yeuyeu Posted January 5, 2009 Share Posted January 5, 2009 Hi Asin, I'm planning on removing the implant only at this moment. I live in NYC and it's just too much hassle to travel to la again (dr.lee's office is super-super-crowded and it takes ages to have anything done). I went to consulation today and my surgeon (not dr. lee) warned me that taking out the cartiledge is not very easy because oftentimes it is sutured there. It is also associated with some risks that I don't remember (breaking bones?). But he also warned me that sometimes just taking out the implant might leave one with a 'saddle nose' if there're a lot of cartiledge in the tip area. However, after seeing my before picture he decided there was not much cartledge in the tip area and that I will be able to get away with removing the implant only. Plus I do want some definition at the tip. In any case, I can always go back and have the cartiledge removed a few month later when I'm beginnning to see the final results. What was your tip like before? I'd say you should ask dr.lee how much graft he put in at the tip and see what he thinks. Link to comment Share on other sites More sharing options...
yeuyeu Posted January 5, 2009 Share Posted January 5, 2009 Exactly pursebao. I feel the situation is a lot worse right now since it's winter break. My consulation was short too. I also felt like the computer simulation leaves a lot to be desired. The frontal simulation is just not very accurate (I did alar reduction); the profile simulation is more accurate. But one lesson I learned from all this is that 90-degree profile really means very little. Few people are bothered by their 90-degree profiles...heck we can't even see it in mirror! What really matters is the profile from an *angel*, say 60-degree, 45-degree, 30-degree, etc. And *that*'s where the HUGE BRIDGE between the eyes become the most noticeable and ugly. That information is simply not provided to us. The whole simulation software industry is just extremely underdeveloped.... To be fair I do like what Dr Lee did to my nostrils. It is no longer flared on the frontal view which is a big relief to me. But now I'm kinda worried about the alar and want some roundness back. I remember signing a form that says revision is going to be somewhere around $1500, but I'm not sure about simply removing the implant. Actually, when I had the surgery a couple of weeks back, I had a chin-implant as well (big, big, big, mistake: no one should ever have chin implant unless their chin is really RECESSED!!) and I took it out a week later at dr.lee's office and he charged nothing for it. So I guess the same should be the case for the nose as well. Link to comment Share on other sites More sharing options...
yeuyeu Posted January 5, 2009 Share Posted January 5, 2009 Another possible reason for removing the implant only is that the bridge is never going back to the same height... scar formation means it'll be higher than before, and leaving the graft (if there isn't too much of them) might just be the right thing to do... But that's just my guess Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 i'm planning to go back to dr. lee to do the removal. he says it'll be $600. he recommended that i wait until the 6 month mark because if my nose looks weird after removing the implant, there is not much he can do to fix it. also, this will be my 2nd revision. i had a revision 1.5 months after the primary surgery because the implant was shifted. dr. lee supposedly put in a smaller implant during the revision but it still looks as big as before, plus its wider. i completely agree with this. the 45 degree view of my face is the worst. i've been going through my before/after pictures to figure out what my nose may look like if i remove only the silicone implant and not the graft. it's really hard to tell because i don't know where the silicone implant ends and the graft begins. have you guys asked for honest opinions about your new nose? it is difficult to adjust to the change, after living with your old nose for so long. it's been 2.5 months since my surgery and when i first took pictures of my face, i thought my new nose looked repulsive. now that i look back on those pictures, i don't think i look that bad, just different. i suppose i have gotten used to the change in my appearance. i still feel that i look better with my old, lower bridge though. Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 i wonder how much difference the scar formation is going to make. is it going to make our noses higher plus wider than before? it sounds like this might be a positive side effect (if there's no increase in width), since our noses were probably a little low to begin with if we received augmentation. yeu yeu, when are you planning to remove the implant? are you having it removed with the surgeon in NYC? i'd like to remove mine this month, but i'm still thinking maybe i should wait until the 6 month mark. i really don't want to live with this big bridge for another 3-4 months though, if i'm just gonna end up removing it at 6 months anyway. Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 by the way yeu yeu, i think your ala will change as the swelling goes down. my old nose was wide and my nostrils flared. i, too, am happy with what dr. lee has done with that aspect of my nose. for the first few weeks post op, my nose was very hard/stiff/swollen. now it has widened a littled and my nostrils got a little bit of "flare" back. it's a good thing; it looks more natural and it is nowhere near as wide or flared as it was before. Link to comment Share on other sites More sharing options...
pursebao Posted January 5, 2009 Share Posted January 5, 2009 yea i totally agree with that, i see the most different when i look at my face in an angle. I always believe that plastic surgery should be just an enhancement instead of a drastic change. i am glad i emphasize to him during the pre op consultation that I dont want my nose to look too different, just enough support to make me able to breathe. I am satisfy with the height and my husband (who is against plastic surgery) thinks my bridge actually looks nice. Link to comment Share on other sites More sharing options...
yeuyeu Posted January 5, 2009 Share Posted January 5, 2009 My own *very* tentative guess is that there are two kinds of tip work that Dr. Lee doeshttp://www.asiancosmeticsurgery.com/html/bnas/rhino_01a.htmlhttp://www.asiancosmeticsurgery.com/html/bnas/rhino_03b.html The change in my tip is much more like the 1st example than the 2nd. There's basically very little 'upward' pointing effect post-op. I don't know whether that's the reason my surgeon tells me not to worry much about saddle nose, but I suspect it is. Also, before my surgery Dr.lee tells me that if during the surgery he finds that there's not enough cartilege, he might use some donated cartledge. I'm not sure whether to interpret that as a sign that he was not very confident about producing much of a change to my tip. I can totally share your feeling. Sometimes I feel I look great in front of mirrors, I've even grown to like my frontal view 1 week after the surgery. But then I discovered that it is only because the areas between my eyes are kind of blurred out when I look straight into the mirror from a distance with a certain kind of lighting (also, when you look at the mirror, you are looking at yourself at *two times* the distance between you and the mirror, so a lot of details are lost). So it doesn't look that pronounced. But when I move closer to the mirror, or change angles, the bridge looks extremely obvious and ugly. I have sought out some opinions about my new nose. But I'm really not sure they are "honest"...... I guess people sometimes just want to be nice (plus I was being extremely depressed and negative when I told them about my nose job, so they might just want to cheer me up)... My parents would have provided more honest input, but I'm too afraid to let them know at this stage... I guess the reason I hate high bridge is that it makes me look way too mature and masculine than fits my personality. Low bridge may look naive at times but it also makes you look more childlike, which can be good if you are that type of person. With high bridge I look more serious, unsmiling and even threatening (it's also making my face look longer I guess). Even my smile is different. Maybe some people would benefit from this kind of change if it suits their personality... That's what I'm wondering as well. I'm really hoping your theory comes out true! I've decided to remove it asap and just scheduled a Thursday surgery with an (I think quite respectable) NYC surgeon. I have had enough of this obssession with my bridge and want to put it to an end asap... plus I don't want to start the spring semester by freaking my friends out... .. Also, given the sheer size of my implant, I'm afraid that letting it stay there for too long might cause loose skin. My surgeon today also told me something about not letting silicone implant stay too long (not to say gortex)...which I forget.. It seems to have something to do with the bone... but I'm not sure. I'm curious about Dr. Lee's remark that the nose might look weird after removal of implant. My initial research hasn't turned up any information against removing implant at an early stage... Of course everyone says you should wait 6 months to see the final result. But I haven't found anyone saying that removing it early might have any negative effect on the nose..... But I guess I'm willing to take any risk to take it out asap..... That's a really reassuring thing to know! What bothered me most immediately post-op was the alar area. Now the alar only looks bad in photos, especially with frontal flash. But it looks reasonably okay in mirror. I'm hoping it will improve in the next couple of months... Otherwise, I will just have to start learning how to pose for cameras...... Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 i just booked an appointment to have my implant removed this friday as well. i'm really worried that my nose will look weird. let's hope that our noses will look good after implant removal. good luck to us!!! can you keep me posted on how your nose is after implant removal? i will do the same. i feel like there is an asian standard of beauty - certain features are considered to be "ideal" such as high noses, big eyes, light skin... etc. but i've come to realize that they are not necessary to be attractive. i have been obsessed with asian noses and bridge height ever since i got my surgery (isn't that sad?) and i'm finding that low bridges can be beautiful too. i've seen many very pretty asian girls with low bridges, and i can't really imagine that a higher bridge would make them prettier. i also feel like a high bridge has made me look more mature and masculine, not to mention less asian. my white friend says that although i look fine now, i looked more exotic before surgery. Link to comment Share on other sites More sharing options...
pursebao Posted January 5, 2009 Share Posted January 5, 2009 asin, i just have my second revision cuz my graft is shifted to the right that made my tip looks very lopsided. Dr lee gave me local anesthesia and i was holding a mirror as he adjusted it. The graft is only a thin piece of cartilage that is implanted on the bottom of the tip. And you can feel where the silicon implant end. Its right above the highest point of the nose tip. if you go back to the old post, I remember this girl Jang who went to BK clinic, she had the implant taken out due to infection and post some pictures of it. I will see if i can find them. Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 the change in my tip is more like the second girl. my tip was very round before surgery and now it's more pointy. her bridge was very low before surgery though. it was non-existent in the area between her eyes. the change in the first girl is pretty subtle. her tip wasn't that round to begin with. i think cartilage resorbs over time so what our tips look like right now is still pretty different from how it will be in 6 months. Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 oh wow that's pretty crazy how you were conscious and saw everything that was going on. i wonder if i can do the same when i have the implant removed. dr. lee says that if my nose looks funny without the implant, he will put a smaller implant back in. i'd like to see what it looks like while my nose is "open" so i can determine whether it looks okay. i can feel the graft at the tip of my nose... i still can't tell where the silicone implant ends, although i can tell where it begins at the top. how does the graft sit? does it sit upright along the columella (i think thats called a columella strut)? i have seen those pictures of jang. i think her nose looked pretty much like her old nose after the implant was removed. the cartilage didn't make a big difference. Link to comment Share on other sites More sharing options...
pursebao Posted January 5, 2009 Share Posted January 5, 2009 yea i thought i was pretty crazy too seeing him taking the graft in and out a few times. He asked me if i want it out completely or have it a little off center because he can't put it exactly in the middle, so thats why he gave me a mirror. He actually gave me a mirror during the first revision to make sure i think my alar are even. The trick is to see it as soon as he did the changes because the nose swells up fast and it will be harder to tell after couple mintues. So ask him for a mirror before he starts. If you only get local anesthesia, u can give him a ok before he sew everything back in. BUT the numbing shot STING!!! it hurts sooo much, I tear and sweat everytime i get the shot or shots. yea the graft sit exactly like a columnella strut like this:http://www.spaldingplasticsurgery.com/images/revrhino/fig-14-Strut2.jpg I think the best way to get his attention is to schedual it on a day when he is not too busy. The office was almost empty during both of my revisions which are during weekdays. I am surprised he actually remember my name, where i live and apologize to me for drugging me for the third time hahhaa. Link to comment Share on other sites More sharing options...
pursebao Posted January 5, 2009 Share Posted January 5, 2009 my graft looks exactly like this (the first minute of the movie) but he put it through my right nostrils. http://icyou.com/topics/treatments-procedures/cosmetic-surgery/rhinoplasty-operating-room-columella-strut-placement+ Link to comment Share on other sites More sharing options...
asin Posted January 5, 2009 Share Posted January 5, 2009 thanks for the information pursebao. so dr. lee sewed a thin stick between the cartilage just like dr. nassif did in the video? the graft on my tip doesn't feel like a thin stick. there's an article written by dr. lee on emedicine about asian rhino. there are some pictures on there. check out picutre #3. it shows a septal graft secured onto the columella. is that what the graft is shaped like? from the feel of it, the graft on my nose is more like that one. it's more like a plate than a stick.http://emedicine.medscape.com/article/1293426-media how does your nose look now since dr. lee couldn't get the graft centered? my graft feels like it can be uneven too because one side is harder and pointier than the other. i am probably gonna get some "twilight anesthesia" as well as oral medication along with the local anesthesia. you are brave for enduring the surgery while fully conscious! Link to comment Share on other sites More sharing options...
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