jez Posted July 17, 2009 Share Posted July 17, 2009 No my eyes are natural ^_^ Link to comment Share on other sites More sharing options...
gonnawin Posted July 17, 2009 Share Posted July 17, 2009 Hey flame, I was just wondering about your statement that Shah has only done 2 alar plasties? I know there are only 2 samples on his site, but it doesn't necessarily mean that that's all he's done. Most patients want their cases to be confidential and wouldn't want their cases to be up on the internet for everyone to see. Did he actually say that 2 is all he's done? Link to comment Share on other sites More sharing options...
noseconcerns123 Posted July 17, 2009 Share Posted July 17, 2009 in terms of healing, my face was swollen for about 10-12 days (really swollen for the first 4 days). Even though I didn't touch my bridge, it too was swollen for maybe two weeks. i do recommend (especially since you're doing surgery abroad) that you bring someone with you that you trust. On the fifth day, when i got my stitches removed, my nose was huge- even the bridge was huge and with no definition. I was somewhat nervous in the beginning, so I recommend you bring someone who can calm you down. If you do decide to go alone, definitely try to stay calm for the first couple weeks because it does get a lot better. as for pictures, i dont have my laptop with me right now (on vacation) but when i do i'll try do dig up some photos. Link to comment Share on other sites More sharing options...
kktg9202 Posted July 17, 2009 Share Posted July 17, 2009 Hey Thanks so much. I would really appreciate pics as i can see what it was before and after so that I can get more of an idea of change, what your bridge was like before, and how changing just the tip can change the shape of the bridge. Basically I want to be as conservative as possible, but improving the shape and length. Whenever you can provide the photos, that will be great, because I really want to go ahead and do this. I will be there with my sister, although I am very worried as i have to go back to work in 2 weeks and dont want everyone noticing (especially my parents) that my face has changed. Link to comment Share on other sites More sharing options...
flame Posted July 17, 2009 Share Posted July 17, 2009 Hi John1, You raise some valid points. The stats are still fuzzy but it was a phone conversation (off the cuff) and he wouldn't have had all the stats/figures in front of him for proper quotes. The 25% figure was more of an estimate off the top of his head but he definitely said he has done over 300 rhinoplasties on Asians. What I wanted to figure out (more importantly for me) is how many of those Asians are orientals with short, flat, wide noses like mine. I actually didn't get a clear answer on this on my email so I will be emailing him again. Hope he doesn't get annoyed at my asking him so many times! My general impression is that most of his Asian clientele may very well be Middle Eastern or East Indians... hence why so little alarplasties.I can also double check on the alar plasty fig ure again since that is something I'm interested in doing along with my tip refinement. Having said that, I did check his publishings (articles he's written or co-authored) listed on his website, and there is one article about Alar Retraction (which is a complication of alarplasties). So even if he hasn't personally done too many, he knows the principles involved. Myself, my alars are not too wide or prominent and need minimal touch up so I'm confident he can do it. But if I had really wide alar like what is typical on an African/black patient, I would probably look elsewhere to have it corrected. Again, this is just my own personal opinion. Everyone has to decide what they are comfortable with. Even if his numbers include noses he has done during residency, shouldn't these count towards his overall experience? Especially if he trained with the 2 best guys in their fields! Personally, I'm ok if he has limited experience on Oriental noses... as long as he has a keen artistic eye (knows what looks good on a face... so glad to hear he's worked with models) and good rib harvesting technique. I don't want any future problems with my rib cage or implant warping. I don't want an Asian nose anyway (hence why I'm having it fixed!), just a well defined, good projected nose that looks good on my face. I think as long as I am very clear with him that I don't want to end up with a large or long nose, I should be happy with my results. At the end of our rushed phone call, he did mention we need to have another proper phone consult before I fly out and in-office consult day before the surgery. That shows me that he wants to spend as much time as he can with me to figure out what I want. I am happier with this type of surgeon than one who tries to fit too many into his day so ends up not really listening to what I want. I guess we all need to weigh our criteria carefully and choose the surgeon that fits best. You're right, there is no "perfect" surgeon that will meet 100% of our criteria for everyone... because we are all so different with very different goals. Hi Gonnawin, When you had your consult with him, did you ask him about the alarplasty data? Was this lack of experience the impression that you got too? Link to comment Share on other sites More sharing options...
john1 Posted July 17, 2009 Share Posted July 17, 2009 i would just strongly advise that you control the results of the alarplasty. the last thing you want him to do is wing it. its irreversible and done right, it looks awesome. done wrong and you wont. i personally dont like the asian alarplasties that rizk did. i dont know what city you are in, but if you are anywhere near la or nyc, i would suggest you pay for a consult with lee or choe and ask them to draw lines where they would do the incision on the alarplasty and then measure the mm's. then tell shah. lee did mine and i am so happy with them. i just told him to make sure that they werent too small and he confidently said "i wont". and its not like he was conservative, he hit it spot on! another suggestion would be to have shah do the bridge and lee do the alarplasty. i would hate for you to be disappointed. best of luck! ok ill shut up now! Link to comment Share on other sites More sharing options...
flame Posted July 17, 2009 Share Posted July 17, 2009 No, no, John1, please DO NOT shut up! I LOVE all your input. You have a very analytical brain and your questions have helped me out a lot. I like your suggestion about going to Lee for the alarplasty. It will have to be another trip though. I am half-way across the world. I will see what Shah says about his experience with alarplasty (I sent him another email to double check on this figure). Also, when I am in the office, I will make sure to look at pics with alar reductions (if he does have more). If I don't like what i see, I will certainly wait. The procedure, done on its own, is fast and inexpensive. It's better to have it done right because I can't get my alars back! Do you mind posting a before and after pic of your alars? Just a close up where we can't see the rest of your face (if you would like to maintain privacy)... so I have a "gold standard" in my head for what I need to look for in a good alarplasty! Link to comment Share on other sites More sharing options...
john1 Posted July 17, 2009 Share Posted July 17, 2009 yeah i dont want to be a nag. i just went through all this stress and worry about my results. the 2am panic attacks are no fun! i can only imagine how bad i would feel if things didnt turn out. not sure where youre flying from but there must be a connection thru la. you can get it as you are flying home but it will prob 5 days to your trip. if you pm me ur email i can email pics to you. rather not post them. not sure about gold standard but of all the things i had done im most happy about that. Link to comment Share on other sites More sharing options...
john1 Posted July 17, 2009 Share Posted July 17, 2009 and if you fly around the world i think the ticket is a lot cheaper! Link to comment Share on other sites More sharing options...
flame Posted July 17, 2009 Share Posted July 17, 2009 Ok, just got more info (Shah is amazingly quick with email responses -big plus in my books!!!): Out of the 100 costal cartilage cases, 40 to 50 were Asians of all various nationalities (chinese, filipino, spanish, etc) I was also TOTALLY off base with his number of alar reductions: the "2" cases he mentioned were "revisions" because the patients asked for further reductions. He said "alar bases is around 65% of all his cases which is 650" were his exact words. So now I feel a LOT better about getting my alars trimmed with him too. But of course, pics pics pics. Will view them in the office. He is also trying to get consent from a few Asian patients to post/send me their pics. Anyway, hope this helps everyone. Link to comment Share on other sites More sharing options...
vivi_bee Posted July 17, 2009 Share Posted July 17, 2009 Flame- i was wondering what is your opinion on this... I read on a doctor's forum that he said "using both ears is more painful then rib cartiledge" I dont really understand why using 2 ear cartiledge would hurt more then rib.... i personally disagree.. cuz i dont even understand how would HE know? Do u believe this? What do u think? Link to comment Share on other sites More sharing options...
flame Posted July 17, 2009 Share Posted July 17, 2009 I understand about wanting to maintain privacy. You've been very helpful, raising questions and concerns that I would not have thought of myself. HOw do I pm you? Link to comment Share on other sites More sharing options...
john1 Posted July 17, 2009 Share Posted July 17, 2009 i dont know what rib feels like, i imagine it would be a problem if you had to bend over or something. ear doesnt hurt so bad when you are just hanging out. the first few days tylenol was a good thing. but with the ear, if you had 2, then i can see there being a HUGE problem when sleeping, especially early on. im not a back sleeper so it was good to be able to sleep on the good ear from time to time. if both were cut up, i dont know what i would have done. i probably would have been pretty miserable. its been 3 weeks, and last nite was the first time i could sleep on my cut ear without jumping in pain. Link to comment Share on other sites More sharing options...
flame Posted July 17, 2009 Share Posted July 17, 2009 Hi Vivi_bee I really don't know. My guess is perhaps because using both ears creates 2 surgical sites whereas rib cartilage only has one?? I've read that the level of pain is similar between harvesting from the two areas: ear or rib. Why? Are you considering using both ears to get cartilage? If you need that much cartilage, wouldn't it be better to just use rib? I read that ear cartilage, due to its shape, tends to curl and warp if used to augment the bridge. Dr. Toriumi's website has a very good section on why he uses rib vs. ear vs. synthetic. Why don't you send one of the docs an email about this? Maybe after reviewing your case, they may even say you don't need both ears harvested! Good luck. Link to comment Share on other sites More sharing options...
john1 Posted July 17, 2009 Share Posted July 17, 2009 i think if you click on my name there should be a box you can click. Link to comment Share on other sites More sharing options...
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