Get the real deal on beauty treatments—real doctors, real reviews, and real photos with real results.Here's how we earn your trust.

POSTED UNDER Sinus Surgery REVIEWS

This Doctor Causes Empty Nose Syndrome - Seattle, WA

ORIGINAL POST

This guy gave me what is called Empty Nose...

etepesq
This guy gave me what is called Empty Nose Syndrome which is a medically surgically caused problem. It happens after over aggressive nasal surgeries. In 2006 I saw him with problems of basic nasal congestion and after failure to respond to sprays, he talked me into a "Sub-Mucosa Resection" which is generally accepted as the best procedure with minimal risks. The only problem is that is not what he did. While I was asleep, he did a "Sub-total Turbinectomy" which is a completely different procedure. SMRs are supposed to reduce nasal turbinates from within and preserve the 3D shape and continuity and function of the mucosa tissue. What he did was cut them off with scissors leaving me with stumps for nasal turbinates. I felt worse after the surgery. My sleep got worse. Breathing felt absent but I didn't know what Empty Nose was then because I was never warned. ENS is a debilitating condition that gets worse over time, generally taking as much as 5-8 years to fully manifest itself. This guy ruined my life and has caused me constant suffering. I saw him 6 years later and he told me "people in the desert had their turbinates removed and were fine". There are many studies out there regarding turbinate reduction and most plead to be conservative but this guy believes in the most aggressive studies and that is what he does. he cuts them out, so stay away from this guy and keep your health.

He believes in radical turbinectomies. Do not let this guy give you Empty Nose Syndrome and ruin your life. ENS is one of the worst things you can have. It causes constant suffering: Anxiety, muscle weakness, disrupted sleep, panic attacks while sleeping, constant feelings of suffocation and dryness and related nerve pain.

etepesq's provider

Ludwig A. Allegra, MD

Ludwig A. Allegra, MD

Board Certified Facial Plastic Surgeon

etepesq rating for Dr. Allegra:

Overall rating
Doctor's bedside manner
Answered my questions
After care follow-up
Time spent with me
Phone or email responsiveness
Staff professionalism & courtesy
Payment process
Wait times

Replies (12)

User Avatar
May 4, 2015

I'm sorry you are suffering. Thank you for sharing your experience on RealSelf.

October 24, 2015
Angie: Thank you for hosting an honest place to discuss things.
User Avatar
May 29, 2015
This individual underwent a relatively modest reduction of tissue to improve his breathing. He felt initially that this was inadequate and proceeded to have additional tissue removed elsewhere. It is unclear why there is no voiced concern regarding the subsequent surgeon. This concern has been exhaustively reviewed and he was in fact treated appropriately, consistent will all standards of care.
August 10, 2015
October 24, 2015
Hey Doc, With all due respect (none) You removed HALF of the ITs yourself. I have the CT scans. You left me with STUMPS for nasal turbinates. I had agreed in writing to an SMR which is a mucosa preserving procedure which has it's own CPT code which specifies preservation of the mucosa. You performed a Sub-total turbinectomy for basic nasal congestion as you have done to many others and it is a horrible idea and a bad place to start. You are apparently too lazy or unskilled to raise flaps and prefer simply cutting them off with scissors. I felt so bad after your surgery that I sought another opinion from the first guy I saw Stanley Herschberg and he as many of you ENTs unfortunately think that if you can't breathe though your nose that the answer is to take more. You are not alone, but you are one of the worst and I think about you EVERY night that I can't sleep and every day that I am weak. You are extremely misguided and dangerous.
October 26, 2015
Maybe noses are just too hard for you.... Perhaps you should just stick to Liposuction..
May 10, 2017
Dr Ludwig, you can squirm and twist all you want, but the bottom line is you did not explain to this person what the turbinates are before the surgery. That is not informed consent and you know it.
August 10, 2015
October 26, 2015
Here is one of the Empty Nose studies and the analysis there matches mine almost exactly for both Normal and Empty nose conditions. The analysis I showed for myself (above) was from models built from my CT scans before and after YOUR operation! You caused my Empty Nose for sure as my breathing sensation felt absent after your surgery, my sleep got drastically worse and breathing through my nose became hell on earth causing me to seek a second opinion (Stanley Herschberg) who no doubt made things worse but you caused it to start with FOR SURE. Why don't you read it and learn something? perhaps stop messing up people's lives? and perhaps start taking informed consent seriously before you get sued. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0084243
November 23, 2016
Poor you. Thx for sharing.
UPDATED FROM etepesq
5 years post

Dr. Allegra, Here are the CT scans

etepesq
Here is your work. Live with it. I have to live with it every day. This is before and after YOUR surgery. My sleep was already worse and I already had many ENS symptoms already but didn't know what ENS was yet. I obviously wish I could take back Herschberg making it worse but YOU already caused it. Sleep isn't supposed to get drastically worse. I remember having no feeling after your surgery and that breathing felt absent. That was you.

Replies (0)

UPDATED FROM etepesq
5 years post

Dr. Allegra DID in fact cause my Empty Nose Syndrome

etepesq
I work in engineering at an Aerospace company and I have done my own CFD (Computational Fluid Dynamics) analysis on air flow through my nose before and after Dr. Allegra's surgery. There have been many CFD studies done by universities and they generally show that the velocity of air through a normal nose in in the vicinity of 200cm/second. My analysis prior to any surgery was very close to those values which gives my work validity. Following Mr. Allegra's "surgery", local velocities declined by as much as 75% !!!! (see attached charts BLUE is before Allegra/RED is after) Air flow patterns changed from that of a normal nose of air distributed through the upper/middle and lower to an extreme drop of in the upper and middle and a very low flow through the hole he left in the bottom by cutting out my Inferior turbinates. Mr. Allegra quoted me a study where people in the desert had turbinates removed and they were fine etc. This is a minority opinion from a study in the Middle East and it appears he based his life's view on this. This is a minority opinion not shared by most of his peers. That aside, Mr Allegra had a duty to follow informed consent laws and at minimum explain what the function of your nose is (heating, humidifying and filtering air for your lungs). He mentioned none of these basic functions and convinced me that turbinates were useless structures that were in my way. Next, even after I agreed in writing to an SMR (a safe procedure) he performed a radical sub-total turbinectomy which is a much higher risk procedure. He failed to follow informed consent laws by misleading me about even
basic functions of the nose and he mentioned no risks about Empty Nose or even a dry nose, then he performed a procedure that I never agreed to. My breathing felt worse after his surgery and while I did foolishly accept someone's second opinion a year later to take more tissue, it was because I felt worse and the damage was already done. This guy is a NON doctor, NON scientist and falls below the standard of care. Stay Away!

Replies (8)

April 4, 2016
Can u tell any place in Asia or India where I can get this CFD test done.plus you can visit Dr. Steven houser he seems to treat ens.
September 20, 2017
I'm starting to suspect I have ENS, have also come across Dr Steven Houser.
September 20, 2017
Unfortunately I'm miles away as I'm in the UK.

I know I need to get a CT scan I'm currently waiting an ENT appointment. My symptoms are, nasal dryness, chronic pressure feeling in my nose, frequent pain, nose feels strangely empty often, feel better when I'm lying down with my head on pillows.

Hope you get some compensation, medical help or both.
June 28, 2016
My nose is ruined also. I can't share the scientific's of it, but I'm actually scared of what will happen when I am reaching the debilitating ages and how the hell am I going to breathe as an old bed ridden person (if it should go down like that). I've developed the breathing terror you have as well. trying to get to sleep and your body relaxes as it should, so you can't flex your nostrils like you have to normally, to open some part of the passage that remains. I had a surgery when I was 17 because I had a bump from being hit in the nose a good handful of times. That went well and I didn't have the issues that my ENT caused with my surgery 4 yrs. ago. I trusted this man to know what he was doing. I had nasal polyps and didn't know what that meant, but I wasn't bothered very much as far as I could tell about that. My issue was at bed time. When I would lay down to sleep, my nasal passages would pressure or swell. I used the breathe right strips, and that worked. I didn't want to be dependent on them for my entire life...but now it's horribly worse. He also was displeased about the little line down the tip of my nose, that I actually liked ! He was telling the nurse about it while examining me...about how they USED to do that, and basically he didn't like it. Now, what he was supposed to do to help me was take cartilage from in my nose, or my ear, and put it on the bridge of my nose in a way to keep it open. He told me everything was going to be done through the nostrils, because I was concerned about scars etc. Well her tore the little do dad that separates my nostrils, so there"s a zig zag scar there and my nostrils are uneven for ever now. Also he made my nose so much bigger (to me) , that when it was over, when I looked in the mirror at my once cute-ish nose, I was now a nose with a face, instead of a face with a nose. It was devastating. He doctored the tip of my nose to take the line away, and I never agreed to that at all. He told me everything he was going to do, but never asked how I felt about that. Anyway, he used cartilage from my nose and not ears. What I ended up with was a stripped and scared nasal passage with a larger obstruction inside my nose. The cartilage only took up space and does not open my airways...quite the opposite. I can feel with my fingers, when I put the tip of my thumb into my nose and my forefinger along the nostril, a mass. They are uneven as well. One side has a bigger mass. This never opened my airways or eased my sleep. It's a life sentence of dry passages, breathing issues and traumatic anxiety as my body feels it's being suffocated! I have to jump out of bed at night and shake off what is happening to me, with my heart racing and my mind so tired. It truly makes me wish I could just die and not have to deal with the oxygen loss and consistent ongoing sleep deprivation. This surgery left me with unsightly bumps that are visible on the bridge of my nose....they are especially noticeable when I smile. I also had tortuous dry nasal passages that literally felt like fibrous twine was lining my nose. I did have resolve (never fully) with the use of coconut oil in my nose. That was a life saver, only strangely enough the processed coconut oil works better than the organic virgin variety...but if you have issues I would recommend the virgin due to it's anti-fungal properties. The majority of sinus infections are not infections at all, but an overload of fungus and should be treated with anti-fungals, NEVER antibiotics. Antibiotics exacerbate the issue and cause disbiosis (altered bowel flora). THEN, you are going to be sick over and over as you gain more and more weight. Just a bit of real info there. As well as all of his lack of talent as a doctor, I was forever changed by the anesthesia. I lost feeling all over my body. Not entire loss, but a dull lack of sensation all over including my genitals. When I washed my hair, I could feel the pressure on my head, but the normal feeling of fingers on my scalp was gone. My nose loses feeling and tingles at the tip, and the precautionary antibiotics I was put on after the surgery dried my body out profoundly and gave me disbiosis that I have not fully, and may never fully recover from. I started breaking out on my back, which is something that never happened to me before. I knew it was due to the antibiotics because I have been studying health and fungus for years prior. I immediately gained 10 pounds, and I have a 5'2" frame. During the rest of the first year after I gained an additional 10 pounds! Now I am a health conscious person, who knows good from bad foods etc. I could not lose the weight ! And I started losing hair and had strange soars on my scalp that just stayed like a crusting. I'm a woman, although this comment link may say otherwise. The disbiosis caused my once very health vaginal area to dry up. I used to have a very healthy system with more moisture than I knew what to do with...but clean, no infections, etc. It caused me to lose my sex drive and the anesthesia caused sensation loss.....so thanks for that nightmare Doc. My health deteriorated and my aging really amped up. This assault on my system caused gray hair as well...for real. I was so happy before the surgery. I was energetic and exersizing and socializing a bit...then it's like I had to join the elderly world of all sorts of symptoms and dramatic aging. Every single morning I would wake and think of what has been done to me...no joke, every day ! I just wish this A hole would have never put his lying hands on me. Now although some have my issue have improved (do to implementing supplements and probiotics and digestive enzymes, I'm still left with my breathing like 4 times worse than it ever was, and a dependency on the nasal strips that now don't work as well as when I had my cuter more functioning nose. OH MY GOD TOO, I was hoping that the surgery would improve my singing voice....was REALLY hoping to sing more beautifully, but nope, now I have a nasal singing voice and find myself tugging on my nostrils to get a breath that doesn't restrict. The mass inside my nose is about 3/4ths of a centimeter by the way my fingers feel, when I use my thumb and forefinger on the outer part and inner part of the nostril. You can imagine, pretty much real restricted breathing. Plus, oh my God, I and everyone else has to HEAR me breathing now!

Kathleen Las Vegas, Nevada
November 16, 2018
February 19, 2020
The comment above really helped me to understand the inside of my nose and what goes on with breathing.

The comment only showed what this man went through with this doctor and really feel it is important to Real Self to allow BOTH SIDES of a situation to be shown.

I do understand the Real Self policy and Code of Conduct and I wish you would reconsider keeping this persons post up.

The photos help so much.

The controversy help me formulate my questions for my doctor.

The troubles this person went through are what happened to him and he describes his data and experience. That seems like that would be top priority and be a reason Real Self exists.

I think Real Self is a website for the people to gain important information from the patients after they have been seen by the doctors Real Self has listed and others recommend and if others do not recommend it is important to know why too

Thank you!
February 21, 2020

So happy you posted this. Too many doctors get away with this. I believe the reason why they are still performing these surgeries without consent even is because it is what makes them money and also because they are so heavily covered - legally and medically.

I am so glad you did cfd tests. Curious if you did any acoustic rhinometry tests as well... I am assuming that you did. And have you gone to the mayo clinic?

I am actually in the midst of a heavy case of this myself after negligence after an aggressive outfracture. It was the scariest thing I've gone through. After a year of wondering what the hell was going on and my doctor (who resides in Virginia) said nothing about it, I had no idea what turbinates were, but kept coming back to this ens that was alligning with nearly every symptom I had. The doctor got really pissy with me and blocked me in fact after I found out & gave him a 2 star google review. (which hey, it was an honest 2 stars right?) 

All I can say is - you deserve compensation for the permanent damage and most importantly your pain & suffering.

Is there anything you have done treatment wise that has helped?

Have you considered implants??

I have done a lot of research myself and have had a lot of aid in healing myself. I also have an idea that could potentially cure the whole thing and I am certain doctors could perform it but currently are not at least to my knowledge.

We may in fact belong to the same ens group on Facebook.

But I wish you all the best.

God bless you

Lexa