8 Replies

1. Needrevision on July 5th, 2009 1:20 pm

   Oh yeah–I just want to mention that I got my operative reports and there is no mention of any bridgework in it at all. So, I cannot tell you exactly what grafts were added to the bridge in my revision, but it is clearly different and not for the better.

2. g82 on July 5th, 2009 2:15 pm

   I have to say that I don’t really see the ‘lumpy bumpy’ stuff — but maybe that’s better seen up close or in fine detail?

   I actually prefer a ’stronger’ nose, so I have to say that I like your new nose. Although, I think part of what is hard for you — is that your original bridge was smaller. It may just be that you’re having a hard time adjusting. For me, it’s the opposite. My bridge was wider before, now it’s smaller — and I want a wider bridge back.

   I think a lot of this has to do with your face shape — and your other features. Small and dainty people with huge noses look a little ‘off’ — just as large people with really ’small noses’ — look a little out of proportion.

   Can you take us through a little detail of your original decision to get rhinoplasty — and why you had a revision? That will help the story I think — to kind of get an idea of a timeline.

   Also, can you call your surgeon’s office — and ask about this? It looks like there was bridgework — but maybe there is still some swelling. How far out are you? I know that not all surgeons are as detailed — but if they worked on your bridge, and didn’t put a single comment in there about it — it seem like they were smoking something in the operating room, or what I’m not sure My op reports came back very detailed in terms of what grafts were used. I think it’s a disservice to patients to not take accurate operative reports. Surgeons should be fined for that.

   I can’t say a yes or no on the re-revision yet. Are you having any functional issues? Yes, I do think surgeons can remove grafts — and that most revision specialists have expeirence with this. Although, if the grafts are in for ’support’ reasons, it becomes more complex — as you don’t want to make way for functional issues. From a cosmetic standpoint, I don’t think your nose is super bad — warranting you to do anything ‘too’ soon. Definitely take your time to research. If you want a smaller bridge, Im pretty sure that can be acheived. I’ve always heard it’s easier to take out, than to put back in.

3. g82 on July 5th, 2009 2:18 pm

   Also, what is your skin thickness? I think this is an important piece to the discussion. Thin skin usually dictates the need for some type of camouflaging material.

4. Needrevision on July 5th, 2009 5:40 pm

   I totally agree with you that a lot has to do with face shape. My face is narrow–so having a wide nose doesn’t really look right. My natural nose was extremely narrow–I can honestly say the width almost tripled after my surgeries. I’m about 2 years out from my revision, and I’ve been so patient in terms of waiting to see if I’ll “get used to it” or if I may have some graft shrinkage/reabsorption, but alas none of this has happened.

   You bring up a good point that some of the grafts that were added in my revision could potentially be support grafts. I hope a good surgeon would know when these can be removed!! I can’t imagine going through another surgery and not being able to breath.

   Just a little synopsis of my experience, since it may be helpful for you to get the whole picture: I had a primary in 2006 to deproject my nose and to take down the hump on my bridge. It stuck out quite a bit in front of my face. A very “ethnic” nose, as some may say. The results from my primary looked NOTHING like my imaging. I am telling you: day and night difference. While my nose didn’t stick out, it didn’t have much definition either and from the side looked rounded at the tip. My septum was also quite deviated yet again–this time more so, since I could not breath through my right nostril. When I consulted with him for my revision, Dr. Davis told me my primary PS did way too much to my nose in my surgery–that is, he took out too much cartilage. I was an idiot and went back to the same PS because 1) he was certain he could address these remaining issues and 2) on some level, I felt that if he caused the mess, he should fix it (note: this is not a good way to think!). My PS harvested cartilage from my right ear for the revision. He used the cartilage for a columella graft, a tip graft and whatever he decided to stick in my bridge.

   I am royally ticked off that the bridgework is not documented in my op notes. Aside from being ticked, though, I wonder whether this will hurt me in the end since the PS I choose may be completely blind-sighted when he opens me up and sees whatever is in there. It’s just scary on some level.

   Do you really think I can write or ask about the bridgework? It’s been almost 2 years since I’ve seen the office. They will most likely say whatever is in the notes is accurate (can you really imagine them saying, “yes, we left something out”??).

   I agree about the taking my time part! I certainly am, but on some days, I’m tempted to just pick a doc and get it over with! That’s bad of me, I know. BTW, I have been told I have medium skin thickness–which is ideal for grafting–thick enough to not need camouflage and thin enough to show definition. What about yourself?

5. g82 on July 5th, 2009 6:29 pm

   Would I contact the office about my op reports? You bet I would! You have every right to know what was done during your surgery. Actually, I believe part of this falls under patients rights — and the right to your own medical records. I believe that by law — medical outfits must keep detailed records on patients, especially of the surgical nature. Say you’re allergic to anesthesia, yet this is mentioned nowhere in your report — and you forget to tell the doctor? Not a good thing. That’s why we have detailed medical records.

   Are you just wanting the bridge narrowed — or are there other concerns you have? I think this is definitely possible — however, you’ll need to discuss the possible risks of taking out grafts, etc. Grafts are primarily support structures. I don’t know if they’ll completely remove a graft, but it’s possible that they shave then down — or reduce them in size.

   I would find a doctor who does imaging. I know you’re not sold on that — but a lot of doctors have ideas in their heads. If you can’t reach a communication level of 110% with a doctor (who doesn’t use imaging), then you’re throwing darts at the idea of being on the same page. Just think about explaining something to someone who doesn’t get it — sometimes it’s just easier to ’show’ them. Surgeons aren’t always the best listeners. They are confident by nature — and may think they have the best ‘approach’ to the job. However, this is your nose — and YOU should control the ship, not them.

   I have medium skin thickness too.

   I understand the part of wanting to fix this ‘now’. We all do — but remember that speed and accuracy don’t always go together. You’ll need to be very precise in your approach to get the best end result. Hilinski does email consults if you’re interested. I did both that, and saw him for an in-person consult. He’s a very nice doctor — I just haven’t reached a decision about whether he’s my doctor.

   I’d make a list of 5 surgeons you think to be the best for your case — consult, and go from there. If you’re out-of-state, a lot can give you a basic consult over email.

   And never be afraid to ask questions. If a surgeon is bothered by that, move on. You’ll want every question you have answered. The best way to make a decision is to be well-informed.

6. g82 on July 5th, 2009 9:44 pm

   Need Revision,

   If you’d like to correspond more off-site — I can send you better photos. I think a non-cropped face helps, but don’t want to plaster my pictures all over the internet.

   You can reach me at snowboardchiq69 at hotmail.com

   Yes, it’s a real email — I made it in high school and haven’t bothered to change it yet

7. Needrevision on July 6th, 2009 5:45 pm

   g82–I will definitely get in contact with you this week! Love the email, BTW!

8. court1128 on February 4th, 2010 3:58 pm

   Just looking at the nose itself of your post revision, i dont think it looks bad at all…but again we cant see theh whole face shot so its hard to tell.

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