dallas101 Posted February 22, 2014 Share Posted February 22, 2014 Any feedback on Dream or before and after or b&a ? Link to comment Share on other sites More sharing options...
espressolatte Posted February 23, 2014 Share Posted February 23, 2014 I've been looking into alternatives to pure rib rhinoplasty, using an I-shaped implant and using ear cartilege for the tip. I am wondering though, is it possible for the implant to extrude? I can see why the L-shaped is likely to, but the I-shape does not have the 'tent' that puts pressure on the tip. Nonetheless, I read a forum member's post that her I-shaped implant extruded. Link to comment Share on other sites More sharing options...
vannytelly Posted February 23, 2014 Share Posted February 23, 2014 The clinic i went to provided 3DVectra services. To show you before and after. The doctor did the after image for me but I didn't quite like what I saw. But then, the results after the suregry; I loved! so.. it is a guide to how you look, but not necessary the exact way you'd look like after. Link to comment Share on other sites More sharing options...
mrsking Posted February 23, 2014 Share Posted February 23, 2014 Hi EspressoLatte, Would you care to share why you cross out the rib rhinoplasty for bridge enhancement? I know its more invasive to harvest the cartilage and the possible warping of the cartilage later. Anything other concerns? Thanks Link to comment Share on other sites More sharing options...
espressolatte Posted February 23, 2014 Share Posted February 23, 2014 Thanks for sharing your experiences VannyTelly, and it’s great that you loved your results! The main reason I ask about how important the simulations are is because I would like some idea how I might look with a higher bridge, pointier tip, etc. Having lived with my current nose for so long, it’s really hard for me to imagine the contrast! MrsKing, I haven’t ruled out rib cartilage but I have been revisiting alternatives since I’ve had the chance to talk more to other patients. Besides the invasiveness and risk of warping, I have read reviews from patients whose noses turned out too large and bulky, the longer healing process, and the fact that if there are issues with silicone, revision and recovery can be done with more ease. The latter is very important since I am still in school. Also, even though I would prefer to have my first rhinoplasty to be my only, I still have the option of rib if I do need a revision. I have been looking at the B&A photos for rib and though I like the side profile results, I have generally not been too impressed with the front view. With artificial implants, you have more control over the shape and height. Overall, I’m disconcerted with the fact that people who have underwent rib rhinoplasty are either very satisfied or very unhappy with their results, at two extremes… However, my main motivation for rib still stands, since it appears to be the safest option and least likely to cause complications long-term. Revision looks very likely for silicone implants at some point, and I do not look forward to the physical and mental stress of additional surgeries. I feel more comfortable using my own tissues, rather than having a piece of man-made plastic under my skin. All in all, I think I’m still in favor of rib, but I am wishing it goes well the first time. I am honestly still torn, so I am consulting with some non-rib clinics in the mean time to get more information. Link to comment Share on other sites More sharing options...
mrsking Posted February 23, 2014 Share Posted February 23, 2014 EspressoLatte, thanks for sharing your thoughts. Not easy to make a decision on which way to go. I am on the same boat. I studied the website of a Chinese doctor, Dr. Ting Wang, who is supposed to be excellent in rib, and have a feeling that warping and revision is also a real possibility. Good luck, and keep us posted on your decision if you can. Link to comment Share on other sites More sharing options...
k-couture Posted February 24, 2014 Share Posted February 24, 2014 id say your chest chance at attainign the look you want is from your first procedure and never a revision. Revisions are so much harder and have a higher chance of error than a primary surgery. If you have a wider nose and very low bridge, typical of south east asian features, then an alar reduction + tip plasty and ask for a bridge implant that is as high as your skin elasticity will allow. That will give you the most aesthetically pleasing results. Tho some surgeons feel an alar reduction is not necessary if they can project the tip enough to pull the nostrils forward, giving a slimmer look. depends on the surgeon Link to comment Share on other sites More sharing options...
k-couture Posted February 24, 2014 Share Posted February 24, 2014 expresso, simulations are completely useless. Its very unrealistic. It is only good for YOU to show the surgeon an idea of what you want to look like. Don't bother getting them to simulate for you because there's so much more involved when the surgeon operates on you. Example, if you have a very short and wide nose, bridge augmentation will be an improvement. How much to augment will depend on how much elasticity your skin has. I find its best to request the highest possible for your nose structure since it will be only the maximum your nose can support. Therefore it will fit your features. With alars you need to be a bit more specific as if you make your alars too small it may make your nose too tiny. Tip plasty is kinda the same case with the bridge in that asians can almost never get the sharp pointness of caucasians because of the different skin type. and nose structure. But we can get a fairly well shaped tip with the right method and surgeon. Link to comment Share on other sites More sharing options...
seoul-kr Posted February 24, 2014 Share Posted February 24, 2014 Hi everyone, I'm heading Korea this March for tipplasty, need some answers here. For a very long while I am still no confident with silicone or any foreign implant. I find my nose bridge not that flat but many clinics suggested silicone for me. May I know, did anyone choose tipplasty + filler first, later changed to implant? I heard that there will be some complication if to get an implant for patient who used filler before. True? Does it consider as revision case if the patient goes back 2nd time to add implant for nose bridge, how abt tip then, does Dr need to remove & redo? Sorry for many questions but really hope someone can help me. Thanks! Link to comment Share on other sites More sharing options...
k-couture Posted February 24, 2014 Share Posted February 24, 2014 Any component that is to be operated more than once at the site is considered a revision. Also, as i say to everyone who is concerned about foreign implants, DO NOT USE CARTILAGE IF ITS YOUR PRIMARY RHINO. Only cartilage for the tip. Septum or ear. Avoid it for the bridge unless your skin is damaged and cannot sustain the silicone. I wouldn't use the hard silicone or goretex. Hard silicone can cause more stress on your soft tissue and goretex should something go wrong will have difficulty removing it, starting from having to excise some of the soft tissue and hence thinning out your nose. Look for clinics who use the product called Ultra Soft Silicone, which is a firm but very flexible and soft piece of silicone.Its a new material developed in Seoul. Alternatively you may want to consider dermal grafts. Artificial donor ones called Auto Dermis. But i do not know much about that implant tho i am considering it for my 2nd revision. I have seen before and after from one forum memeber who looked good after it. She had a dermal graft plus fat injection at the very top of the bridge. Link to comment Share on other sites More sharing options...
k-couture Posted February 24, 2014 Share Posted February 24, 2014 I'm most likely getting my surgery done at dream. I wrote a detailed review thread when i went down to seoul in oct last year u can go check it out. Dream doesn't have before and afters on their website i don't think. I personally prefer that as it gives it a more professional feel. Before and Afters on websites are not important anyway. Some clinics use photoshop while all clinics will obviously only put their best work on there. If you can reliable before and after you should request pictures in pms from members who have had them done at your clinic of choice, using the same method which you have decided upon. Otherwise before and afters are not reliable. Link to comment Share on other sites More sharing options...
k-couture Posted February 24, 2014 Share Posted February 24, 2014 I can't pm you, you need to reach 10 posts first before u can pm. If its not too private u can ask me here and i'll try to help. xx Link to comment Share on other sites More sharing options...
mrsking Posted February 24, 2014 Share Posted February 24, 2014 Hi Coutour, Thanks for a lot of great info that you posted. I find them very helpful! Would you mind elaborate why folks should avoid rib cartilage for bridge if its the primary surgery? MrsKing Link to comment Share on other sites More sharing options...
seoul-kr Posted February 25, 2014 Share Posted February 25, 2014 Thank you, K Couture. I'll ask around this new material "Ultra soft silicone". The one that you saw, do you know where she did her nose? JW suggested dermis fat graft to me when I said no silicone. Using own fat is much much better than foreign material, only problem is the fat survival rate is . I may have to go back to top up fat after several mths. Link to comment Share on other sites More sharing options...
k-couture Posted February 25, 2014 Share Posted February 25, 2014 The one who used dermis did it at Dream. She used fat graft + auto dermis. So her dermal graft is a donor manufactured one. Meaning its taken from a dead person, then treated and manufactured by the company to produce a product called auto dermis. May be a bid morbid for some lol but i frankly don't care haha. For me i prefer manufactured implants because of the shape. Also the fat she used was not for the bridge augmentation per se. Surgeon used fat graft at the very top of her bridge only and only that part. I think it is because she had a forehead augmentation so they wanted to blend the dimensions. Link to comment Share on other sites More sharing options...
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