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POSTED UNDER Asian Rhinoplasty REVIEWS

Cons outweigh pros. Choose your doctor wisely...

ORIGINAL POST

I've had many issues with the way I looked, so I...

s991
$9,200
I've had many issues with the way I looked, so I finally decided on rhinoplasty this year (note that I had fat transfer and buccal fat reduction too, but I'll describe the rhinoplasty first). Shout out to Shakibabe88 for her thorough review, and I hope my review can be of help to other people, even though I have mixed feelings about my results. While some of my comments seem to be critical, please know that I do somewhat like my rhinoplasty results, but there are many caveats that I hope my help some of you when planning for rhinoplasty.

Initially, I had only been interested in alarplasty due to the wideness and droopiness of my alae (which is caused by a slightly retracted columella, if you see in my earlier pictures. During the consult with my doctor, he suggested augmenting the tip and lengthening the columella to help with the droopiness and spreading of the alae. Some cartilage would be added to the bridge to give a bit more definition. A slight alar base reduction would also be performed. I stressed that I wanted only slight modifications to my nose, so that it would appear natural.

I had surgery under local anaesthesia... which is common, but definitely uncomfortable; I should have probably opted for general anaesthesia or for some type of sedation and local anaesthesia. The nose is very hard to completely numb, so there were moments where I could feel painful pinching when the anaesthesia wore off. After surgery, my face was definitely swollen, as expected, although the pain was not so bad with the help of painkillers. I did look pretty disfigured though (puffy face, upturned nose) - --- try not to fixate on how you look coming out of the operating room! I know my self-esteem was pretty low the first month after surgery... Patience is definitely needed when trying to evaluate how your surgery went.

My initial thoughts of my nose, within the first two weeks of surgery were that it was too upturned and too augmented. This in effect narrowed my nostrils (augmented tip stretches the nostrils upwards), but also made my nostrils look slightly pinched, due to the existing lack of curvature in my alae. My doctor ultimately decided not remove part of the alar base so that I would not have slit-like nostrils. I realized that swelling causes the nose to be upturned, and it will take awhile to return to "normal", whatever that means. Swelling around the temples and zygoma due to the fat transfer was perhaps the most upsetting for quite awhile because I looked like a muppet.

Fast forward to nearly two months after my surgery, here is what I think:

Pros:
1) My nose no longer appears to flatten or lose definition when I smile. Having the tip projection helps give me somewhat of an alar crease, which was what I was looking for, so that when I smile, I have a defined nose.
2) My bridge gives definition to the eye and brow area, at least in my opinion

Cons:
1) My alae seem to droop even more now that my tip is rotated up (I think I had cartilage added to my columella, which fixed my retracted columella, but this did not address the issue of drooping alae sufficiently). This detail was most important to me, as I wanted my alar base to be parallel to/flush with my columella (I was hoping that alar base excisions could also move my alae slightly up, if that makes sense, to make my columella look less retracted).

2) most of the swelling went down, but one side of my nose looks too projected versus the other; it isn't super obvious until you start turning my head to a 3/4 view or profile view. The tip seems slightly crooked due to this asymmetrical swelling - I thought I looked normal at this point, but looking at some recent pictures of me, my nose looks slightly "done". I know that the swelling will take awhile to resolve, but I think any changes to my nose after this point will be pretty subtle; we'll see in a year I guess, and I will update everyone.

3) Long upper lip and drooping of corner of mouth more apparent. This isn't directly caused by the rhinoplasty, as I had both traits before surgery. But with a projected nose/tip, those problems are slightly exacerbated. This is probably the worst side effect I think, because it contributes to an unnatural look. I'm considering depressor anguli oris muscle release or worst case a lip lift to fix this in the future.

Yes, I have a lot of criticisms, but I think most of them are directed towards features that were already a part of my face. The rhinoplasty was effective overall-- I think the doctor applied the necessary and standard techniques involved in asian rhinoplasty, but I do wish I had considered how the rest of my face would look in relationship to my new nose. In general, my nose still seems overprojected (slightly, but surely), and since my mid-face and upper lips are pretty flat, my nose definitely sticks out. Going forward from here, I am considering very small cheek implants to fill out the midface. I will try to give updates every month! :)



Some opinions on Fat transfer: It was a great idea to get some subtle volume, but not the type of structural support I was looking for. Most of the fat in my cheeks disappeared within the first month. At least that gives me the indication that cheek implants may be a better option. Although my doctor also added fat to the temples, forehead, and zygoma to blend the fat transfer results, I think I should have veto'd the addition of fat to my zygoma much harder. It made my face look wider :/ I understand that this technique may appeal to my doctor's sense of aesthetics, but I respectfully disagree with adding any fat to the sides of my zygoma.

s991's provider

Chase Lay, MD

Chase Lay, MD

Board Certified Facial Plastic Surgeon

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Replies (12)

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June 1, 2015

I'm sure your review is going to help many others going through this sort of rhinoplasty. Thank you immensely for sharing on RealSelf!

June 23, 2015
You are a pretty girl before and after the surgery. Your before nose was already a nice looking asian nose and the after nose is cute too. I also think you have a pretty face shape and don't think you need any cheek implant. You are a pretty girl without any surgery!
July 13, 2015
I'm pretty sure your before and after photos are the same pic, except digitally altered in the after? Why would you do that?
July 14, 2015
So that picture was sent by the docs office. Ignore the picture on the right, because yes they basically altered my photo to give a prediction- hope that clarifies!
July 14, 2015
some doctors offices will give photo predictions after their consults that's why
February 6, 2016
Oh thanks for the clarification! Sorry for coming off kind of rude, now I feel stupid lol
July 28, 2015
Thanks for sharing. I'm also an Asian female thinking of very subtle rhinoplasty just to increase projection of my tip with my own cartilage.... You're review has helped. I think you look great!
February 3, 2016
you are still a very beautiful girl!
UPDATED FROM s991
1 month post

Effect of tip projection on nostrils

s991
My nose tip is still a bit hard and stationary, but you can see that when I frown slightly, the projected tip tends to pull on my nostrils, making slit shapes. Hoping my tip goes down

Replies (1)

July 28, 2015
I think you look great and natural.
UPDATED FROM s991
1 month post

before pics

s991

Replies (4)

June 13, 2015
As far as doing something to increase projection in your mid face, I would experiment first with denser fillers like Voluma in the cheeks before you consider implants. Cheek implants seem to have a very high dissatisfaction rate, and there are some outright disasters posted on Realself. Plus if you remove them, it can cause lots of issues like sagging. If you like the look you can get implants down the road. Good luck.
June 13, 2015
Thanks for the suggestion! I'm definitely going to approach changing my facial structure very cautiously, weighing several options- especially since some of my facial proportions have changed -in good and bad ways. I'm not entirely satisfied yet, but hopefully I'll gradually get there.
June 13, 2015
I think that's wise. With fillers you can make little adjustments at a time. As the saying goes, beauty is measured in millimeters, and little adjustments on just one feature can have profound unforeseen effects on the face. I will also add that you still have a ways to go to see the true final result, and it might be good to let everything settle before changing something else.
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October 20, 2015
I think you look beautiful in every pic! I don't see what you see!