gonnawin Posted July 15, 2009 Share Posted July 15, 2009 Hey mani, My nose issue sounds eerily similar to yours... the issue for me has been how the alar spreads too much when I smile. At rest it isn't too bad. I guess the way to explain it is the alar wedge is too "round" and so it has a natural flare to it. It is trickier than most rhino issues because when i went on different consults years ago, most would defer doing my case and i got different referrals. Anyway, what's important to me is having a somewhat "seamless" look, without the alars looking "cutoff." I also think projecting the tip would help a lot. I'll keep you posted on my findings. Let me know how your search goes. Link to comment Share on other sites More sharing options...
john1 Posted July 15, 2009 Share Posted July 15, 2009 ive read about the warping as well as rib being very stiff and hard which people have complained about. but the main factor is that its very difficult to do a revision. i think its because the cartilage binds to the bone. but if the cartilage is wrapped in perichondrium perhaps then its easier to remove? i dont know. if you need revising it may be difficult to find someone qualified to do a revision well. for an objective opinion you may want to post a question on realself.com. usually a few ps will get back to you with an answer in a few days. ive read a lot about bridge issues and people not liking the result and thinking its too high, etc. i know firsthand how significantly changing it is. so with the higher revision rate on the bridge (vs tip and alars) the difficult revisability was a definite factor. that said, the "natural" nature of your own cartilage is attractive. Link to comment Share on other sites More sharing options...
flame Posted July 15, 2009 Share Posted July 15, 2009 Hi Gonnawin, If all goes well with the phone consult, I'm hoping to fly to Chicago in August. Will keep you posted as to the exact date. Must book the surgery first. You're more than welcome to come along during my appointment to review the photos and scope things out! I'm a 25hr flight away so it's a one-trip adventure for me. If I go, it will be for the surgery. Hi John1, Thanks for the advice. I don't mind it feeling hard as long as it looks natural. As it is, my current silicone not only looks unnatural but also feels it. If Shah is as good as I hope, revision should not be in my future. But it is good to know about it being difficult to revise later. I'll ask Shah about that during my consult. Link to comment Share on other sites More sharing options...
rememberme123 Posted July 15, 2009 Share Posted July 15, 2009 Hey flame.. have tried to pm you but seems like i can't do it. Could you please update the forum here about your consult and experience with Dr Shah? He is one of my top choices for rhinoplasty too.. but i can only do the surgery next year... Hopefully all goes well for you..! Would really appreciate it if you could update.. THANKSSS! Link to comment Share on other sites More sharing options...
fifipek Posted July 15, 2009 Share Posted July 15, 2009 hi can u give me dr chuang email add? thanks Link to comment Share on other sites More sharing options...
fifipek Posted July 15, 2009 Share Posted July 15, 2009 hi did u do ur eyes? at where? im wanna do double eyelids n epicanthoplasty Link to comment Share on other sites More sharing options...
gonnawin Posted July 16, 2009 Share Posted July 16, 2009 Hey flame, I was also planning on flying out there to Chicago. I want to do an in person consultation prior to booking a procedure. I'm looking at either august 14 or 21. Let me know how things go, maybe u can just pm me your contact info. Link to comment Share on other sites More sharing options...
flame Posted July 16, 2009 Share Posted July 16, 2009 Sure thing! I'll give a complete analysis as soon as I can. Link to comment Share on other sites More sharing options...
flame Posted July 16, 2009 Share Posted July 16, 2009 HI Gonnawin, I will keep your dates in mind (aug 14 or 21). Hopefully my consult will go well and they will have an august opening for my surgery. I will be staying in town for 2 weeks so I'm sure we can meet up sometime. Not sure how this pm thing works either. Does anyone know? Link to comment Share on other sites More sharing options...
noseconcerns123 Posted July 16, 2009 Share Posted July 16, 2009 i did get rhinoplasty with Charles Lee in LA. He is good with the tip and alar, but some previous posters have complained about his work on the bridge (slanted, etc). I didn't actually get an implant so I can't say firsthand. With implants, although implant removal is fairly easy, previous posters have complained that their bridge got wider and less defined after removal due to scar tissue. He does not harvest rib cartilage, so that's something to consider. i consulted with a few other plastic surgeons in LA, and one thing I noticed was that a lot of them tend to inflate their percentage of asian patients. They would claim that 30% of their patients are asian, and then when I ask for the breakdown of the percentages of ethnicities, they would say 50% of their patients are caucasian, 30% latino, 10% african american, then pause....and readjust their numbers. Link to comment Share on other sites More sharing options...
kktg9202 Posted July 16, 2009 Share Posted July 16, 2009 Link to comment Share on other sites More sharing options...
john1 Posted July 16, 2009 Share Posted July 16, 2009 hey, just wanted to make you guys aware of some morphing software that i used that i found really helpful in helping me decide what i wanted to do. its called virtual plastic surgery or something like that. you can google it. a little tricky to use at first but once you figure it out its easy. its especially good for analyzing alar reduction and bridge and chin implants. you can see what a huge difference alarplasty can make! it costs like $29 but thats cheap given what the surgery costs and the importance. i found it really helpful so just wanted to put it out there. Link to comment Share on other sites More sharing options...
flame Posted July 17, 2009 Share Posted July 17, 2009 Hi all, Had my first phone consult with Shah this morning. Good news and bad news. The good news is that he seems very caring, thorough, knowledgeable and flexible. He listened to my concerns and addressed each one. The phone call was cut short (office behind schedule) so I didn't get to ask him all my questions. I emailed him the rest of my questions (pertaining to stats that we are all wondering about) so I will post his answers later. So far, he did say 25% of his clientele are Asians (I emailed him later to clarify how many of these are Orientals/Southeast Asian). He has done over 800 rhinoplasties of which about 300 were Asian (if I remember correctly). He is very aware of aesthetic concerns of Asian patients and will work with each patient to achieve what we want. He confirms that he only does 1 rhino a day so that his focus is only on that patient for the day. He's written 2 papers on rib graft warping and carving issues to decrease it. He did mention that the Asian girl on his website requested a very soft augmentation... which I thought was good that it was her choice since I'm looking for more projection and definition for my nose. JOHN1, he did mention extending my tip with perichondrium and septal cartilage but he said it so fast that I am still confused as to where he was going to get this stuff so I emailed him back to clarify. I don't think he is planning to use this on my bridge though since I am getting the rib graft there. He did mention that my nose will feel very hard for at least 6 months... which is alright with me... at least my glasses will sit on my face properly. lol. He is young and obviously haven't done as many rhinos as Dr. T (his mentor) or the Korean docs but it doesn't mean he doesn't have the skills to do a fantastic job. Personally, I would rather go to someone like Shah who will take the time to sit with me and work out exactly what I want (esp since I am bent on getting ONLY rib and nothing synthetic) than to someone who has an assembly line type of clinic and who are more familiar with Goretex, silicone or other synthetics. However, onto the bad news (sorry Gonnawin and Manimani)... he has only done 2 alar base reductions. Thus, not much experience with alarplasty. Will keep everyone posted on his answers to my other questions. Link to comment Share on other sites More sharing options...
john1 Posted July 17, 2009 Share Posted July 17, 2009 thanks for the update. but unless im missing something something really doesnt add up. how do you do 800-1000 rhinoplastys which includes around 300 asians and only 2 alarplastys? i would think at least 1 out of every 5 asian rhinoplastys would include an alarplasty unless by asian he includes middle easter and indian, but even there 2 is hard to understand. this doesnt even count african americans which are probably even higher in alarplasty. i mean alarplasty is one of the most common rhino procedures. and the asian and african american in his b&a pics had alarplasty so that cant be all the alarplastys hes done? plus if he does 1 surgery per day and operates 3 days a week like most, that would be max 150 per year if he was always fully booked, so he must be in practice for at least 5 years now? thats a best case scenario unless he is counting operations he assisted on also in residency??? i would guess his 800 claim is a bit fuzzy. also 300 divided by 800 is more like 35% not 25% so that doesnt add up either and with asians making up 2% of the population in the us, 35% seems like an awful lot for someone who isnt marketed as an asian specialist and almost all his photos are of caucasians and he supposedly specialized in models while he was in nyc. i would guess his 300 claim is a bit fuzzy too? just my 2 pennies. Link to comment Share on other sites More sharing options...
shinangel Posted July 17, 2009 Share Posted July 17, 2009 LOL! Link to comment Share on other sites More sharing options...
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