Rhinoplasty, Revision Rhinoplasty, Nose Jobs for Celebrities and others.
around lunchtime of April 30th, 2008Rhinoplasty or the re-shaping of the nose is the top or one of the top plastic and cosmetic surgery procedures perfomed here in Beverly Hills, across California and around the world. I have written numerous articles on Rhinoplasty and what this procedure can and can’t do but I feel that people are not getting the message when it comes to ways to shape the tip cartilages and increase the height of the nasal bridge.
Lately, I’ve seen a wave of patients that underwent closed Rhinoplasty with placement of a silicone L-shaped graft to the nasal bridge to increase the nasal height. The problem isn’t the dorsal segment of the graft but rather the vertical segment of the L-shape. This short vertical segment is designed to go between the two sides of the tip cartilages and by doing so will logically increase…not decrease the size of the nasal tip. The junction of the vertical and horizontal portions of the graft sits just above the nasal tip cartilages and can cause skin erosion and damage to the nasal skin. Bottom line, patients have this L-shaped graft elsewhere and then come here to have it removed because they don’t like the aesthetics of what it did to their nose.
The graft can be trimmed leaving just the dorsal segment but typically the nasal tip cartilages must be repaired and the strengthened by using a conchal cartilage ear graft to the nasal tip all performed through an open Revision Rhinoplasty. So if you are looking to increase the height of your nose and want your nasal tip smaller….you may not want the L-shaped nasal graft which, in my opinion, may require you to have another Rhinoplasty to deal with the issues this type of nasal graft can create.
Francis R Palmer, III MD
I wanted to know if there is any way of adding a slight amount of volume to the nasal bone (since my previous surgeon shaved too much)? What will be used to add volume? How many revision rhinoplasties have you performed so far into the year? You seem like a Dr that should appear in DR90210. Is there any recent shows that you will appear in anytime soon. Thank You
Steven :: 1 week, 6 days after
Hi,
I just had a revision rhinoplasty almost 4 weeks ago and I’m still not totally satisfied. I used the same doctor from before…and he still did not make the problem go away.
Initially…I went in for an open rhinoplasty to bring in my nostrils a bit and to thin out my tip but instead he added a silicone graft that you could see right through my skin and it made my nose look very prominent as if I had a crooked bump!
So…almost 4 weeks ago…he went in again to replace the graft with a thinner smaller one so it would’nt be visible. When he removed the splint I was pleased with the results but then after a few days later I began to feel really unsatisfied because my nose still has that prominent look!
Even though he brought in my nostrils a litte and lifted my tip…I still feel my nose looks big because of the graft. I’m really starting to get the blues about having to go through a THIRD rhinoplasty but it’s my face and I want my self esteem back!! Sometimes I regret getting it done in the first place….but I wouldn’t regret it if it was done right the first time.
How soon can I get another revision? I really want him to finally remove the graft and bring in my nostrils a little more for an elegant sleek look. Or should I put my trust and faith in another doctor?!
I’m so confused…. Please Help me!
-Summer
Summer :: 1 week, 6 days after
Steven,
Yes, the bridge of the nose can be built up after your Rhinoplasty. You have several options deopending on how scooped out the nasal brdige is at this point. Radiesse can be injected to increase the height or cartilage/man made grafts can be added to the nasal bridge. The latter does require another Rhinoplasty (closed) in order to gain access to the nasal bridge. I do many Rhinoplasty and Revision Rhinoplasty surgeries and have done so for about 20 years.
You may want to e-mail photos of your nose to drfpalmer1@aol.com and schedule a phone consult where we can discuss my findings and recommendations. This can be scheduled by e-mail or call my staff at 310-652-9583.
Dr. Francis R Palmer, III
drfpalmer :: 1 week, 6 days after
Oh Steven,
I was filmed for Dr 90210 last year. They filmed me all day at the office and at home. The executive producer wanted me on the show but the E Network execs said that I was too together for the show. Go figure…I guess TV wants a certain personality but I am what I am, period! I am pitching my own TV shows that I would be proud of the content and manner in which Plastic Surgery and Plastic Surgeons are portrayed. We’ll see if they make it on the air or not, who knows.
Dr. Francis R Palmer, III
drfpalmer :: 1 week, 6 days after
Summer,
You will have to decide if you want to continue with your present plastic and cosmetic surgeon or not. In either case, you may want a second opinion. Revision Rhinoplasty should not be done any sooner than 6 month intervals as this may cause permanent damage to the nsasl skin. You can e-mail photos of your nose to drfpalmer1@aol.com and you may want to schedule a phone consultation where we discuss my findings and recommendations. You can schedule that by e-mail or contact my staff at 310-652-9583.
You didn’t mention if the silicone graft was L-shaped or a straight piece along the bridge. L-shaped grafts will increase the size of the nasal tip and can erode through the nasal skin…in my opinion, they should not be used in Rhinoplasty.
Dr. Francis R Palmer, III
drfpalmer :: 1 week, 6 days after
Dr. Palmer,
I have a consultation scheduled with you on 8/19. However, I have a question. The surgeon who did my revision utilized ear cartilage to even out my tip, smooth out a sharp edge on the left side, lend support to the right side of my tip and fix a dent just above my nostril. I still have the dent, my right nostril is still weakening. On a positive note, the top view is even and the sharp edge is no longer visible. My problem is mainly the tip looks fat, and the left side is quite a bit larger than the right. From the dog’s view my tip is uneven, right nostril smaller than left and tip slightly off center. It’s funny. Initially, I wanted the tiny bump on my bridge removed. That’s it. I loved my tip, and specifically requested it not be touched. Unfortunately, my primary surgeon cut and divided the tip cartilages. So, I am where I am, and I digress. My question is can one really improve the appearance of my nose at this point and make it smaller again? And, is there any way to do it closed? I keep telling myself to leave well enough alone. Then, I look in the mirror and get so sad because I know that my nose was much prettier before I ever touched it. I was much prettier before I touched it. I would love to hear your opinion before I make the trip to California.
Melissa :: 2 months, 2 weeks after
Melissa,
That’s why you’re having the consultation with me…for me to take a look at your nose, listen to what you’d like to acheive and then tell you whether, or not I think you should proceed. I won’t know the answer to that question until I examine your nose and see you in person.
That’s the toughest decision to make is when is enough, enough but that’s what you pay me for…to help you make that decision. We are not here to convince you to have a Revision Rhinoplasty but my goal is to give you an honest evaluation and recommendation on what’s in your best interest based on over 20 years of performing Rhinoplasty and very complicated revision Rhinoplasty.
If you don’t get that type of advice and answers, you’ll always wonder what if, should I, could I etc. This way, you’ll have your answer, either way….surgery or no surgery, you can lay the issue to rest and move on with your life.
Dr. Francis R Palmer, III
drfpalmer :: 2 months, 3 weeks after