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Jamil Asaria, MD
Certified Facial Plastic Surgeon
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Complex Revision Rhinoplasty - update to original post Dec 2013

I mistakenly posted this first in the comments section.....
I just wanted to follow up on my revision rhinoplasty performed Oct 30, 2013. This was a big deal for me, a very big deal. The fact is, anybody electing to have an initial rhinoplasty (as I did 30 years ago) has spent more time than most looking at their nose in the mirror, from all angles, and that's probably putting it mildly, let's be honest. The hope is that following a successful procedure, you'll be happy with what you see in the mirror and that obsession will fade. If the surgery is disappointing or leads to functional issues, or both as in my case, the impact can be kind of devastating, even humiliating. The surgery was elective of course. Everything was working just fine, and in my case, my ‘strong’ nose suited my face and ethnicity just fine. But I was young and rash, and reason didn't manage to punch through that thick layer of vanity, until afterwards when it landed a punishing blow indeed. I felt like a fool as well as having this now foreign, weak, poorly defined nose that no longer even functioned properly. Time wasted in front of the mirror only multiplied, and served to strengthen an already poor opinion of not simply my nose, but my whole, pathetic self. The self that set out to improve what didn't need improving, that spent his time obsessing about petty, childish, foolish notions while the world around me moved on with serious matters that give a man real worth. But, time does heal and you move on, hobbled in some way. I would always think back and wonder what I would have been like if I had never done it, but that too is time wasted.
30 years on, I started to seriously consider trying to correct that mistake. I got a referral from my GP to an excellent ENT, who in turn referred me to Dr Asaria in Toronto at FACE Cosmetic Surgery. He’s clearly a rising star, a relatively young man by the standards of the trade, but still down to earth, and really a nice guy. I wanted function restored as much as possible, although I knew that after the hack job 30 years back, restoring function 100% was too much to ask. To give you an idea of the extent of the damage done, I used to love to sing prior to the original surgery, and apparently, I was pretty good. That ended abruptly. It broke my heart when I realized what I had done. I also wanted to restore some of the strength my old nose had. The very thing I thought made it ‘ugly’, was what I wanted back most. I went from having a large Roman nose with a nice bump perfectly placed, full of character, to a long, thin nose with little definition and a slope – it seemed to me so foreign and unnatural. I felt like my face had lost its best friend, not by a fateful accident beyond my control, but by design, by choice, my choice. The surgeon did a terrible job, but it never would have happened had I simply moved on from that silly obsession in the first place.
Anyway, back to Dr Asaria. The revision surgery required rib grafts and their meticulous sculpting. What took the original surgeon approx. 20 minutes to destroy 30 years ago, under a local anesthetic, required 6 hours under a general to repair. Dr Asaria did a great job, he really did. I told Dr Asaria I wanted a strong, functioning ‘Roman’ nose, even if it couldn't be exactly the one I foolishly betrayed. He didn't disappoint. It’s almost 18 months later and I’d say it is 99% final. The swelling post op was huge, but just as he said, 90% of it had resolved itself within 3 months. That last 10% takes a long time to settle and resolve after a complex revision with grafts, especially the tip or lower third. But it’s that 10% that will really make the difference. That’s where the subtlety of a great surgeon’s genius lies hidden. It is artistry meshed with science. Competent is nice, great is better, much better. Dr Asaria is great. I really don’t spend much time staring in the mirror anymore, but when I do I always smile just a little in deference and gratitude. I will always wish I could go back in time and reverse that stupid decision all those years ago, but try as I might, that isn't going to happen. My nose no longer feels foreign or unnatural, despite the fact that it kind of is really, when you think about it. Rib cartilage used to shape and support a new nose? Hardly natural, but all the more impressive precisely because of that fact. In the Abrahamic traditional telling of the creation myth (Judeo/Christian/Islamic), it is said that God took Adam’s rib while he slept, and from it created woman, Eve. That’s very impressive, a miracle! Dr Asaria is only a mere mortal of course, but fashioning a perfectly natural looking nose from rib cartilage is a pretty darn special talent if you ask me. Function is also much improved, I can even sing again, a little bit anyway.
FWIW, my advice to a young person thinking of cosmetic surgery is to wait. Make it through your twenties, or at least half way, and see how you feel then. No disrespect intended, but maybe you just need to grow up a little. You may still elect to have it done, but it will have been a more thoughtful decision, made by a more mature mind. This forum is testament to the fact that these things don’t always work out as intended, and the results can be devastating. If and when you do make that choice, take your time finding the right surgeon, have all your questions answered and don’t feel pushed. In this city, Toronto, Dr Asaria is the surgical artist you want, IMO. Be patient following the surgery, I can still see very subtle changes month to month. But a year at least is absolutely necessary in order to see the finer touches reveal themselves.
I’m afraid I really don’t feel comfortable posting photos, even tight shots, I just can’t do it. Maybe it’s my age. I don’t even keep a Facebook account, which is probably beyond comprehension for many of you youngsters. Sorry for the lengthy post, and thank you once again to Dr Asaria. Signing off now to enjoy the rest of my life. Good luck with whatever you decide.

Being young, vain and foolish, 30 years ago I had...

Being young, vain and foolish, 30 years ago I had a rhinoplasty on what was a perfectly imperfect nose. Results were poor, both aesthetically and functionally. It left me with a collapsed vale and impaired airflow. What was supposed to strengthen my self-esteem pulverized it for years afterward. So, the decision to have this corrected was a big deal for me, hence the 30 years I guess. Dr Asaria came highly recommended by another physician I trust. I immediately felt comfortable following the consult and decided to proceed with the revision surgery. He advised it would take 4+ hours, which surprised me since it took about 20 minutes to ruin 30 years ago. In fact, he took 6 hours in surgery! My nose was a mess requiring very careful reconstruction. Dr Asaria took the time to do it right! This was very complex, detailed surgery that was done correctly and will last for as long as I do. I am very happy with the results, both functionally and aesthetically. I think he's a rare example of excellence and I don't hesitate to recommend him. And a really nice guy to boot!

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Certified Facial Plastic Surgeon
251 Davenport Rd., Toronto, Ontario
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Dr Asaria's surgical skills are clearly exceptional, he's something of a wunderkind I think. But what he does, if done well, requires having at least some of the talents of a Michelangelo as well. It's a rare blend, scientist and artist working together in the patient's best interest. Dr Asaria did a great job, I am very grateful.