the surgeon actually understands from the patient". I'm happy that we embarked on this journey together. He was so open. His bedside manners are beyond average. The fact that he is a Beyoncé fan, gave him a few extra points :) I felt like he was family and our conversations went from surgery, to books, to family, to life experiences. The fact that he is a people person was beyond amazing, more than I could possibly wish for. If you've had a bad doctor, finding one with these qualities makes you appreciate bedside manners so much. I love his personality.

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