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

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 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.

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.