Rhinoplasty Changed my Life - Montreal, QC

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Hello, My Story… My name is Louis and I had...

My Story… My name is Louis and I had Rhinoplasty in January 2013. That is the day my life changed forever. Let me start from the beginning. Since my late teens, I had always wanted to have a nose job to reduce the size of my hump. I wanted a straight nose. It wasn’t a big deal in my life… just something I wanted to do. Well, at the age of 34, I decided to take the plunge and get it done. I looked online for dr’s and found one with a lot of positive reviews. Making a long story short, I woke up the day after surgery feeling relatively good. 6 days later, I had the cast removed and even though there was a lot of swelling, I liked what I saw in the mirror. Over the next few weeks, I often looked in the mirror trying to get used to the avatar looking back at me. I was happy with my results.

Things changed… At 3 weeks post op, I took a picture of my face from the front and I noticed the swelling was healing unevenly. I chuckled with my wife looking at the picture on how asymmetrical my nose was. There was a dent on the right side. I heard that swelling can settle unevenly so I wasn’t too concerned. Well, for the next three weeks, the dent became more and more noticeable and it began to worry me. I Google “Dent on nose after Rhinoplasty” and started reading what this could mean. I read everything from this is normal part of healing to a possible collapsed of the middle vault. I made an appointment with my PS and after examining me he said, it’s not collapsed and not to worry about it. As the weeks went by, it was obvious that this was not normal. I was experiencing breathing issues on my right side and the dent was not going away… it was getting worse. I start reading a lot about rhinoplasty and the possible negative outcomes. After a while, I was relatively certain that I had at least a mid-vault collapse on my right side and possible mid-vault collapse on the left. That’s when I went from bad to worse.

How my life changed… I am married with 2 young children. I love my wife and love everything about being a father. Being a father is one of the few things in my life I do very well. Well… this has completely changed. I have become clinically depressed. I was put on anti-depressant medications which has not helped at all. I cry a lot. All day sometimes. I rarely play with my kids because of the constant crying. My son, who is 3 years old, is too young to know why dada is crying but, he does know dada is sad. My son told my brother in law that “dada sad a lot and dada sleep a lot”. Well, when I heard that, it crushed me. I thought I was doing a good job hiding everything I was going through from my kids but I guess not well enough. My wife was and continues to be very supportive but it hurts her to see me suffer like this. I have incredible guilt for putting everything in my life I held dear at risk for something so vain and meaningless. I live with that quilt every day and that is by far the hardest thing I deal with.

What do I do now… Well, as I said, I have and continue to read everything I can find about mid vault collapse. I mostly look for how it can be fixed. So, this is what I have learned. Spreader grafts are the standard remedy for mid vault collapse and is recommended to be placed through an open procedure by a revision specialist. Your own cartilage is best and to stay away from artificial products. So, the best cartilage is Septal… I had septoplasty so that’s not an option for me. The next best cartilage is debated among the experts. Some say Ear cartilage is fine and others say Rib is beast. Both have negatives. Warping! Absorbing! Displacement! Infection! Visible irregularities! Etc… The chances of these risks occurring are always “rare” “unusual” “uncommon”. “In the hands of an experienced surgeon, these risks are infrequent” so on and so on. Success rates and percentages are rarely given. Only vague relative terms which is extremely frustrating. All that being said, if a revision surgery is in my future, I have to start somewhere.

My search for a revision specialist… I am not mentally stable by any stretch to consider revision at this point. I am very depressed and untrusting of any Dr. Having this surgery is not a decision to be made when depressed. However, the thought of living with my nose the way it is now is overwhelming. I have to wait at least until January 2014 anyways before any surgery can be done. But more so, I have to be mentally at peace. So, I am making a list of Dr’s to consider and I would like feedback from everyone here. So far I have the following: Rizk (NY), Bennette (NY), Pearlman (NY), Becker (NJ), Toriumi (IL), Portuese (WA), Lamperti (WA), Nassif (CA) and Kim (CA). What are your thoughts on these DR’s? Has anyone had revision surgery with them? Are there any Dr’s I should remove or add? This is a preliminary list and I really do need to work on it. With your help, I hope.

My gratitude to those of you here who share… This site is both a blessing and a curse. I wish I had never heard of it. I wish I had never needed to use it. But, because of what has happened, I’m grateful it exists. I have been on this site quite often in the last few months. I read Dr’s recommendations and most importantly, I read on those of you who are in the same boat as me. I must say, I am not one to talk about personal stuff. I like to deal with things on my own. But this is just too much. This is just too hard to go alone. This is too overwhelming. I have my wife and family that support me but, they don’t know what it’s like. I know I am not alone with my battle as I have read a lot of similar stories on this site. I thank you all for sharing and for your help. I don’t even know who you are, but you have helped me tremendously. Thank you for that. And, that is why I decided to share my story. That is why I decided to open up. We all can help each other find what we are looking for. Whether it’s to find a great surgeon, or find the strength to live with our imperfections. So… I ask you… if you have something to say, negative or positive that can help me and others, please share. Please send me messages either in private or public. I need your help. I need your help on what questions to ask Dr’s. I need your help on which Dr’s I should see. I need your help on how to cope with my guilt and depression. I need your help…
Thank you for your time.

October 10, 2013 UPDATE 8 Months post op Rhinoplasty

Hello again,
Let me just say to all those who messaged me, thank you for all your support and guidance. It really means a lot to have as much help as possible during all this. I have decided to post some pics. You can see the middle vault pinching, more so on the right side. This has been the reason for my breathing issues. Breath right strips work very well. My bridge on profile is too concaved as well. Even though I did not have any work done on my tip, I notice it’s still swollen and as it comes down, the profile is looking better. Hopefully, the swelling will come down enough to where my profile will be ok.
Where am I at now... Not much has changed since my first post other than I have learned a lot about rhinoplasty and in particular, middle vault collapse. What is so frustrating is this debate between rib and ear cartilage for the use of spreader grafts. How do so many dr’s have different views on it. It doesn’t make sense. Obviously, I would rather use ear cartilage but not if it means that I’m back to where I am now in a couple of years. Anyone who have spreader grafts from either ear or rib, I would love to hear from you. Please message me either here or in private.
My Doctors list… As I live in the north east, I think it would be wise to find a dr. close to home. That being said, I also have family in Phoenix which would allow me to recover from a surgery on the West coast. This is my current list of possible revision dr’sI have made a short list. Dr. Pearlman, Dr. Rizk, Dr. Becker, Dr Thomas Le, Dr. Oakley Smith, Dr. Kosh. I have read negative and positive reviews on all these Dr’s which is frustrating but, they seem to all do a lot of revision work. If anyone has had revision rhino with any of these dr’s, please message me. If you think I should add any dr’s to my list, please let me know. I plane to consult with about 5 dr’s. I will also start a list of Dr’s on the west coast. I have Dr. Nassif so far but I will find a couple others. I’ll share those names in the future
That’s it for now. I’ll update my status when I can. Thank you all again for your help and please, let’s continue sharing with each other.

October 21, 2013 received a couple Doctor opinions

I have been doing a lot better lately. I’m enjoying life much more these days and I’m not in tears all the time. Thanks again to all of you who have sent me your kind words and support. It really does help and I appreciate it immensely.
So, I’ve seen an ENT for an opinion on my condition. He said I have narrowing of my mid vault (nothing new there). He then said, “The operation to fix it always fails.” A little upsetting to say the least. I’m not sure what to think about that but I want to consult other Dr’s before believing it.
I have also communicated via email with Dr. Lamperti out of Seattle. I have read many of his answers to Realself users and he seems very honest which is why I contacted him. He reviewed my pictures and answered all my questions in detail. Dr. Lamperti’s suggested to use spreader grafts with ear cartilage to open up my mid vault and improve my breathing. I’m hoping to find and speak with anyone who has had this operation. Please message me with your experiences… good or bad.
I will be contacting a few more Dr’s in hopes of having some online consultations and then eventually making some in person consults. I'll update my review after each consult.
Thanks again to all my Realself friends. Thank you Dr. Lamperti for your expertise and your time.

Dr. Oakley Smith

So, I'm considering Dr. Oakley Smith out of Toronto for my revision. I have read many good things and I have a consult with him in January. If anyone has had rhinoplasty by him and wishes to share your experience, good or bad, please message me. I really need some feedback on this. Thanks

Consult with Dr. Oakley Smtih

I had a consult with Dr. Oakley Smith in Toronto and it went very well. I found him very informative, honest and I didn't feel rushed at all. I still have a lot of reflection to do but I am leaning toward Dr. Smith for my revision.
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