Need answers
I’m a 19 year old male looking for some answers. I broke my nose about 3 years ago and I ended up with a disproportionally large dorsal hump. I was refereed to a cosmetic surgeon in order to correct the problem. He made it look like the surgery would be no big deal, and so I went through with it. I was mostly satisfied with the result, however there had been a collapse in one side of the lateral cartilage, causing the other side to protrude unnaturally. At the time I was unaware that the protrusion was caused by a collapse, so when I pointed out the deformity to the doctor, he offered to “shave off” the “excess”. He also said that my septum needed to be straighten because it was deviated, and that some excess bone on one side of the dorsal area needed to be filed down. Again, he made it seem like those things were no big deal. So, being naive about rhinoplasties at the time, I went through with the revision. The results seemed to be satisfactory at the first, but after 6 months it became clear that the surgery had created more problems than solved, if any at all. The tip of nose lost support, resulting in it looking droopy. The nose also looks pinched now, which it never did before. At the same time, “removing the excess bone” was nothing more than scooping out dorsal area a little more. Of course, the collapsed cartilage was not addressed at all, and the deformity caused by it is just as much present.
I’m not sure what to do now.
I’ve been very depressed and angry at the fact that the second surgery had been such a failure. To recap, here are what the problems my nose is facing: collapsed lateral cartilage, pinch, lack of support at the tip and slightly scooped out dorsal area, not to mention the nose has been operated twice. Is asking to correct all those problems too much? How complex, if possible at all, would such a surgery be? I need an honest answer as to what I can hope for. At any rate, can you suggest a surgeon? I live in Toronto, but I’m ready to go anywhere in the States or Canada.
Thank you very much
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What exactly did your surgeon do in the first surgery? You mentioned you had a dorsal bump as a result of your nose being broken. Did he shave that bump or did he actually rebreak and reset your nasal bones? Was your septum deviated before your first surgery or is this something that your PS noticed afterward when you were facing a revision?
I totally feel your pain when you say your doctor made the issues sound easy to address…I do not understand why they do that. Rhinoplasties are complex surgeries–no matter what. Nothing is simple and nothing is for certain. Let me ask you this: was your PS a revision specialist? Does he do revision or reconstructive surgeries routinely?
I’m no expert, but I wouldn’t bank on your surgery being simple. I think any revision is a complex surgery. That said, I think your issues should be able to be improved (not necessarily made perfect) in the right hands.
Your lack of tip support will most likely be addressed with some sort of columellar strut. I’m assuming you have no more septal cartilage left for grafting, so the next PS will most likely want to harvest some either from your ear or your ribs. If your dorsum is scooped, both ear and rib can be used to “fill” in the concavity. I will tell you this, my experience with ear on the dorsum is not a pretty one. It is lumpy and bump, unless it’s wrapped in fascia of some sort or your doc shows you some convincing photos where he has used ear on the bridge and it looks good. Rib, on the other hand, is not lumpy and bump, but if not carved right, it can warp over time. Also, if the rib graft is not made narrow enough, you will end up with a wide nose.
From what it sounds like, if you go in for a revision, don’t expect your nose to look any smaller. It will most likely look and be larger (wider and higher, that is). For a guy, though, this may actually look better. For a female, this is what got me in trouble–a wide and high bridge ain’t so feminine.
Suggesting a surgeon is a dangerous game. I suggest compiling a list of names and then consulting. You can even send them photos of your nose (two profiles, one front and one bottom up shot) and ask what they can do/what they would suggest. Most docs will probably be accommodating considering you are from Canada and they in the States.
Surgeons I would consider: Guyuron, Davis, Le in Baltimore–possibly Frankel in LA, Hilinski in San Diego. The last two have websites.
Also, are you looking to lengthen or shorten your nose? Make sure you make it clear to the doc if you do not want your nose shortened, if that is the case.
Hi there!
Your story sounds a lot how mine played out. I broke my nose in a faceplant off a slide in sixth grade. I attempted to get the nasal hump rasped in 2003, which led to further problems and a revision in 2007. Needless to say, my breathing is worse off now — and a few cosmetic issues I would like fixed. I hear you when you say it got worse. It’s hard to imagine being worse off than you started, but it’s possible.
I’d advise you to check into some ‘nose specialists’ who have a primary focus on rhinoplasty, especially revisions. Revisions are in a whole different category of nose surgery.
I’ve heard Dr. Rival mentioned from Canada, but don’t know much about him. I think he’s rather young too — so you would want to make sure he does a lot of revisions. Hang in there!
You can get it fixed, but it will take a lot of research on your part. Don’t go back to the same surgeon. Find someone who specializes in revisions — that’s the most important thing you can do.
Good luck!
Thank you for your prompt replies. Needrevision: I’m not sure I feel comfortable with taking cartilage from my rib… I’ve read that this is normally done when the nose requires considerable construction. Plus it introduces a whole new set of possible complications. The reason I want a dorsal augmentation is to give the dorsal area more definition, i.e. to make it more ‘pointy’. As it is, it’s too flat and consequently looks too wide, not to mention it looks strange from my profile. Is ear cartilage really unsure business regarding that issue? About restoring strength to the tip, and correcting the pinch and collapse, is ear cartilage convenient?
g82: I’m doing everything I can, I’m looking everywhere. I’ve heard of Rival too, I’m planning to consult him in September.
Thanks