Terrible Revision Rhinoplasty Experience!

Provider Review

Robert A. Guida, MD

Board Certified Facial Plastic Surgeon

1175 Park Ave., New York, New York

• 17 Dec 2017

I went to Dr. Guida for a revision rhinoplasty and septoplasty, and my experience and results were horrible. I was a complicated case, and Dr. Guida failed to acknowledge that fact, admit his limitations and turn me away, and adequately prepare for my surgery. Other doctors I consulted told me that because I have thick nasal skin, my nose would require more support from rib cartilage grafts. They estimated that I would require five or six hours of surgery. When I met with Dr. Guida, he didn’t provide much information or show me any computer imaging, but he said he could do my surgery in two hours and I wouldn’t require grafts. I was surprised and skeptical given that he contradicted what other doctors told me. I asked him if he was sure he could do the surgery--especially, in so little time and without grafts. He seemed “put off” that I was questioning his judgment and assured me that he could. He created an air of authority, credibility and trust, so I eventually felt relieved that I wouldn’t require rib surgery and he could do the procedure in less than half the time as other doctors. Unfortunately, I lacked better judgment at the time and ignored warning signs because he told me what I wanted to hear. I figured that because he was a Park Avenue surgeon, he knew what he was talking about and nothing would go wrong. Clearly, I was mistaken. Dr. Guida badly damaged my nose. He removed so much cartilage that my nose became deformed, disfigured and dysfunctional. There was no longer adequate structural support to keep my nasal passages open, so they collapsed. I could barely breathe and would often wake myself up gasping for air. Dr. Guida told me that it is sometimes normal not to be able to breathe as well after a rhinoplasty. However, since I’ve had my nose fixed by another doctor, I know that is untrue. Given my poor surgical outcome, I question whether Dr. Guida adequately prepared for my procedure. My surgery lasted less than two hours at his office and was scheduled late in the afternoon following other patients’ procedures. I was in recovery for no longer than 30-45 minutes. I was still groggy and nauseous from the anesthesia when the nurse came in, told me to get dressed and rushed me out the door. Neither Dr. Guida nor any of his staff ever called me in the following days to check on my well-being. As Dr. Guida and I had discussed in the consultation, he was supposed to do an open rhinoplasty, which is more effective for revisions and complicated cases like mine. However, he not only decided not to do that type of procedure, he then lied to me by claiming he did. I foolishly let him do another surgery on my nose to try to fix the problems he caused. I was desperate and did not want to take the time to search for--or have to pay a lot of money to--another doctor. Ironically, Dr. Guida said why trust someone else. He took cartilage from one of my ears, and the second surgery was a disaster. He left me in even worse shape. He tore the top layers of skin on one side of my nose. It looks like he took a vegetable peeler and carved a path across the side of my nose. In addition to the carving on one side, the other side of my nose has two parallel dented lines, marks and bumps. He also left a dent on one side of the upper bridge. I have so much scar tissue from three bad surgeries; and as a result of Dr. Guida’s botched rhinoplasties, I now have a scar running across the middle of my nose. The ear cartilage he put in my nose was a failure both aesthetically and functionally. It didn’t provide enough support in my nose to improve my breathing and it looked horrible. He left me with a big, painful lump on the side of my nose and ruined my ear for nothing. He claimed that the lump of cartilage he put in my nose was more visible because I have thin skin. However, every other doctor with whom I consulted said I have thick skin. When I expressed my dissatisfaction, Dr. Guida suggested that I go to an elderly dermatologist, in his late 70s at the time, to get injections of Silikon 1000, a permanent filler of medical-grade silicon oil. This dermatologist had many negative patient reviews, including claims that he was rude, yelled at them and made inappropriate, off-color comments. I was also concerned about someone his age administering a substance that leaves no room for error. Not only was Dr. Guida referring me to a doctor of questionable character and, possibly, with age-related impairments, he was also recommending that I have permanent silicon injected in my nose to try to hide an unsuccessful surgery. Dr. Guida also failed to tell me that Silikon 1000 is not FDA-approved for use in the nose and it has a laundry list of potential side effects, ranging from permanent lumps, redness, inflammation, infection, pain, migration to other parts of the body, etc.—and even death! No doctor will inject you with Silikon 1000 unless you sign a waiver/consent form that absolves him or her of any responsibility if something goes wrong. Once Silikon 1000 is injected, the results are permanent. It cannot be fixed or removed. Dr. Guida tried to convince me that this dermatologist was the best and that his other patients had great results. Given that he was not always forthcoming and honest with me in the past, along with the obvious red flags associated with this dubious substance, I dismissed his suggestion. Upon doing my own research, I discovered that many doctors will not use Silikon 1000 because it’s not FDA-approved for use in the nose or other parts of the face and there are too many potential risks. Many patients who don’t have immediate side effects may experience—and have experienced—adverse reactions months or years after being injected. I feel it is completely irresponsible of Dr. Guida to recommend this permanent filler in the attempt to cover up disappointing surgical outcomes. My experience with Dr. Guida has left me physically and emotionally scarred, and I feel that my safety, health and appearance were not properly prioritized. He failed to effectively manage my challenging case. I was not the right candidate for ear cartilage grafts, and they proved ineffective. He never offered to do the rib cartilage grafts that I needed and if he does not do that type of procedure, he should have been upfront about that from day one. After my two unsuccessful surgeries with Dr. Guida, I was so depressed and self-conscious that I didn’t want to leave my house or even be around family and friends. I had to pay nearly $30,000 and undergo five hours of surgery to have my current doctor fix all of the structural and cosmetic damage. I was in post-op recovery for over four hours dealing with nausea. My current doctor said there was “a lot of empty space” as a result of having too much cartilage removed. Thanks to my current doctor, I am now “in a better place,” but not all of the damage could be repaired and visibly erased.