24 Yo. Profile Balancing (Rhinoplasty + Chin Aug. + Fat Grafting) - West Hollywood, CA

I'm somewhat pleased with my face up front but...

I'm somewhat pleased with my face up front but I've always loathed my profile since I was in high school. Taking pictures makes me uncomfortable and candid profile pictures always depress me because my profile is so ugly. I do have a great jawline and high cheekbones but they are flat anteriorly and thus my midface sags making me look kind of tired for my age. I've been wanting to balance my profile for 10-11 years now and I'm biting the bullet. I've scheduled my surgery for Oct. 22 with Dr. Gary Motykie. I consulted with one prior surgeon but he did not morph my pics and came off as arrogant and left me with more questions than answers. Dr. Motykie morphed my pictures to exactly what I wanted on first attempt and I'm so excited to have him fix my face . I know these are morphs but if he can give me results like this I will be extremely happy. The only procedure I'm nervous about is the fat grafting as I have thin skin and I'm worried the fat will cause lumps and unevenness.

Pre-op Appointment - good so far.

Hi all,

Just an update. I just had my pre-op appointment with Dr. Motykie for my procedures this morning. His office is located in a nice part of west Hollywood only a few minutes walk from Beverly Hills. The office was nice, clearly upscale and posh. Modern / minimalist decor. His logo/branding signature "M" is pretty ubiquitous throughout the office.

Upon walking in I was greeted by Diana, who was responsible for coordinating my payments and online consultation. She was warm and friendly, as well as the other lady I cannot remember her name - she takes your pre and post op photographs. I was handed my pre op packet containing consents / disclaimers/ agreements / safety disclosures and whatnot to read and sign. I saw quite a few of Dr. Motykie's patients walk in with their casts on for what I presume was their one day or one week post op visit. To my surprise they had very little bruising .

Diana went to the back and I was later greeted by Marisela, who was equally friendly and helpful. She prepared my prescriptions and gave me a brief overview of the medications and some instructions. She also suggested the pharmacy next door as a convenient place to have them filled prior to my surgery.

Wait time was not too terrible I think I waited about 30-45 min to be seen . My appointment was at 9:30 AM on a Wednesday so not sure how much of a factor that was.

I was later taken to the back by the afotementioned lady, she asked me a few questions in regards to medical history and allergy medications and then instructed me to pose for the pre op pictures against a black velvet background. She used a professional dslr high resolution camera for these. After a quick 5-10 min she later stepped out and Diana came in and asked me several more questions in regards to allergies and medical history. After a few minutes she stepped out and told me Dr. Motykie would be seeing me soon after. I waited about 30 minutes or so, it wasn't terribly long but certainly lengthier than the typical doctor visit. However once Dr. Motykie came in it was immediately apparent why this was the case. He takes his time with each patient. He walked me through each of my procedures and told me what he would do. He also made sure I had all questions addressed in regards to any procedures I was having done. For the rhinoplasty he asked me to list the top 3 things I wanted addressed with my nose. I mentioned I wanted the hump reduced, my tip to be made more refined and symmetric, and my nostrils to be symmetric. I also inquired in regards to the chin implant sizing and shape, he told me he would size me during surgery but generally for men he likes to align the bottom of the chin to the lip overhang, he also stated that for me he would utilize an extended anatomical implant for it to provide a seem less count our with the rest of my jawline. I also asked many questions about the fat transfer as that was the procedure I was most anxious about due to the unpredictable nature and worries of being overfilled. We went over carefully of where I wanted the volume and we both agreed on the same thing - my central midface was a bit deficient, he also assured me that I would not be overfilled, the goal was to make me look proportional and balanced. Furthermore he also gave me the option to morph the high resolution pictures overnight to emphasize the fat grafting and also encouraged me to make a list of things I wanted or forgot to mention or things I did NOT want and bring it to him prior to my surgery the next morning.

The consultation lasted about 30 - 45 minutes for me and I felt it sufficiently thorough to assuage any worries. As I was the first patient scheduled the next morning he also had the anaesthesiologist pop in real quick and do a brief questionnaire for the next morning.

I found Dr. Motykie very personable . I liked that he had a sense of humor. But most of all I was very pleased with his view on aesthetics and emphasis on facial balance and proportion. I truly get like we came to a good meeting point where both our visions were aligned and that he provided solutions for meeting halfway should it have been otherwise. Overall I felt my pre op appointment with dr Motykie was excellent and a relief given I was somewhat worried I would walk out of there feeing like he was not the "one" despite me having done an online consultation, paid the fees, requested time off and all the other logistics expenses.

After the pre op appointment I was led by Diana to her back office where she showed me some of the chin implants that would be used. She also gave me a brief run through of everything and ensured I left comfortable and pleased. She also handed me a "goody bag" containing a spa robe, a little bag containing some skin products, a bottle of arnica, and some probiotics - all with Dr. M's branding of course. She also handed me my receipts from my online payments and my Written prescriptions as well as pre op and post op care packet all in a nice folder.

Overall the experience was excellent and of quality. All the staff recognized me and acknowledged me without having to introduce myself which was a nice touch. I am not sure why some other reviewers rated their consultation poorly as I found everything excellent, Diana and the team were responsive and were fast in turnaround time - I was able to consult online from my initial email to having the surgery scheduled all within a months time (included pre op medical clearance and lab work etc).

I also thought it was extremely convenient they are located literally like 20 steps from a pharmacy where I was able to fill my prescriptions and get some saline spray and other post surgery conveniences.

I'm excited and absolutely looking forward to my surgery tommorow morning at 9:00 am. I hope the results are equally as excellent as my experience with all this so far. I'll keep you guys posted ! Estimated total surgery time for my procedures 2.5 hours.

Surgery Day .

Hi All,

I had my procedures done today. I was instructed to go in around 8:30-8:45 am as my surgery was at 9 am. I walked in with my friend but the front desk was unattended and we waited a good 15 or so minutes before anyone came out and handed me some more paperwork to sign. I was later taken to the back and given my OR garments by Diana and instructed to change and wait for the OR nurse and Dr. Motykie to see me. I waited a good 15 min or so before the photographer lady came in and took several more high quality pictures. Afterwards, the research nurse came I and walked me through all the procedures, medications, and post op care instructions. She also asked more questions about medical history etc. the anaesthesiologist came in after another 20 min and did another brief questionnaire - prior anaesthesia experiences, meds, etc. after about 5-10 min he stepped out and the nurse continued. Dr. Motykie later came in , reviewed everything , provided newly morphed pictures for further fat transfer appreciation and examined my face one last time. One of the surgery nurses later came inane escorted me to the OR - only a few steps away from my prior room. The bed was set, the anaesthesiologist conversed with me and before I knew it I was awake with bandages and a cast on my face.

Thus far I think the toughest part has been the dry throat after anaesthesia . It felt pretty terrible for me but I managed. I was a bit " hangry" as I had not eating anything in 16-18 hours or so ( I wasn't hungry much day prior) . The nurses brought me back to consciousness, though not sure if I was just cranky but I felt the older surgery nurse a bit hard of hearing and not as responsive as I would have liked. She was on her phone texting and talking to the other nurses but overall it was fine. I was a little frustrated my best friend and caretaker was a little late to pick me up and to top things off the uber driver was a bit incompetent and had limited English proficiency. I got to my hotel very much annoyed though I suspect the long fasting period + post surgery throat pain was not much help.

Anyways, surgery day went well. Not quite the excellent experience of the day prior but certainly still good.

Here's an overview of my experience so far:

Chin implant : i already love the chin despite the swelling I think the improvement is truly instantaneous. There is numbing/ tingling of the lower lip and chin. Which does not hurt but does feel a bit odd. Dr. Motykie utilized an intra oral incision at the gum/ lip junction so there shouldn't be any scarring.

Fat grafting : I noticed the increased volume in the exact areas I requested. My cheekbones look nice and defined/ contoured and I can tell it'll look great once the swelling reduces. There is so light bruising in the under eye/ upper malar area but nothing major. Dr. Motykie also utilized an intra oral approach for the insertion as this avoids the scarring and also reduce any chance of lumpiness and also easier to "blend" the fat. The fat was removed from a love handle area as that's really the only place I have much fat. There's a small hole at the site and minor bruising. I do feel slightly sore there like hitting the weights at the gym.

Rhinoplasty: Dr. Motykie noted my nostrils were uneven possibly due to a deviated septum, though he was not too sure and noted he would look when he's performing the surgery and address any deviation or turbinate enlargement which he said he would bill the insurance if the was he case and return the fees that would be covered which is nice. I like that he ensures that the nose is not only aesthetically pleasing but also functional. When I awoke from surgery I noticed I could breathe quite well , which pleasantly surprised me .

I will also add that I did not have any nausea or dizziness after anaesthesia and have been feeling better and better by the hour. My throat feels fine and I'm 4 hours post op. I managed to eat some lentil soup and potatoes just fine.

Bleeding had not been too bad but the swelling has increased slightly in particular the grafting area and the jawline area. Also, he did not place any stints. My rhinoplasty was also closed using intra nasal techniques.


Currently just resting at my hotel and laying low. I will post another update tommorow.

Post-op day 2 visit.

Hi all, I went in today for my post op visit to have the medical assistant clean my bandages and make sure no infection or issues going on. She also taught me how to clean my nose with hydrogen peroxide and a long q tip. I also found it quite nice they provided me with a bag containing more gauze, q tips, and hydrogen peroxide.

I'm surprisingly not too bruised still , although the swelling is still quite noticeable in particular he undereye/ malar area. Another thing I found quite surprising is that I have not had much pain since my surgery. I have not taken a single pain pill since my surgery. At most there is a very subtle dull ache and that's all. The numb lip and chin still takes some getting used to but it's not an impediment for me chewing solid foods.

Post op - day 3

Hi all, woke up this morning still considerably swollen though my friend thinks the swelling has improved. I'm still having considerable numbing of my chin and lower lip. My jawline is still swollen - evenly throughout. Nose feels fine.

I went for a casual 30 min - 1 hour stroll through Beverly Hills on night of day 2 as I felt pretty good and was not experiencing any pain. However towards the end of the walk a dull ache started to set in on my nose. I was not a sharp throbbing pain but certainly persistent and annoying. Furthermore after the walk I started getting extremely congested I wanted to blow my nose so bad. I decided to head back to my hotel and relaxed for the rest of the night. I did have to take one of the pain pills at this point because the dull ache was really starting to get quite annoying. I didn't have to much issues waking up this morning as far as having a dry throat goes. Day 3 has been okay, lots of swelling still present . I also went for a casual walk around town today and there is very little pain.

I do get a few stares or looks waking around town with the cast and bandages but I've equally gotten compliments and wishes for good luck from several people including some that have had their nose done recently. The looks don't bother me much .

Post op

Hi all,

No big update today. Still considerably swollen although I think I'm starting to see it subdue tonight at the end of the day. I'm also starting to see less blood and "ooze" on my gauze. I don't ooze much unless I go out for a walk and whatnot. I just took it easy today and stayed in, walked a few minutes over to a restaurant and had some Peruvian food .

I think of all things I'm more anxious to have my cheeks go down in swelling as they look huge. Hope I can look presentable within a week by the time I'm back at work.

Post-Op Day 4

Looks like swelling is starting to subdue slowly but surely. My upper eyelids aren't as swollen as the past couple of days. The bruises on my upper cheeks are starting to turn yellow.

I went for a brief walk this morning to grab breakfast and came back to my hotel where I napped for a bit. I also removed the gauze today as I did not have anymore ooze or blood.

The antibiotics are upsetting my stomach - I've developed diarrhea so I'm having to drink even more fluids. I've been supplementing with Dr. Motykie's probiotic supplement that came in the goody bag so hopefully that will help.

I did have to get out and go for a walk in the afternoon - I think the walls were starting to get to me. I was also over analyzing and I did start to have a minor panic attach about the fat transfer to my cheeks as they're still looking huge. I just had to remind myself that I am only four days post-op and most of the swelling is still present. I guess it didn't help to read other peoples unfortunate experiences with fat transfer (overfilled/uneven/etc) . I just need to be patient and trust that Dr. Motykie did an excellent job.

Post Op Day 5

Hi all,

I'm at post op day 5 now. Swelling and bruising continue to go down slowly but surely. I'm able to breathe ok out of my nose now, very minimal oozing and no more bleeding. The medial part of my upper lids are still swollen so my eyes still look very hooded. My jawline is still swollen as are my cheeks.

Im trying to keep my mind busy and active in the meantime otherwise I tend to start over analyzing and get very anxious . The biggest source of anxiety for me are my cheeks as they've shown the least decrease in swelling and they're still huge and I feel like I cannot recognize myself and look like Kris Jenner. The bruising on the cheeks has dissipated but they remain very big still. I'm unsure of how much of their volume is attributed to swelling but I'm hoping they decrease by at least 50% within the next week . Currently they are far too big for me and look overfilled and very feminine. My ideal goal I expressed to Dr. Motykie with the grafting was to address some of the undereye hollowness and to look more well rested as well as addres a flat left cheek. The areas that were augmented are correct but the volume still seems excessive to me. I guess not much I can do other than wait and see and hope most of this volume is swelling and that most of the fat gets reabsorbed. I've also noticed it's very hard to appreciate the volume in pictures. The pictures show very smooth and ideal contours but it's an entirely different thing when you're seeing it in front of you.

I'm due to have my cast removed in two days by Dr. Motykie before flying back home. I'll express my cheek volume concerns then if no change is seen. I believe they also mentioned that on the week post op they might do another steroid shot. I'm not sure if that's in regards to the rhinoplasty or just general swelling or if I can have a shot to reduce the fat transfer but I'll discuss with Dr. M at that time.

Best.

Post op - day 6

Hi all,

I'm now post op day 6 . As you can see swelling and bruising have gone down considerably. I'm looking more and more like myself. I've been going on walks daily to help things flow. Also drinking plenty of fluids and getting lots of sleep. Tommorow is the big reveal to get the cast off and I'm excited to see the turn out. Im happy with the chin and what I can see of the nose.

Despite this, I'm actually quite depressed due to my cheeks. If I could turn back time I would not have gone through with the facial fat transfer . Honestly I did not think enough about this procedure. I'd been wanting the chin and nose for 10+ years but only considered the fat grafting the last few months. What's worse is I did not try out other temporary fillers before trying the fat grafting . I wish I would have though it thoroughly and though I cannot blame Dr. M for fulfilling what I requested, I do wish he would have maybe picked up on my anxiety and barrage of questions at the time of my pre op and perhaps advised me otherwise. I am only 24 and honestly the fat graft is really not needed at all unless you're severely hollowed or looking to augment your cheeks. I do also realize I'm only post op day 6 and that fat grafting can take months before settling but I'm also afraid I'm young and these grafts will settle and heal rather quickly and the large volume will stay. I have had several breakdowns the past couple of days solely due to my cheeks as they are now far too big for my taste and I feel I look very feminine . I will discuss concerns and options with Dr. M tommorow . Right now I can only hope that the swelling will reduce and that the fat will atrophy to 25%-35% of the volume now present.

Best.

1 week post op

Hi all,

So today was the big reveal. I had my cast taken off today. My appointment was at 9:30 am but I was running a few minutes late due to the crazy LA traffic. The office was accommodating and was able to get me in shortly after I arrived 10 minutes late. Menal took me to the back and removed the cast off, she also gave me some tips and instructions to reduce the swelling and clean my nose as well as decongest it.

I'll have to admit the cast removal was really anticlimactic. You spend a week with the thing on and you're anxious to see what's under there and when you finally get it off you look even more distorted. Truly you look like a creature from the movie avatar due to all the swelling on the nose and eyes. My nose looked very flat and upturned and in addition to the swollen cheeks and eyes I looked like a pig . It was pretty depressing. I did get scared for a minute as I could not grasp how what was before me was to look like what was shown to me in the morph. Menal was comforting and assured me the swelling would go down as I was still very swollen, she also provided me with some Afrin and Claritin to ease the congestion and gave me a shot of dexamethosone intramuscular on my butt to further ease the swelling as I would be flying out the next day and that can tend to exacerbate the swelling. Diana and Marisela also came in shortly after to see my nose and chin and complimented me on how great everything turned out despite the swelling. Dr. Motykie later came in and looked over everything and said everything looked fine and that one of my nostrils was still uneven likely due to the splint squishing it but should resolve in time. He also assured me that it's quite normal for people to freak out about their appearing the first couple of weeks and that's it's normal for people to question their decisions as they cannot recognize themselves from all the swelling but he assured me things would turn out great and that the swelling should start to decrease quite rapidly over the next week or so and that by the first month I should be looking like myself and be quite pleased. He also added that things may go through a period of brief swelling and unswelling after the one month mark as they continue to improve. I did mention my cheeks and he stated that was normal as with the nose, that things would slowly settle with time.

To my surprise there were very little restrictions on the after care. Other than obviously hitting my nose or sleeping face down on it I was ok to smile laugh sneeze and whatnot. He also said it was ok to wear sunglasses and go to the gym but added that cardio should be kept to a maximum of 15 minutes for the first couple of weeks otherwise the fat grafts may completely atrophy.

I also asked in regards to a follow up visit since I live out of town and he stated that for out of town patients he likes to see them within 1-3 month time frame and then finally at the 6 month mark. He was also very flexible and stated anytime works fine whenever I'm in town just to call the office to coordinate it. He also encouraged me to send him pictures of my progress and give him a call or email should I have any questions or concerns.

Menal also suggested I try out the infrared sauna for free at the spa to help decongest and reduce swelling. I was given a warm farewell and a hug by the office staff and encouraged to come back soon.

All I can say is it's been a definitely interesting experience. A bit tougher than I anticipated as this is my first surgical and face surgery experience and truly there's a lot more psychological stuff that goes into it that I wasn't quite prepared for. Dr. Motykie and staff have been most wonderful every step of the way and are very warm and personable and attentive to your needs. They're also very committed to giving new patients the best experience throughout despite the occasional long wait (understandable as Dr. Motykie is in high demand) . Thus far I can truly say my experience has been wonderful and I hope my end results are truly wonderful as well. I will not update my progress on a daily basis but I will continue to update on a weekly basis, monthly, and eventually yearly until I feel the end result is reached. Please feel free to reach out if you have any questions. I cannot say definitively whether it was worth it quite yet as its only been a week .

Best

Old pics

Posting pictures of my old nose/ profile for comparison.

11 days post op

Hi all,

Just a brief update. Major swelling has gone down but I'm still noticeably swollen around the eye and cheek area. I had some family in town that I visited and although it wasn't immediately apparent to them what I had done they thought I had changed my hairstyle - they couldn't quite pinpoint what was different until I mentioned it. From this i was able to tell that although I am recognizable to others and I'm not extremely swollen , I am still not quite my "old" self as far as welling goes. I also returned to work today and coworkers I'd told about said I did not look too bad but coworkers I had not told looked at me kinda funny and one even mentioned I should get some rest as I wasn't looking well (haha). So I'm short 11 days post op major swelling has subsided but not to the point that you can go entirely unnoticed. A close friend of mine also mentioned he couldn't tell I had a chin augmentation until I mentioned it. If anything he thought I had cheek augmentation (despite me not mentioning the fat grafting) . I think at this point the fat grafting is what's causing the most "off " look as my cheeks are quite swollen in comparison to the rest of my face. Regardless, I'm quite happy with my improved profile. I'm still trying to stay away from mirrors and front facing selfies because I personally think I still look like an avatar haha . My eye "area" hasnt quite come back yet and the cheeks still look ginormous to me .

2 weeks post op.

Hi all,

So today marks my 2 week post op. Things are starting to look better. At this point my profile is exactly what I wanted. I'm still having quite a bit of swelling though and it's more noticeable from up front. The upper bridge/brow/ area between my eyes is still pretty swollen and wide. The pig look is starting to go away i think my tip has dropped a bit since last week. In general the left side of my face is more swollen than my right. My left cheek is more swollen than the right , but it is possible that there's more fat grafted to that cheek as that was my flat cheek and Dr. Motykie mentioned he would try to make it even with my right cheek. I think at this point I am OK with the amount of fat present in my right cheek and I would be comtent if it stayed like that. The left cheek still needs to go down though. The chin has improved too , it's gone from swollen/amorphous to more defined . The right side has gone down nicely and the implant tapers off and blends to my jawline seemlessly it's really not even palpable . The left side is still swollen, it feels quite hard and there's a palpable notch where I presume the implant ends. It feels like a hard ball, there's no real discomfort but it just feels weird . I can also feel the implant (or swelling) along the left side. I've read it's normal for swelling to be uneven sometimes so I'm not too worried. My lip is still a little numb and my chin still feels slightly tight. My dissolvable stitches have still not dissolved or fallen off.

I still think I look weird haha I just want my eye area to be back to normal. Also my lower cheek/ jaw area is still swollen so I feel like I look chubby right now.

Side note : my skin has been terribly oily since the first week. My skin has always been normal/dry type and immediately after surgery it was extremely dry and flaky but after the first week my skin has been so ridiculously oily it's not even funny. I look like I'm sweating oil it's gross. I can't wait for my skin to return to normal.

3 weeks

Hi All,

I'm now at 3 weeks post op. Can't believe it's almost been a month since I had it done. Im starting to look more like my old face as much of the swelling in my jawline has dissipated and my eye area as well.

Chin: I love it ! Looks great and natural. Contours seemlessly with my jawline. Right side I can't even feel the implant or where it ends. The medial part is more defined and not as puffy as before. The left side is still slightly stiff but has gone down. The notch has decreased in size but it's still slightly palpable. The notch is felt right where the masseter muscle starts. I'm not sure if the implant is buckled there or if it's still residual swelling but It has gone down. It does not bother me and it is completely unnoticeable. My stitches fell off a few days ago. I'm still having some numbness in the area and some movements still feel funky and make my chin feel tight i.e. Pursing lips

Rhinoplasty: much improvement in the swelling around the eye area. The areas adjacent are still persistently swollen as well as my radix area. I think my tip is still quite swollen I feel like sometimes the combined radix and tip swelling make my nose look scooped . My tip is also not as defined currently so I'm assuming the swelling is to blame.. I'm also getting less congested, I'm not having to pull out those weird worm snot things as much. Yesterday I noticed one of the dissolvable stitches in my left nostril came out . I'm not having much of any pain for the most part but occasionally my tip will feel sore and upper lip movements can aggravate it . Usually this happens when my nose is really dry and it's probably the scab/incision site still sensitive.

Cheeks: still quite swollen but I've noticed much improvement this week . The medial areas adjacent to my nose have gone down but the upper cheek area right below the Lid area is still swollen. It's hard to appreciate in pictures and in person at times but under overhead light the weird shelf like transition looks puffy . The left cheek has reduced down as well but unfortunately my cheek still has the same shape as before , kind of blunt/flat and not round like my right side. I hope the grafting didn't exaggerate this assymetry but it's still early to tell.

I think at 3 weeks I'm starting to slowly see more of my features Come back. Specially the eyes. One of my coworkers mentioned I looked more "normal" today haha.

1 month update

Hi all,

I'm a little over 1 month post op now. Things look much better. Much of the swelling is gone but there's still a bit more swelling to go. I look pretty normal now. Im still having persistent swelling in the cheeks, they don't look as big but they still look puffy . I did feel some bumps along the lower rim of my eye socket but these have either decreased In size or I massaged them to smooth them. The bumps were not visible . I do have a light colored blotch under my inner left eye which I suspect may be fat visible under my lid skin but nothing too obvious.

My nasal bridge is finally thinning out . I do still have some wideness / swelling in the upper radix/middle brow part. The sides of my nose walls are still a little puffy. It wasn't until a few days ago that I could start "scrunching " my nose as the swelling resolved. My tip is still quite stuff and swollen . It's quite wide still , the right side more so. I'm still hoping more of the tip will drop as the swelling subdues.

My chin looks fine. It's been my favorite part all along.. It looks very much natural and it continues to become more defined and streamlined to the rest of my jaw. I do still have numbness on my upper lip but the tight feeling is starting to really go away and occasionally I even forget i got an implant put in.

Overall everything is going great. The only minor concern is wanting the tip to drop a little more and also wanting the cheek puffiness to go away but I'm only 1 month post op so I'm thinking everything will look great a few months down the line.

Unhappy with fat transfer

Hi all,

I'm a little over 1 month post op. About 5 weeks. This update will be in regards to the fat transfer as I'm really quite unhappy with it.. I'm fairly certain it's been the single most problematic thing in this journey for me and biggest cause of anxiety all along. I seriously think I made an expensive mistake with my face .. I should have heeded my doubts and resisted the reassurances I was thrown repeatedly when voicing my concerns.. I do realize there is probably some swelling still present as the typical swelling from fat transfer is 3-6 weeks but I also had rhinoplasty at the same time so it's probable that the grafting swelling is prolonged. Despite the steady volume decline I've seen over the course of the weeks I am unhappy with the results for several reasons :

1) it looks puffy and unnatural in overhead/fluorescent lighting. While I may look okay in warm /dark/ low level lighting. It looks horrible in overhead fluorescent lighting. I am completely disgusted when I look in the mirror at the gym.

2) there are small contour irregularities. Yes it's a risk but it is inevitable I think. Specially when my face was as lean as mine and with the extremely thin undereye skin I had, I can see irregularities in overhead lighting when I do certain expressions such as half squint. Etc.

3) biggest reason : it looks completely unnatural when I smile. Seriously my smile is completely changed I cannot recognize myself. When I smiled my skin used to stick taught my against my cheekbone and not go past my undereye area. Not anymore... It's like the fat lifts with the muscle and squishes my eyes or something horrid making my cheek look long and continuous... So depressing I cannot smile in pictures anymore without looking like Joan rivers !!! Wtf

4) despite my conservative request to simply fill the undereye area to reduce my tired and sunked look my eyes . My cheeks were waaaaaaaay too full. Seriously, I look horribly fat and te assymetry between my left and right cheeks has been further highlighted. I was told there would be more fat inserted in my left cheek to even it out as it was flat but instead I'm left with a still somewhat flat cheek and a huge right cheek . My right side was my good side but now it's my ugly side. I was assured I wouldn't be overfilled but that's not the case. thank god I refused to have my nasolabial folds or "uneven" upper lip tinkered with.

5) the grafting has detracted from my cheekbones and changed their contour. I had taught skin that draped over my cheekbones, the contour was firm and bony and you could see their roundness but not anymore, there's a weird puffiness and my cheeks are no longer their old shape... Depressing.

I've been panicking over this mess I got myself into I really did not do my due diligence with this procedure and I really should have tried fillers first before messing with this nightmare. I'm also a bit frustrated that so much fat was put in despite my wishes for something very subtle.

I can't say this procedure should be completely avoided , but In my case it was absolutely unnecessary and has left me worst than I ever imagined. This should be reserved for severely gaunt people or elderly . Also if you're a woman you'll get away with it better than a man would as men's faces are more chiseled and angular.. This is soft volume - it's left me undefined and too effeminate for my taste. Overall, The grafting has been a nightmare from the start, the swelling was horrendous for weeks and everyone first asked if I had cheek implants despite me never mentioning the grafting... I did not mention the fat grafting to my mother or grandmother I just said it was swelling from the rhinoplasty and they joked that the "swelling" was making me look like Lyn May and Jocelyn Wildenstein ... UGH.

I'm praying that everything will reabsorb and that my skin will not remain loose and saggy afterwards. I do accept that I'll probably have some residual lumps and contour irregularities but I pray that they are minor. I just want my smile and old cheeks back. I'm employing vigorous high pressure massages daily and doing 1 hour of cardio daily in hopes they will reduce.

I emailed Menal with my concerns and was told the swelling will continue to reduce with time but if I was unhappy I could massage it . She also said she didn't think they were overfilled (wtf? I never sent pictures , she only saw me in person 1 & 7 days post op when extremely swollen) she also suggest trying their infrared sauna . I asked for options to reduce the grafts in 3-6 months if I am Not satisfied and she said I could have their radio frequency treatments or Dr. M could do some injections ( of what I don't know but I sure hope it's not more fat, possibly 5FU or steroids maybe?)

Anyways I want all the fat GONE . I know some will remain but I pray it's negligible. I will continue the high cardio and high pressure massage . I'm already starting to research docs in my location to help remove this mess but I hear removal is hard and can be a nightmare.. Please see the pics comparing my unnatural smile.

Update

Hi all ,

Just posting another update. The cheeks have improved much since my last post. Swelling continues to go down. I'm starting to look more like me. I obtained responses from Dr. M in regards to the fat grafting. 9ccs of fat were transferred to the midface area and I have the option of kenalog injections or RF treatments starting at 2-3 months post op.

The fat grafts don't look "bad" but it's not the look I'm going for. I had a very boney / masculine/skeletonized face before with literally almost no fat over my cheeks but the fat grafts completely detracted from that and now I feel I look chubby and soft. What I wanted to achieve with the grafts was filling in the sink in midface that I had (which also added to making my nose look disproportionate along with my small chin) . I've noticed the grafts have not helped whatsoever in addressing this mid face hollowness and the appropriate solution for this is paranasal or premaxillary augmentation via implants. All the fat grafts did was make my cheeks look chubby and soft and messed up my contours so I want to reverse it asap.

My nose is looking better . It's a nice nose. But sometimes I have doubts if it is the nose for my face. I had strong masculine sharp skeletonized features and I don't know if a "smaller" nose is fitting. I set out wanting a strong,straight, nose but I feel like it looks a little short or too close to my face sometimes ... But i do really believe the fat grafts are throwing my nose and chin out of balance because my cheeks are big... Perhaps when I reverse the fat grafting it'll rebalance my face for the look I prefer . But then again I'm not done healing... I did express concerns regarding my tip as I felt it was still a big upturned and I was assured it would drop with time so we will see...

A note on facial beauty - a western perspective

Ive been doing a lot of research on what makes a face beautiful by western standards.

In the west, angular well defined features are what's typically regarded as beautiful. In order to achieve this one has to have well defined features. Models and attractive people have beautiful bone structure that shows and photographs very well. They're faces are practically skin draped over a beautifully balanced underlying bone. They also age very well because of this as the skin fits taught against the supporting bone structure and thus better resist the forces of gravity. My beautiful mother is 43 years old and gets mistaken for my sister all the time. She's not had one single filler or cosmetic procedure on her face. The only thing that makes her look even aged is the subtle undereye bags brought on by a slightly sunken midface (guess that's where I got it from ! Lol heredity).

When a face is out of balance its almost always attributable to an underlying boney deficiency. In my case I had a deficient chin and a deficient maxilla. The result ? My nose looked disproportionately large on profile view because of both the small chin and sunken midface. I think the appropriate fix for this was by both augmenting my chin and having paranasal and premaxillary implants to both lift the nasal tip and place my old nose in better balance. My old nose was very straight from the front and the bridge was straight but there was a very subtle hump where the cartilaginous part began and drooped down . I think the boney deficiency was largely responsible for this "drooping". Had I undergone paranasal and premaxillary augmentation I may have done well without a rhinoplasty altogether and had a much more balanced profile that would age much better. I could have also avoided the unessecary fat grafting. I think I've now created some imbalances as my cheeks are now disproportionately large. Unfortunately my midface still sags and sinks in despite the grafts and if anything I think the added weight from the grafts will probably speed the rate of ptosis than had I not had the grafts. I'm now trying to undo that poor choice on my part. I don't know what damage I've done now. My face looks "off" when I smile. I look chubby/fat and my once great skin is riddled with little pimples and inflammation. Also, the nose/lip angle is different and now my upper lip looks very and I look like I have had work done on my lips now too. I always had a perma "pout" because my mouth protruded due to the boney deficiencies. So now I'm left with big cheeks, saggy midface, and an upper lip that sticks out even more lol.

Which brings me to my next point : I think too often people and surgeons try to overcompensate for boney deficiencies utilizing fillers and other injectables which creates an issue with overfilling. The problem is it gives an "illusion" of high well defined cheeks but it does not address the underlying bone problem. Instead people end up with unnaturally full faces that do not animate properly, look very plastic and later sag terribly .

So word of advice: if you're seeking to better balance your face, first analyze the underlying bone structure and consider implants before considering fillers and other injectables. Granted if the deficiency is very minor you could probably get away with injectables. I'm not saying fillers and injectables don't have their place in PS - I'm sure they're great at delaying some signs of age but that's not what some of us set out to do with Plastic surgery!

Update

Hi all, just updating on my nose. I can't believe it changes so much every week and throughout the day. The swelling at the top of my nose is starting to go down more making my nose look less scooped/short which is a relief because I was worried it was too short and scooped. The swelling on my tip is going down as well , I still have nostril show from the front so I'd like for it go do down more. Other than that it's looking good so far. No breathing issues , no pain, occasionally sore at the top of my bridge but that's all.

Adjusting

Updating on my nose.

My nose is appearing longer now. I'm OK with the bridge portion so far but my tip is still very swollen and upturned. I still feel I got a piggy look from the front from all the nostril show. Also the swollen raised tip makes it look like my nose is scooped which I hate.

My chin is fine, i love the projection it gives on profile view but I'm still getting used to the front facing. It looks fine in person but in pictures it looks very wide and blackish which looks enormous to me. I don't know if a button/wingless implant would have been better since although I had a receded chin I had a very strong jaw and the extended anatomical further accentuated that. I can tell there's still some swelling as it occasionally feels tight.

I made a separate review for the fat grafting . My cheeks have gone down significantly but they are still far too full for my taste and my smile is still distorted. I've been aggressively "smashing" all the lumps on my cheek/undereye area and it seems to have helped with making them flat but the puffiness and volume are still there. I really hope they go down more I feel like they're so huge :( I know it was only 9ccs but that is still too much more me since I already had strong/round cheeks. I just wanted to look rested :( but now they're enormous and throw my face off balance.

I've been looking more like me lately but I'm anxious to know how much is still swelling and how much is final result. Im only 2 months post but I still feel like my face looks enormous with the chin/cheeks and like my nose looks tiny now . I was not an ugly person before. I used to get a lot of compliments from strangers saying I was handsome/beautiful etc . I just wanted to better balance my face because I didn't like how it was unbalanced in pics. But now I feel like a freak show at times. I feel like it was all too much and that I look so fake and plastic or too perfect . I get stares at the gym occasionally and the other night at dinner this woman across the bar kept staring at me the entire time and I even caught her slyly taking a picture of me! My friend said I look like a model but I don't know if he's being truthful or saying that to calm my worries . I just feel so concious and self aware now of my face like its too fake or I don't know. I'm not saying this for self pity but just expressing my thoughts.. I realize I'm still early in my recovery phase but just wish that time makes things better and I look more normal . Sometimes I question whether I chose the right doc or if I chose one that wasn't conservative enough. Truth is I was afraid of going to a doc that was TOO conservative where there was hardly any difference and I would feel like I did not get my "money's worth" so to speak and be left I satisfied. But now I wonder if I went the complete other way and went to a doc that was TOO aggressive . I honestly chose My surgeon because I liked his before and after a and they had a noticeable improvement and looked balanced and natural and not completely plastic ... But I don't know if my prior face really needed such a significant change... I guess I just have to give it time and adjust. It's been a hard journey and although I look more like me now it's not easy or helpful when friends/ fam tell you they miss your old nose/face etc. though, funny enough some family and friends genuinely never noticed the change at all even this early in the healing process... Such a bizarre thing. I guess it truly goes to show that sometimes we overblow our own perceptions of ourselves . Still, there's enough change for others in our life to notice and even yearn our former face.

Nose chopped

Updating on my nose. My skin hasn't fully "shrink wrapped" around my nose yet. My tip is still quite swollen. I'm getting worried that my tip will not drop anymore. I'm unhappy with the amount of nostril show I'm having . Also I don't know why but the "chopped" appearance my nose has has really been bothering me. I explicitly told Dr. M I liked the length of my nose but it appears so small and blunted. Also I'm noticing as the swelling goes down that my nostrils appear to flare a lot . I asked for some tip definition but my nostrils look huge and almost flipped inside out its really bizarre I've never seen a nose like this. I don't know how much swelling is distorting my tip but I feel like my nose is just bridge and tip like there's no middle cartilage area. My looks so short and blunted/ chopped and flared it's like some bizarre piglet / Polynesian/Asian nose . I don't like this look at all. I really feel like it does it fit my face . It's like I have huge cheeks and jawline and I small tiny chopped nose. I don't understand . The nose does not reflect the dimensions on the morph I was provided. My nose hardly aligns to my upper lip and the angle is completely different from my pic morph. I'm still having a hard time adjusting to my nose and I'm 3 months out. I don't understand how some people are ecstatic with their nose after cast removal. This has not been the case for me. At one point I was happy with it around the 2 week mark but since then it's gotten tinier and tinier and I'm getting really concerned now that my nose is far too small for my face and my tip will be pinched/skeletonized since it's already way more defined than it was prior to surgery. I will have to mention this to Dr. m at my 3 month follow up..

Sad

Oh just FYI there's a review on Yelp of some lady that got an ugly chopped nose from Dr. Motykie too... I'm so scared this happened to me now too :( I'm starting to get a sense that my surgeon just had his way with me and did things I did not ask for after luring me with picture morphs and impeccable before and afters. We agreed on the morphs and the morphs are what drew me to chose him because they looked like the ideal nose I wanted but the result is not looking anything like it. I was explicit in stating things I did not want done to my nose and i feel like these have been disregarded and I was given a chopped/generic nose that does not fit my face. I'm already unhappy about the fat transfer I received you can see my other review for that. I will be so disheartened if I'm left unhappy with my nose. I cannot believe I paid someone to leave me worst than before. I really don't understand . :( I've been having such a hard time since my surgery I'm confused how people are so ecstatic with their results early on but for me it's been a struggle . I've been telling myself to give it time and swelling will go away and look better but how much longer ??? There's things with my nose/ cheeks that I think at this point may be fair to say will not change. I seriously doubt my nose will lengthen . And I seriously doubt my nostril flare will decrease. I seriously doubt the lumps bumps and distorted smile will change for the better . I'm just so depressed and deeply saddened that my surgeon did things to me I did not ask for and worst still I was explicit in saying I did not want. I can't help but question how he could be proud of doing something like this. Like we as patients come seeking and improvement to feel better and happy about ourselves but instead are left worst . In all honesty I feel like almost he didn't give a rats ass about what I wanted or he completely half assed my procedures?? It honestly doesn't help reading all the bad reviews he's gotten on here and Yelp... I honestly starting to feel like he is completely hit or miss and only seems to perform when the cameras are on him . Ironic how his motto is "get it right the first time" and he has a video highlighting the importance of hearing and communicating the patients needs but I feel like he was completely lacking in that?? Are there any other patients out there that have had any work done by this doc and were left botched unhappy or initially had these experiences I'm having but now love their results?? This is really affecting me psychologically and socially.

Not impressed

Revision in the future

I'm 90% sure I'm going to have a revision. I really do not like anything about my new nose. It photographs better in "selfies" but i cannot stand to look at it in the mirror every day. It's short, it's tiny, it's upturned, you can see up my nostrils, it plainly does not fit my face AT all. It screams "nose job" . Maybe months from now the tip swelling will subside and drop down and give the appearance of a longer nose but the dimensions are the same. My bridge is way too thin and lower and my tip was chopped and deprojected so much it does not even go past my upper lip. I serious have a smaller nose than a lot of women now. I'm really quite upset my surgeon did not deliver according to what we agreed. The results are nothing like the morph. My new nose is not in proportion to my face. It's literally a tiny scooped miniature nose plastered in the middle a wide face with strong features. Truly disappointed my surgeon gave little consideration to my desires and did things I was explicit about . I think he has poor understanding of male facial aesthetics overall. I'm upset for letting myself be misled by the "perfect " morphs and before and afters on his website . I've requested my operative report and will start making a list of revision rhinoplasty experts . Just crossing my fingers that he didn't remove so much of my nose that I won't be able to get near the dimensions needed for a nose that fits my face. I did not want a perfect nose, I wanted an improvement in my profile but instead ended up with something a many times worst . My nose was really not that hard to address I don't understand why he needed to be so aggressive with my nose to the point of emasculation. That's not even taking into account the huge cheeks he gave me with the fat grafting. So so so disappointed. I honestly feel I could have gone to a third world country and received better results at a tenth of the cost.

Improvement

Hi all,

Just a quick update, I had my 3 month post op visit with dr M. He said I was very swollen still and gave me a steroid shot. Cheeks have gone down drastically and honestly I'm not sure that the difference is really even that noticeable now. He said I was still swollen on the right side too. Also my nose has gone down a lot more. It looks much better now. I can still tell I'm quite swollen sometimes the sides of my nose feel swollen and tight so that will go down more. My tip has dropped down a bit but it's still very swollen. He also said my tip looked crooked which he was not happy about he said to massage it and push it to the other side. Honestly I don't really see the assymetry but I will follow his instructions, I don't necessarily want a perfect nose I really just wanted an improvement on my profile so if the tip is slightly off that's fine just as long as it's not super obvious. My chin looks fine, occasionally feels tight but for the most part I don't feel anything there . I've been much better now I don't really think about my procedures or much of the anxiety and worry that I had the first few months. There are still a couple things that I don't like about my nose but for the most part it's fine. I'm trying to spend my time doing more productive things and not spending so much time obsessing about my nose and face during the healing process. I'll probably post an update with pics at 6 or 7 months. Dr. Motykie told me to wait at least 6 months before making any real conclusions on the outcome. I'm 3-4 months out and things look a million times better so I'm kind of excited to see how things look in double the time as more swelling resolves.

Thanks for the positive feedback and support. This has not been an easy journey!

4.5 months

Hi all. Just posting an update with pics. Crazy how much the swelling distorts things. Swelling has gone down ALOT but I still have quite a bit of swelling between the eyes . I marked red areas of swelling. My tip is still swollen. My nose looks fine but my only real complaint is that my tip is still a bit elevated for my liking and so my nostrils show a bit more than I'd like but it's entirely possible for it to drop more so I will continue to be patient. I mentioned earlier that dr Motykie said my nose leaned to the right and to massage it and push it to the left . I don't see the distortion too much so I've stopped tinkering too much with it. I actually bruised the tip the other day massaging it after working out and taking a niacin I guess too much blood flow in the tip and the massage caused it to bruise a tad. So I've left it alone I'll just ice it from now on.

Chin looks great. It feels tight on occasion but most of the time I don't notice it. It's also getting a bit more defined.

Cheeks have gone down a lot. They look okay . I'm still swollen though. At this point I can live with them. It's not a huge drastic difference as they were prior.

Overall I'm happier with the results every day. I'm a bit excited to see how the end result turns out. Everything looks pretty natural so far. I've talked to a couple people and they said they would have never guessed I had anything done . I get lots of compliments as well. I've finally managed to get over my post op depression in the past month or so . I was pretty down for a while but things are looking up.

If you're one of dr Motykie's patients going through this just be patient it's not easy at all.

Almost one year!

Wow. It's been almost a year now. In two weeks I'll be exactly one year post. Crazy how time flies. I must say it was not an easy road specially at the start. For anyone considering this or going through this trust me things do get better!! I was not at all psychologically prepared for the whole process but I can certainly say it's been worth it in the end. I get a lot of compliments now and people I've told never could guess I had anything done. The results have come out so natural and I know I still have residual swelling. I do occasionally have a random day or so where I "miss" my old look but I think it's just still adjusting and having to get over the initial psychological barrier of seeing your face change suddenly. But overall it has been good. The chin has settled down great. I don't even feel it. It looks natural. In normal/ far pictures it looks fine. Close up selfies / smiling sometimes I feel like it does look a little on the bigger side but I'm not too worried and I've learned to stop over analyzing pictures. In person it looks absolutely normal and great. My fat grafting has settled down ALOT and looks quite normal. Some people never guessed I had that done. I also don't look as gagged anymore and don't have undereye hollows. I can be up late or get little sleep and I look just fine haha. Ocassionally if i consume a lot of salty stuff it does look a bit on the puffy side. I think the undereye fat was great. I don't have any lumps bumps or irregularities though I can palmate some small bumps but it's nothing noticeable unless you actually palmate and not at all visible.

The nose has settled nicely. It's changed much in the past month and sometimes I wonder if it even was such a huge change from before. I also breathe much better than ever as apparently my septum was deviated and I was not aware. The one and only annoyance is my left nostril I'm not sure if too much was taken off the tip or if it's just the natural anatomy I had before and was made more noticeable after the surgery but my left nostril kind of flares out a lot and the tip looks a tad sunk in. It doesn't bother me a ton but sometimes in pictures it's noticeable.

Overall I feel like Dr. Motykie truly delivered what was requested and he did a good job. The only thing I do think would be better was just some more thorough explaining and preparation as far as what will be done and how and how the healing process will go. Though perhaps maybe he chooses this approach instead to avoid those nitpicker patients who want to micro control every aspect and not let their surgeon full control of the process.

Anyways I'm posting pics of my progress. I'll be following up for my one year appointment within the next month. I'll try to answer questions when I can. I generally try to avoid this site now as I'm satisfied with my looks and don't plan on getting more work done and just trying to be generally more body positive. But to all of those truly considering undergoing these procedures do your homework and prepare psychologically!! And physically ! And BE PATIENT!!!!

Few more pics

Los Angeles Plastic Surgeon

Will update review at 6 months

3 out of 5 stars Overall rating
3 out of 5 stars Doctor's bedside manner
3 out of 5 stars Answered my questions
3 out of 5 stars After care follow-up
1 out of 5 stars Time spent with me
2 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
3 out of 5 stars Wait times
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