Mark B. Constantian, M.D., FACS
I had a silicone injection nose lift about 15 yrs ago. I've noticed a blue discoloration of my nose. It looks like a hematoma and sometimes I experience head aches. What's the best alternative cure for discoloration of my nose?
I agree with Dr. Culbertson. Without examining you I cannot be sure, but the discoloration is often the silicone showing through the skin circulation of the nose, giving a bluish tint. Remember, though, that the silicone is there for a reason: to avoid a deformity from just removing the implant, you and your surgeon must be prepared to replace the silicone with a rib graft. This is an excellent solution, but you must see a surgeon who is experienced in that type of reconstruction--one who can show you good results and whom you trust.
I had rhinoplasty and I hate the outcome. I don't have a botched job but this nose is not what I asked for and I look much less attractive. I want my nose tip round again, and also my hanging columella and if possible my bridge bump. Also, I'd like my nose to be smooth again, and to move when I smile, when I make faces (it does not move that much anymore). The overall shape of the nose is not SO different, but as my nose was already small, it looks too small for my face. What can I expect? Thank you!
The question you ask is actually very common. In a paper I published last year, about 20% of the 150 secondary patients I had operated on were having surgery to restore a prior shape. You have the right to your own body image. It is also common for patients to want to restore bridge height--even a bump--and the old tip shape.
You also mention the stiffness of your nose, which is very likely the result of the "open" technique you had performed. You therefore need to be revised by a surgeon who can confidently change shape without losing support and give you what you wish. I do not want you to have another unhappy experience. Find a surgeon whom you trust who can show you examples of cases like yours with results that you like.
Good luck, Fatima.
To achieve the best results in rhinoplasty surgery, do I need to choose a surgeon who is an ethnic expert in this field?
I have a long nose and a wide chin. I want to have rhinoplasty and surgery to improve my chin. I want to choose a good plastic surgeon so that I will have the best results. Do I need to choose a surgeon who is an ethnic expert that performs these surgeries?
I think that ethnic rhinoplasty is somewhat of a misnomer. After all, who isn't ethnic?
What is important is that each change that the surgeon plans is one that is explicitly decided between patient and surgeon. However, there is no technical difference in carrying out the operation - in other words, creating a straight nose with better shape requires exactly the same techniques in an Eastern European as it does in an African American. The plan, however, must be clear to patient and surgeon, because some patients wish to retain certain ethnic or familial characteristics and some patients wish to lose them.
Finding a skilled surgeon whom you like, who can produce your intended result, and who listens to you is the most important goal.
M.B. Constantian, MD
For some time I've been thinking of getting rid of the bump on my nose. It has always bothered me as it makes my face unattractive from the side view which destroys my confidence. I do however have a few questions. Will my nose be weaker after the surgery or exactly as strong as it was? Will I need to have more surgery after the first one to keep my nose in shape. Is there anything I should be concerned about if rhinoplasty can do harm to my nose?
As much as any plastic surgery, rhinoplasty is surgeon-skill-dependent. You need to find a surgeon whom you trust and whose results with nose shapes like yours you like.
As a rule, rhinoplasty should not weaken your nose, even if you have well-done septal surgery at the same time. Once it is healed, your nose will be able to withstand life well - but of course not trauma that could injure it now.
The chances of revision depend on what your nose looks like now - some shapes are more difficult to correct than others - and on what your surgical goals are (how you would like your nose to look). Because you have not had surgery and still have your septum, your revision rate should certainty be less that 8%. If your nose is also symmetrical (not crooked to one side), it would be less than 5% in my experience.
You are wise to take the decision seriously. Decide what you want to accomplish and find a capable and compassionate surgeon and you will be pleased.
M.B. Constantian, MD
I had revision rhinoplasty after my tip had been over-rotated. I was told that my ear cartilage may be used. While under anesthesia, bone grafting from the septal spine (septal cartilage) was used to create a bridge, and the bone between my eyes was split fracturing into my orbital and up to my eyebrow through my supra-orbital notch. Is there ever a case where this would be necessary? I'm in pain, feel fluid from my left eye that travels through my nose and settles in the back of my throat. Thanks for your time.
It is of course impossible for me to advise you accurately without examining you and understanding what the surgeon intended. If you are asking if a fracture through the nasal bones into the orbit and the bone between your eyes (which I take to be the frontal bone) is normally done in rhinoplasty, even revision surgery, the answer is no.
You do need to be examined by a surgeon experienced in facial aesthetic and reconstructive surgery. It is very likely that you can be helped.
I wish you the best.
M. B. Constantian, MD