Question : I notice that when I am not smiling, it looks like I am frowning. People actually comment that I seem angry. I don’t know if this involves just my mouth or both my mouth and eyes. Would a consultation help me identify whether I need a cheek lift, an eyelift or both?
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Posted in Revision Rhinoplasty, Rhinoplasty and Revision Rhinoplasty on April 11th
Question: I am male, 24 years old and I am really unhappy with the nose job I got this year. It doesn't look like what I wanted it to. From the front view, it looks like the sides of my nose are pinched in. Does revision rhinoplasty take as long or longer than the original nose job? Should I wait a period of time before I schedule the revision? I don't think that there is any scarring.
Answer: Without seeing you or some photos, I really cannot tell what you need. Revision rhinoplasty for what you describe, however, can be a more complex procedure than the original rhinoplasty. Surgical time would be 2-4 hours depending on the type of cartilage grafts needed to fix the pinching. I would not operate on you until 18 months after the original procedure. I would be happy to see you.
Posted in Rhinoplasty and Revision Rhinoplasty on March 14th
Question: I have been told that I have a hanging columella. What does this mean, and what types of rhinoplasty can fix this?
Answer : The area underneath the nose between your nostrils is called the columella. Hanging is a relative term that means is sits too low. It can be trimmed as part of a rhinoplasty through an endonasal or open approach.
Posted in Rhinoplasty, Rhinoplasty and Revision Rhinoplasty on December 19th
Question:
Is alloderm a good choice when the nose needs to be built up? How is it used?
Answer:
Alloderm is best used to wrap cartilage grafts. By itself, it generally mostly goes away over time.
Posted in Revision Rhinoplasty, Rhinoplasty and Revision Rhinoplasty on December 15th
Question:
When is it okay to go to your original doctor for a revision procedure? When should you be looking for another doctor or even a specialist?
Answer:
The best person to revise a rhinoplasty is most often the person who did the original operation. He/she knows where the grafts are, how the cartilages were changed, what sort of shape the cartilages were in at the original procedure. Of course, that assumes that the original surgeon does a lot of rhinoplasty. If he/she is confident about what needs to be done, you should stay with the original surgeon.
Posted in Rhinoplasty and Revision Rhinoplasty on August 23rd
Question:
I’ve had nose bleeds ever since my rhinoplasty surgery, which was two years ago. Is it possible I suffered a septal perforation that’s to blame?
Answer:
Yes, it is possible. Frequent bleeding and crusting is a symptom of a septal perforation at the front of the septum. A whistling sound is another symptom. Have you surgeon check your nose.
Posted in Rhinoplasty and Revision Rhinoplasty on August 22nd
Question:
The tip of my nose curves to the left. I don’t know if it’s really noticeable to everyone else but it’s all that I see whenever I look in the mirror. Is this something that can be fixed with a nose job and is it a complicated procedure?
Answer:
Most likely your nasal septum is crooked (ie deviated) at or near the tip of the nose. Usually to straighten the tip you need to straighten the septum. Yes, this can usually be improved. A word of caution, the skin of the tip has memory, and even a newly straighten nasal tip may have nostrils of different shapes.
Posted in Rhinoplasty and Revision Rhinoplasty on August 22nd
Question:
How is alloderm used in rhinoplasty and is it a good option if you need portions of the nose built up?
Answer:
Yes and No. Alloderm can be used as under the skin to soften the appearance and add padding over the bones. Unfortunately, its affect is temporary. Most of it is eventually absorbed. In my experience, it can be used where you are not depending on it for a permanent volume increase. I sometimes use it to wrap a cartilage graft. It helps stabilize the graft in place. I also use it for the inner layer in the repair of a septal perforation (hole in the nasal septum. There it is used as a temporary support.
Posted in Rhinoplasty, Rhinoplasty and Revision Rhinoplasty on August 18th
Question:
I know that my first nose job recovery period was extremely painful and prolonged, thus not allowing me to go to work for several weeks. Post revision rhinoplasty surgery, how long until I can resume normal activities?
Answer:
Your first experience was not the usual. Most patients need no narcotic pain medication after just a few days and are back to work at 8-10 days, depending on what they do for a living or school.
Posted in Rhinoplasty, Rhinoplasty and Revision Rhinoplasty on August 17th
Question:
I'm 25 years old and had a rhinoplasty two years ago. I'm still unhappy with the length of my nose, am I eligible for another procedure? Would I be more at risk for a polly beak deformity?
Answer:
Yes. You could have a revision operation at 2 years. The risks of adverse scarring are higher in a revision, but there is no particularly higher risk of a polybeak deformity unless the tip is lowered without accommodating for the height of the areas just above it, the supratip. A polybeak deformity is usually caused by the septum being a bit higher in the supratip area, scar or both.
Posted in Rhinoplasty and Revision Rhinoplasty on June 11th
Question:
When using ear cartilage for a graft in a revision rhinoplasty procedure, how is the ear affected?
Answer:
Usually the scars are hidden nicely and the shape of the ear looks about the same as before surgery. Sometimes the ear may be a bit closer to the head as it heals. It hurts a bit more than the nose post op.
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