Dr. Constantian Fixed My Droopy, Crooked Nose

I had a rhinoplasty about 28 years ago, when I was...

I had a rhinoplasty about 28 years ago, when I was a teenager to fix a very prominent curved nose. Over the years, I started noticing that my nose was getting more and more crooked, and still curved down, especially when I smiled. I had read an article in the NYTimes about revision plastic surgery and the articles mentioned Dr. Mark Constantian in Nashua, NH, as being a surgeon who performed a large number of revision surgeries, and I really liked his comments in the article. In particular, he was quoted as saying "rhinoplasty is unique in that “you can lose ground every time.” With other kinds of plastic surgery, patients “are not worse off than when they started.”

Last June (2014) I decided to finally go see him. I immediately felt that I was consulting with a true expert but also felt very comfortable with him. He's has done so many rhinoplasties (primary, secondary and reconstructive) that he could tell as soon as he examined me what my issues were. Turns out that my breathing was also compromised and he's committed to fixing his patients breathing first and foremost. I scheduled my surgery that at that initial visit, for six months later. Waiting was hard, but I wanted to take a full two weeks off and I had to use my last vacation days from 2014 and also 5 days from 2015. I've posted some before pictures to show my awkward crooked nose from before.

Post Surgery

This 4 days after surgery. I look worse than I felt! I didn't need to take the Vicodin that the doctor prescribed, just something called Tramadol, which was like a stronger version of extra strength Tylenol. I wasn't good about icing, so the swelling got pretty bad.

Post op pics (day 7)

On day 5 I went back to Dr C. to get the cast off and the packing out. It was so nice to finally breathe through my nose again! I was pretty squeamish because after getting the packing out, he was trimming some stitches in my nose and all of the tugging and clipping made me think of what must have happened during surgery when I was under anesthesia. Best not to think about it!

I was definitely immediately happy with the result, because even though my nose was swollen, it was much straighter and the tip was much more defined and didn't dip down when I smiled. Dr. C said that my old tip didn't have enough cartilage to support it when the smile muscles pulled at it. He built up the tip with ear cartilage and he also used ear cartilage to brace the sides and open up my airways. What an incredible difference in my breathing. I couldn't stop talking about it!

3 weeks Post-op

Little by little the swelling is going down, but a little exercise or a high sodium day will make it swell up. The right side is still numb and considerably more swollen. Because I've been through this before I knew that it takes a long time for the swelling to subside completely. He did different things to each side, because my nose was pretty asymmetrical. So, it's expected.

One month since surgery! Before and after smile pics.

It's been a month and I wanted to celebrate by posting I'm some old pictures of my droopy nose when I smiled. My smile is mostly back to normal and my nose tip stays put when I smile :-)
Nose is still hard and swollen, and the swelling is in different places on each side. Dr. C had to do different things to the left and right sides, and despite the uneven swelling my nose is less crooked than it was before surgery.
Some one commented today that I look different, it's been several months since I've seen her. Then she said, "it must be because you're wearing your hair up." Anyone have any good non committal answers for that situation?

2 1/2 months out post-op.

Still swollen, but changing. Took some pictures earlier today to document the healing process. Was pretty happy. The I banged my really nose hard tonight, and am a little freaked out right now. It's so swollen.

Original nose, pre-revision and post revision pics

I love when people post before and afters so I scanned a couple pics of my original nose along with the doctors pre-op pics. Like many people I didn't keep the really unflattering pics so not much to choose from.
Nashua Plastic Surgeon

Dr. Constantian is an expert in the fields of rhinoplasty and revision rhinoplasty (they make up the bulk of his practice). When I met him I felt very comfortable with him - he's so calm and composed and a genuinely nice person, and his unassuming manner put me at ease. He's has done so many primary, secondary and reconstructive rhinoplasties that he could tell as soon as he examined me what my different structural issues were. He also showed me how my breathing was compromised. After reading his website and some articles about him I realized that he's super committed to improving the functionality of his patients' noses. His aesthetic ideal for my nose seemed to be very much in line with what I wanted - fairly straight bridge, refined tip, not too upturned. He was up front and clear about what we could achieve with one surgery, and after our meeting he sent me a letter with the specifics of what he would do to correct my cosmetic and breathing issues. Everyone in his office was as professional and lovely as he is... I got the feeling that they've worked together for a while and that they are all on the same page about how to treat their patients and keep a smooth, well run practice. It was very comforting, because I was putting myself in their hands - literally! Finally, I found his fee ($8,900) to be very reasonable for his level of expertise / experience, especially since we're in an expensive part of the country.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 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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