Revision Rhinoplasty - Not happy with results

I warn you, this is going to be long… I am not s...

I warn you, this is going to be long… I am not someone that spends time writing reviews, or time in front of a computer, period.. I don’t even own a social media account, it’s just not my thing. However, today I find my gut telling me to write this review for those of you that are finding yourselves in the same situation I have been in and feeling I am in currently. And to stress the importance of how big a decision it is to have this procedure. How it will impact you emotionally for many years to come. And to stress how important it is to do the research in order to make the right decision on who performs this procedure on you… Bottom line, you have to do your homework!
13 years ago (2003) I had my first rhinoplasty with a local plastic surgeon in Portland, Maine. I did not do my research as thorough as I should have, and instead based my decision to move forward with this surgeon (Dr. Weisberg) based on the fact that he was dual board certified as an ENT, and was licensed to practice plastic surgery. At that time, it hadn’t crossed my mind how difficult a procedure rhinoplasty really is. Or, how much technical skill and experience is required to achieve a good outcome. Reminder that at that time the internet was not as resourceful as it is today, especially when it comes to finding a specialist that will work on your nose and do it well.
Needless to say, I learned the hard way and I absolutely hated the results of my primary rhinoplasty. It wasn’t even a question, I knew from the moment he removed the cast that this was going to be the mistake I have to live with for many years... I started with a long nose that had a hump that began from the top and ended towards the middle portion of my nose. Although, the surgeon filed my bridge down to remove the hump, he did nothing to correct the tip projection and my nose was still very long/over projected, and in the end I was also left with a hanging columella… The entire situation was a nightmare. I remember having consults with him after this and he would stress that this was all due to the swelling and it would get better… I remember expressing how big areas of my tip still were, and how my nose hung so that you could see my nostrils, but he would continue to say my nose is just swollen but we could “revisit” in a few more months if he and I felt the tip was still heavy. He never disagreed that the concerns I had were not valid concerns, but he was not prepared to admit that he couldn’t give me the results he had promised, or did he warn me in the beginning that the areas I wanted addressed would be very complicated, or that he was not as skilled as he should be to perform the type of improvements I was seeking. After taking with Dr. Weisberg on several different occasions, I loss trust in his ability, and most importantly him, to help me make the outcome better. Did it ever get better once the swelling went away, as he had advised in the beginning, and reminded me over and over?? Well, that would be a… NO!!
Fast forward about 5-6 years later when I began researching revision rhinoplasty specialist. This was closer to the time when surgeons started posting websites and showing off their photo galleries of B&As, and it made it somewhat easier for patients to connect with surgeons from all over the country. Not every surgeon was on a website, but more and more began to pop up and it was then that I came across facialsurgery.com, which is the website home for Dr. Denenberg. I believe he may have been the first revision specialist to have a website that was filled with so much detailed information around rhinoplasty and revision rhinoplasty, and he had several photos of patients he had helped, all of whom had so many different issues with their noses. Long noses, over-projected noses, hanging noses, noses with humps, you name it, he had a photo of one! I really felt and believed I had found “the one" to help me with my revision needs.
I had Dr. Weisberg’s office mail a copy of my B&A photos and operative notes to D. D, and anxiously waited to hear back from him; hoping he would know what could be done to correct my poor results. It was maybe a week or two later that I received an email directly from Dr. D, and he provided an assessment of my current state at that time and offered a computer morph of what he felt was achievable. I was so excited when I got his email and saw what he had envisioned for my nose, and I wanted so desperately to be able to make this happen. Sadly, I was not in a position to afford the cost of the surgery, which at that time was I believe around $14-15K, of course this would not have included the cost to get there (Omaha) and the cost to stay there for at least a week. Not only was it too much for me to afford at that time, I was still very apprehensive and fearful of making the situation worse by going through another procedure. I decided I needed to hold off and wait until I could better afford this procedure and be more mentally and emotionally prepared to undergo this procedure for the second time.

It was about 2014/2015 when I again started to research online revision specialist. I was finally ready emotionally and financially to make this happen. It was then that I had also stumbled upon Realself.com, which became a huge part of my research; it was overwhelming to see how many patients were putting up reviews and sharing their photos, as well as the physicians that shared their B&A’s. I was finally in a position where I was not going to let distance or money be the barrier between me and getting a physician that could undo this nightmare.
I reviewed several revision specialists on the east coast, none of course from my home state, but I was determined to find the right doctor to help me. The specialists that I consulted with along my journey were: Dr. Tobias out of NYC, Dr. Alvin Glasgold (New Jersey), and Dr. Eric Joseph (who I just consulted with last October). Dr. Tobias is very nice and he felt he could improve my nose “90-95%...” However, at the time of the consult, which was a $150 consult fee, he did not perform computer imaging, but instead did sketch drawings of my nose to best show how he would make the corrections he felt were achievable. I felt discouraged by the consult, I was expecting so much more than a sketched piece of paper and a bill for what the surgery would cost. There was very little back and forth and I didn’t feel that I had a lot of input in the planning process. Besides, I have friends that are true artists (I live in an artsy kind of city), but I would never let one of them perform my surgery just because they can draw an excellent nose (and they can!). So, Dr. Tobias was out of the questions. I tell you this so you know my own personal experience, you be the judge for yourself!
I then scheduled a consult with Dr. Alvin Glasgold, who I really liked and felt the most comfortable with. His photo gallery had patients with noses similar to my own and searching online I found several good reviews, not only here on this site, but reviews from other sites, as well. Dr. Alvin was genuinely kind and he and I instantly began building a rapport and discussing the options. He was so confident in what he could do and that he has “seen my nose before,” and I just knew he was the one to help me. I scheduled my procedure with Dr. Glasgold that day at the consult. Unfortunately, due to changes at work that were taking place, I was unable to schedule the time off for my procedure and ended up having to cancel. I waited about a year to reach back out to the Glasgold Group to see about rescheduling my revision surgery and was advised that Dr. Alvin had retired… ? Talk about sad and depressed, I felt like this was a huge set back in the direction I was going, and I was worried I wouldn’t find another surgeon as good as he was.
A few months later I came across Dr. Eric Joseph while doing my research again on Realself.com. I was really impressed with his B&A’s and decided to reach out and see if he would be willing to meet with me and see whether or not he may be able to help me achieve my revisions goals. I emailed Dr. Joseph my B&A’s and he emailed me back the following day; advising that he would be more than happy to take me as a patient and meet with me to discuss what he could do to help. I also learned that he was a student of Dr. Alvin Glasgold’s, which immediately made me feel like I was heading in the right direction; no wonder his results looked great! I drove 8 hours to New Jersey last October (2015) and had a chance to sit and talk with Dr. Joseph and go over the concerns I had. He poked and touched and poked and touched some more, he took some B&A of me and worked with me to come up with an after result that he felt was achievable. He also strongly encouraged me to try and get a copy of my operative report from the original procedure, as he felt that without the operative report he could only tell me what he “thinks” is possible based on what he is feeling on my nose, but having the notes would make it easier to plan what exactly he could do based on knowing what had already been done before.

Well, I had misplaced my operative report years ago, and when I called the office to have them send me a copy, they informed me that they don’t keep patient records beyond 10 years and that mine had already been destroyed. The only one I thought might still have a copy of my operative records was Dr. Denenberg, from when they were mailed to him back in 2009. Although, Dr. Joseph was still willing to perform the procedure without the records, I wanted to give him more info to go by so he wasn’t blind-sided by what he was getting into.

So, I thought I would do my best to reach out to Dr. Denenberg in hopes that he would still have a copy of my records. I believe it was the same day that I had not only received a nice email from Dr. Denenberg, but attached was a copy of my medical records… I couldn't believe he still had my records and how quickly he got them to me.... At that time he inquired about if I had ever gone through with my revision surgery, of which I explained to him everything that had transpired thus far; exactly what I’ve mentioned here. He then applauded me for being patient and diligent with looking for the right surgeon to perform my revision. He and I emailed back and forth a few more times, I even sent him an updated set of photos, from which he did a new morph to show me what he felt was achievable.
I was just as impressed with Dr. D this time as I was when I had first reached out to him 6 years earlier. I was still hopeful that the results he mailed me were achievable, and he also agreed that a chin augmentation would be beneficial, which Dr. Joseph felt was not a good idea for my small face. I agreed with the chin augmentation after seeing the morph that Dr. D sent me, and was confident that he was the one to help me with my revision goals. So, I decided to finally, once and for all, schedule my surgery with Dr. D. and called his office in January (2016), and scheduled my revision for April 19th (surgery happened less than a month ago).
My friend and I flew out to Omaha the Sunday before, and the next day I met with Dr. D in person for my consult visit. He never rushes you and he takes his time to go over all the details. Not only that, but Dr. D is so personable and easy to communicate with, he makes you feel like you are his only patient. He took some more photos of my nose and then he and I went back to his computer to really cement the plan for surgery the following morning.
I was so excited when I saw the results that he felt confident he could achieve, I was on a happy high all day waiting for the surgery morning to come. It was settled, he and I agreed to the transformation on the images and the next day I was heading into surgery.

As a side note, I experienced zero pain throughout my healing process, maybe a stuffy nose (of course) but that was it. I did not touch any of my pain meds that he had prescribed beforehand. He also prescribed medication for anxiety to take the morning of, but I skipped on those because I was that comfortable/confident in him, that I didn’t feel the need to take anything to make me feel more at ease.
I was taken to the surgical suite the next morning (Tuesday, April 19th), which is located at the same location as his office. I was prepped and taking into the surgery room where I chatted with the nurses and briefly talked to Dr. D before I was out. The surgery took about 4 – 4 ½ hours. I arrived at his office at 9a, and didn’t get back to the hotel until after 5pm. I remember seeing a flash at the end of my procedure and opening my eyes and seeing Dr. D, and when he saw that I had opened my eyes he said that the surgery was an “A++”, and it looks “fantastic.” He may have threw in some other positive adjectives, but I was so out of it that I was instantly absorbed in the very first comment, “A ++.” I was so happy that I had FINALLY gone through with the procedure and I was now on the other side to recovery.

Cindy, his nurse who has been there for years and is super sweet and caring, took me back to the hotel where I slept until early the next morning. I went back to the office the following morning (Wed the 20th) for my day after surgery follow up. During the visit Dr. D went over how well the surgery went and that he was very pleased with the results, which was why he took a snap shot at the very end. I was then reminded that I should take advantage of being in Omaha, and he gave me a list of places to go and visit so that my gf and were not trapped in a hotel or a week. We did visit almost all of the places on his list, all of which were great, especially the zoo! And I spent the majority of the week just trying to be patient and wait for the day that the cast would come off.
The day of the cast removal I was super excited...

I had already started to see the changes to my lower tip while the cast was still on. My tip was still swollen but I could tell that the hanging columella was no longer there, which was such a big improvement in itself. Remember, that was ONE of the three major problems from my initial procedure. He removed the cast and advised me that I was still very swollen and then after he cleaned my nose and removed the cast/tape, he brought me in front of a mirror to show me where the swelling was most prominent and what changes I could expect to see as the swelling goes down; where the different reductions would take place. I was so blown away by the fact that I no longer had a hanging columella that I almost didn’t care about anything else… Plus, I was still so swollen that the obvious fix was the columella, it was too early to be able to appreciate anything else as it all looked still very large. And yes, I did notice that my nose still appeared somewhat long, but again, he explained how all of that was due to swelling and that I still had 3 or so mm of reduction that would take place as swelling went away.

I was so happy with what he was advising me and again trust was what I had and still do have in him. During this visit I asked if the changes would be significant enough to achieve the result we set out for, and he says that’s why he took the photo on the operating table, because he was so impressed with the results the photo was a reminder of what my nose looked like before the cast was put on and the majority of the swelling had kicked in. So something to keep in mind that this is what I was to look forward to once the swelling goes away… I remember feeling over the moon and I remember giving him a big hug, because I was so thankful and grateful everything he had done.
I got back to Maine Thursday, April 27th, and although I knew I was still swollen, I was so excited to see friends and family and just let them see how much of an improvement there was. I remember emailing Dr. D that day I landed back in Maine and letting him know I had made it home safe and that I would be keeping him posted with my progress as he had asked.
As the changes were taking place every day, I began to get concerned with what I was seeing. I didn’t want to feel like I was that patient that has to constantly get their doctors reassurance that everything was “ok,” but the concerns I began to have were bringing me back to the feelings I had immediately after the cast was removed from my primary procedure. My nose was and still is noticeably over projected, the tip is still bulbous, and my entire nose, especially the nostrils, are very uneven.

I contacted Dr. D with some photos to express the concerns I was having, and he did as I thought he would, and reassured me that I look great and that this is 100% all swelling that is causing this. He also advised that I still had more swelling than what is average at this point. Well, ok, I can live with that, it’s only been a little over a week out from surgery and it’s still definitely early – agree 100%.

As another week went by the changes started to get worse, as in zero improvement aside from the fact that my nose no longer had a hanging columella. I really wanted to trust that this was only swelling, and part of me still does, but I went through this procedure once before and I remember the being swollen stage and how I could tell what part was still swollen from what part seemed not so swollen. I again reached out to Dr. D to let him know what I was noticing and he continued, and still does to this day, to assure me that ALL of this is swelling.
Today is 4 days shy of being 1 month post op, and I am still not sold on the results of this surgery… As the swelling continues to move around, the shape and size of my nose continues to be just as long, over projected, and uneven and even more so noticeably uneven as the swelling goes down (although, I am assure that this is ALL swelling still.)

I do want to mention that Dr. Denenberg NEVER makes me feel like I am bothering him or that my concerns are not being heard, and he still continues to encourage me to keep in contact and to send photos of the progress. He is still confident that the results will be drastically better than they are today.
Initially, I wanted to do this review the first week while I was recovering, as a way to give back to the site and to help others to be informed of this procedure and what to expect, and tips etc. However, I decided to wait it out and see how things go before I put myself out there as an example for others. I am still hoping and praying that this whole outcome takes a 180 from where it’s at today. I am still not seeing any improvements whatsoever, again, aside from the columella hang. I even went as far as to say I would take the old nose back because at least I was use to what I was miserable with… It feels like I am readjusting myself to feel comfortable with being unhappy with something that is just as bad as it was before, if not worse.
And as you have read this review I hope you get a sense of where I am at, and the emotional toll that a procedure like this can have on someone. I am not prepared to post photos just yet because I still want to allow more time for healing to take place. Also, part of the reason I am holding off on photos is that I don’t want to deter anyone from seeking surgery with Dr. Denenberg. This review is strictly to share my progress and express where and how things are going thus far… I promise I will finish my review once more time has gone by, and I promise to share photos with you when the time is right. I think to share these photos now would be a disservice to other patients that are strongly considering the procedure and Dr. D and it would be morally unethical and an unfair assessment of Dr. D’s work given how early in my post op I am. I have a lot of respect for Dr. D and I can’t say enough good things about him. He is kind, genuine, he is funny, and he is passionate about his work!! He tries very hard to educate patients about going into this procedure and what things to look out for. The same site I used when I was doing my own research (facialsurgery.com) I highly recommend reading his FAQ on how to stay out of trouble when searching for a rhinoplasty/revision rhinoplasty specialist. I do trust Dr. D and he reminds me that he is right here with me in this process. He never makes me feel my concerns are not heard, he knows exactly what I am saying and how I am feeling and assures me he is right there with me in this process.. What more could a patient ask for in a doctor?
I really wish I could be one of those amazing journeys that you read about on this site, and then when you see their B&A’s you are utterly amazed by how such results are even possible. I am definitely not feeling like one of those “wow” stories today, I am not even feeling a half a wow today; hence, the reason for the “not sure” at the top of this review. However, I am still absolutely hopeful and still having faith that I will be back to finish this review soon so that I can turn what is feeling like a “not worth it” into a review that ends on a good note, or at least a “worth it.”

Still waiting

I just wanted to touch base with all and let you know where I am at. I can't honestly say that I am happy with my results, but I am also not saying it's worse than it where I started, either. I think there has been improvement, but not as much improvement as I was hoping for. My nose is still noticeably prominent, as far as projection and tip being bulbous. As I was commenting earlier, I am at 3 months and 2 weeks since my surgery, so I continue to hang in there and hope that eventually things will turn themselves around as time progresses. I don't necessarily regret my decision to have the revision, but I would be lying if I said I haven't already started contemplating how to further correct what is still concerning to me. My nose started out over projected, with a hanging columella. The columella was addressed, but my nose still looks much longer than expected, and my tip looks quite bulbous... I don't think I traded one bad nose for another, but I think more could be done to get the results I was aiming for from this revision. I still think Dr. D is a great surgeon, but maybe my case was more complex than I thought it was, so maybe this is the best we could accomplish. I like to think that I have seen much worse than this, and results that turned out by far better than mine, so I still am of the mind that I am not at a loss just yet.

Not what I was hoping for....

So, it is now a little over 4 months, and the direction things are going are not ideal. The kenalog injection helped with swelling of the bridge, some of the tip, but the nose itself is still quite long and the tip is still over projected/bulbous. The ONLY benefit I feel I got from having the revision was the correction of the hanging columella. I am going to wait the year out and look into having it refined some more. I feel like we didn't address all the areas of concern, and the more the nose beings to come down from swelling, the more noticeable it is. I really do think that Dr. D did the best he could, he is a compassionate doctor, but I am just not happy with the results of my surgery and I wish I could say that I was. I was starting to be hopeful when I saw how much swelling was coming down, I thought that it would also correct my projection and length, but that's not at all the case. Maybe it will eventually get better, but I am not holding my breath at this point. I think if you are considering this procedure, and if it is tip work and/or deprojection that you are concerned with, look at before and afters of patients that have noses similar to yours before deciding to go with any doctor - no matter how good they think they are.

Ok...Here are my results..

I also included the simulation that he and i went back and forth on, and this is what we were both comfortable with...

As promised...

Simulation that we agreed on... sorry, i meant to add it with the others... this is what he and i agreed on, and although i think we kind of came close, it's not where it should be.... I am not happy with it... I thought that it was getting smaller, but the swelling has come down on the bridge, but that has actually made it even more noticeably bigger on the tip and the length... I don't want to say i regret 100%, but as the tip starts to level downward from the swelling, you can see that the projection and the size are still not addressed as planned... It's frustrating for sure, but what can i do besides wait? I really hate to attempt this again and have it be just as bad, i really just wanted a much shorter nose.. the frontal is actually the worse, because it's so uneven... I will post that one, too... (sorry for the terrible grammar, i am in a hurry!)

Revision specialist I previously considered...

I thought I would give some of you a list of the specialist I have either seen in person, or am going to go see.. I am strongly considering Dr. Glasgold for the revision next year, I almost went to him this last time, but instead decided I would go w Dr. D because I thought he may have more revision experience. Which, he does have more years of experience, but I know that shouldn't have been the reason to go with one over the other, or so I know now.

Still disappointed

I think one of the biggest disappointing factors is that this procedure is not cheap. I wish we got what we paid for because Dr. D charges more than other revision specialist. Plus, the cost to travel to Omaha, the cost to stay in a hotel for a week, the cost to get blood work done (not coveted by insurance)..... All things considered, I was hoping for much more than I feel I walked away with. I know surgery is a gamble, and there's not guarantees, but it just leaves a bad taste in your mouth when you feel like the doctor feels there's nothing else/more they can do for you, everything was "just where we wanted it," which leaves me to believe he and I were not on same page as I had believed. I still think he's a good person, I don't blame him for having an opinion that he may feel this is a good result, it's just not the results I asked for, nor paid for.... Both financially and emotionally. I hope eventually things get smaller,but I'm not holding my breath. I strongly believe my expectations were within reason, and realistic. Thank you to everyone on the forum for being my sounding board, and being positive... I greatly appreciate your support, it has most definitely helped. Thank you!
Omaha Facial Plastic Surgeon

Dr. Denenberg is a very special doctor and one that cares deeply about his patients and their results. He is hands down one of the kindest doctors you will encounter, and he truly makes you feel as though you are his only patient. He goes above and beyond to remind you that he is with you through-out this process and he follows through on his word. Dr. D is good at making what would otherwise be a stressful situation, a far more manageable one, due to his calm and confident demeanor. I think you will be very hard pressed to find a better surgeon who treats their patients as good as Dr. D .

2 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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