neednewnose Posted July 29, 2014 Share Posted July 29, 2014 I'm relieved others are voicing concerns over anxieties. I thought I was alone. When I look at before & afters it gets a lil depressing. The good results make me think, wish I had that. The others, along with horror stories make me rethink it all. I'm on information overload. I've probably looked at a hundred places, but keep going back to my original choices. I like Korea since I can address other issues, but I can't locate a good rib revision surgeon. I haven't heard back from VIP. I'm leaning towards Taiwan if I can find other procedures there. If anyone is familiar with surgeons in Taiwan, please let me know. Radeon, where are you traveling from? Link to comment Share on other sites More sharing options...
nini93 Posted July 29, 2014 Share Posted July 29, 2014 Hi, For those who have already gotten their nose jobs, do you like your side profile and dislike the front? I had my nj 2 months back, I really liked my 45 degree, it has the right height and curve, but my 90 degree and front profile looks flat. Anyone else experiencing the same problem? Link to comment Share on other sites More sharing options...
neednewnose Posted July 29, 2014 Share Posted July 29, 2014 Maybe I'm mistaken, but you've had diced ear cartilage wrapped in fascia? Isn't it a relatively new technique for rhinoplasty? This procedure is known to have possible issues in the radix area. Some haven't great experiences with a specific aspect of cartilage, maybe their doctors hadn't been practicing the procedure enough. People shouldn't be deterred from using their own cartilage when it's a tried and true method. Some doctors are against using ear cartilage, since it's rather hard and difficult to mold. Ribs expand when you breathe, it's naturally more flexible. You've mentioned your implant is inserted in a pocket between bone and muscle. Has that method been used for a long time? I had an implant very high up against my gums. It felt as though the implant was grinding against them. Even without movement. Then i hear that it can in fact wear down bone. I'd imagine that could be a possibility if sandwiched between muscle and bone. Sure it's "soft" silicone, but who knows the implications (including circulation). I'm not sure it's been around long enough for all issues to be known. Implants are perfectly shaped. It would be like arguing implants for breasts over using one's own fat, but for many they don't like the feel. Or implants just aren't an option. Rib cartilage for rhinoplasty has been used for decades. I've had mine about 15 years. The bridge doesn't have any of the issues people worry about. Mine was probably before all the precautions doctors take now, but when a large piece of rib cartilage is trimmed properly it should hold up fine. Not be bumpy or anything else. Just be sure to find a surgeon experienced with using rib. There is no perfect foolproof method. There are always trade offs in choices offered. Link to comment Share on other sites More sharing options...
neednewnose Posted July 29, 2014 Share Posted July 29, 2014 The 45 degree angle often is flattering. Many sites seem to only show that and/or profiles leaving out fronts. It's aggravating to me. Surgeons almost always give a straight profile, but that's not how I go around talking to people!! I dislike my front view as well. Sounds odd, but I liked when my nose was swollen for the height. Was told the tip would drop over time but never did. It sounds as though it's lacking projection? Link to comment Share on other sites More sharing options...
moreen Posted July 29, 2014 Share Posted July 29, 2014 I am glad someone has brought up problems with rib rhinoplasty. In cali nearly all the surgeons are using rib and they always claim it is best because it is yours. It really makes sense when they explain to you. After I got my nose job using rib I end up with hook nose like those stereotype jewish nose. Doctor say is swelling but over time got worse also look wonky so ended up I have to take out. Really don't recommend rib to people. Nowadays many people go korea is use the dermal back fat is look natural you heard of it? Link to comment Share on other sites More sharing options...
radeon Posted July 29, 2014 Share Posted July 29, 2014 Thanks for your reply Lemiknox, thats the thing about Dr WANG, its located in Dalian and i guess theres no direct flight to it. i guess singapore might have direct flight to Dalian but not everyday. its not like VIP direct flight to seoul and take a train somewhere in Apgujeoung area if i remember correctly. one thing to note dont go there on winter or january if you cant stand cold weather. my god, the weather is torturingly cold and makes your recovery life harder. while Dr Kao, i am still unsure where is his fixed clinic, some people have surgeries there and some over there, and i was told to a clinic that i think forum members not yet knew of. its refreshing to know that you ve been treated good there. also to know bridgette is pretty nice in real life--not just in the mail... i believe the second most important thing in a surgery is the post-care. if the post-care is like ****, only a really good results could salvage the experience, otherwise the whole journey is a nightmare. i dont wish that on anyone, i know how hard it is to have a surgery and post-care is an absolute, somemore thinking of bad-service..yuckss thanks K COUTURE for your info on Rib. somehow it makes me rethink myself on getiing rib however i am pretty convicted on using rib for my nose... should it fail, i will shift to soft silicon. thats why i am going to try for the limit first. hahaha. Hei NEEDNEWNOSE, i am travelling either from Indonesia or Singapore, I am Indonesian but i could live somewhere in both so i travel from either. wanna jump in to my "to a better nose expedition" of mine? hahaha Link to comment Share on other sites More sharing options...
k-couture Posted July 29, 2014 Share Posted July 29, 2014 Yes i did have diced cartilage with fascia. And no its not a new technique. Within the medical community, Roland K Daniel is considered the one who pioneered the technique. However it was used as far back as 2004 I believe. But according to Roland K Daniel, the technique started to become more mainstream in 2008. When i consulted Dr Daniel he suggested that this technique negates risk of warping which is present when rib is used. I agree there certainly is legitimacy to the use of autologous cartilage for the bridge area, if not it wouldn't be one of the primary rhino materials used today. However as I mentioned, from my experience and that of others, and ive had a number of people pm me regarding revision for autologous cartilage, my opinion is for primary cases which are not complicated, the ultra soft silicone will yield better aesthetic results. It is also warranted to compare the shape and structures of silicone versus that of autologous implants, just as it is to compare the use of fat transfer as an alternative to breast implants. Both methods have different risks and limitations after all. Reason why I mentioned implant shape is because that's one of the limitations of rib. I learnt of this from my consultations with Nick Carr and Bryan Mendelson. Before I went to get my first revision, Nick Carr actually advised me against the use of autologous implants and cited that as one of the reasons. I clearly regretted not taking his advice but my outlook on surgery is to take my past mistakes as a learning process. Also with the method whereby the implant is placed under the periosteum above the bone, that method has also been used for a long time. I only found this out when i sought a consultation with Dr Mendelson regarding the proposed methodologies for my revision rhino. I mentioned Dr Park's method and Dr Mendelson actually told me that this technique has not only been used for a long time, surgeons generally will attempt to perform the placement as deep in the nose as possible to minimize risk of deviation. With regards to circulation, from what i experienced I am certain that is not a problem because in my case, I really required alot of circulation due to the condition of my nose before my 2nd revision. I had extrusion from my autologous cartilage at the top part of my bridge. After the surgery while i was in the ward, I felt an unusual sensation on the area where i previously had extrusion. So I requested Dr Park's attendance and he came to see me after his last surgery. When he removed the cast that entire area of my nose, was black. It looked like rotting flesh. That's when i went into panic mode. However when Dr Park examined my nose he noted that he was pleased there was good circulation around the site and he will continue to monitor it. The next morning when he came to check up on me the site went from black to a redish tone. He then told me that things are looking good and that this occurred because circulation is good. btw your nose is using rib cartilage right? If you don't mind me asking, what is the reason why you are seeking a revision? Also what do you mean when you said you had an implant high up against your gums? Do you mean you tip area was pressing against the gums? Link to comment Share on other sites More sharing options...
neednewnose Posted July 29, 2014 Share Posted July 29, 2014 Moreen: sorry to hear things didn't work out for you. Are you in southern California? I don't like my nose either. My doctor feared making me look Jewish (as though that's possible) and morning of surgery went half shorter than what we discussed. Often times it's the method that's the problem, not the material. Having had both types, I prefer the feeling of rib over silicone and wished I'd had that option to start. I was told my implant had a lot of calcification. Seems that's a common issue. I imagine over time it would harden whether soft or hard implant. It was also difficult to have extractions during facials. The nose wouldn't give. Radeon: sure thing! I'm not that journey myself. I'm not sure what's with Dr. Kao either. I thought he was head ENT at a hospital, then heard he left? I planned upon Kaohsiung, but if you're further north maybe I'll be around. Like Dalian, there doesn't seem to be an easy flight to Kaohsiung. Someone I know was telling me about Indonesia. Do you know about rib rhinoplasty there? Link to comment Share on other sites More sharing options...
lemmiknox Posted July 29, 2014 Share Posted July 29, 2014 Yeah there are no direct international flights into Dalian, however from Dalian you can fly directly into Incheon or Tokyo. To fly to Dalian you need to layover in GuangZhou or Shanghai usually. But I really don't see why that's a big deal, it's a small port. Yes I heard it's cold during that time. When I was there though it was stinkin' hot. Link to comment Share on other sites More sharing options...
neednewnose Posted July 29, 2014 Share Posted July 29, 2014 Thanks for that insight. If you traveled to Dr. Lee, why not go to Dr. Daniel himself? I imagine he'd be best at it. Ten years sounds relatively new. FDA (Food & Drug Administration) takes about that many years before approving anything new. Ten years of China allowing plastic surgery scares people away as it seeming "too new" there. I've read doctors' opinions on diced cartilage. Some are into it, some aren't but don't go into further detail. I found one that said "diced cartilage and fascia is a good option but it lacks any support if your nose needs to be lengthened". I need lengthening, so it's not something I would consider. Sounds silly but if several pieces are wrapped together, I fear a piece or two falling out of line and distorting if something accidentally hit my nose. I wouldn't want to use ear, but there's not enough cartilage there for it to be an option for me. Is it possible when Dr. Lee was creating room for the fascia wrapped cartilage, he poked through and thinned your skin? They describe it like a sausage. That's gotta feel so much softer than the implant I had. I was awake for that surgery and had it shoved in haphazardly. My thick skin must've saved it from piercing through. I wasn't so lucky with Goretex for premax. I hadn't heard about placing an implant in a pocket that way. Only for breast. I would certainly panic if my skin turned black! It's good you have proper circulation, but i wonder about these foreign objects over time. I've had my fair share of horror with implants. Thinning skin, calcification, piercing through, embarrassing facials with estheticians. For my lifestyle, I prefer to give rib another chance. I doubt I can get the height I'd like with any implant. I share your sentiment about regret. It's generous you share your experience. I've been apprehensive about going through this again. People aren't always supportive of elective surgery. There was no such online community and limited access to research online when I went through it. Link to comment Share on other sites More sharing options...
k-couture Posted July 29, 2014 Share Posted July 29, 2014 10 years for surgical techniques is actually a good amount of time to do clinical studies on the viability of implant types and methods. If you consider how silicone implants 20 years ago went from the hard blocky silicone to the smoother hard silicone to the soft silicone and now to the ultra soft silicone, its truly an interesting transition as practitioners learn more of the limitations of previous forms. Just like how fillers for nose became widely used around 2006 i believe (least that's when it first started popping up on television and becoming available at cosmetic clinics and dermatologists) but after 3 years or so of using them many surgeons avoid them because they have had cases where patients required surgical excision of tissue due to residue which refused to be absorped. Its the same situation with lippodissolve. A few reasons why I chose Charles Lee. At the time, I had learnt of Roland K Daniel from Nick Carr. Before I met Roland K Daniel, I had went down to beverly hills to meet Charles Lee and the reason why i settled on him was because of plain stupidity. I mentioned Roland K Daniel to Charles Lee and he actually told me that he uses the same method but has more experience on Asian noses and was giving a speech about the technique on Asian noses at some seminar. I was also in awe of his appearing on the tyra banks show :S Hence i didn't bother to organize another trip down from van to see Roland K Daniel. It was only after i had been botched by Charles Lee and sought revisions did I go to see Roland K Daniel. Reason why i didn't get my revision with Roland K Daniel was because by that point I had really lost faith in the diced cartilage method and wanted to go back to silicone as it was the silicone that gave me that perfectly dead straight shape. I totally understand where you are coming from with your concerns about the diced cartilage. When I spoke to Dr Mendelson about the diced method, he actually explained it to me by with the analogy of dicing apples into small peices and wrapping it with rice paper. No matter how you wrap it, its always going to be an irregular shaped implant. True enough when Dr Park removed my diced cartilage I could see what it looked like. Like a small ice cream stick with sprinkles dumped all over it....except it was red cos it was freshly removed from me. I remembered thinking to myself....god that thing was in my nose? Hrmm see i didn't experience any thinning or the issues you mentioned from my first silicone implant. And that was a soft silicone not ultra soft. The problem with it was I had discomfort because the stupid thai surgeon just cut out a dodgey shape which was jagged at the side from a block of raw silicone and shoved it in my nose. Same problem with my chin implant. I eventually did a ct only to be mortified when i saw the shape that was in me and finally understood what had been done to me in thailand. I can only learn from my mistakes but like you said, it would have been so helpful if forums like this existed back then! I remembered going into search engines googling the yanhee hospital, Dr Prechart's name (i think that's how u spell it) but nothing detailed was coming up. Link to comment Share on other sites More sharing options...
k-couture Posted July 29, 2014 Share Posted July 29, 2014 there was a fellow aussie who had her revision at around the same time as myself back in May. Her friend went to Eight (i think?) and got the dermal graft done and seemed to love her results. I have had no experience with dermal grafts (just an auto dermis that didn't fit lol) so i cannot comment much on the technique involved or the material itself. Ummm but i was told that absorption is potentially an issue so you might want to look into that. Link to comment Share on other sites More sharing options...
neednewnose Posted July 29, 2014 Share Posted July 29, 2014 Don't feel foolish about learning of him on tv. I'd think the show would check him out too. LA docs, hairstylists, makeup artists etc have good PR people (unfortunately). I found my second doctor through a glowing review in an old rhinoplasty article in Allure magazine. Then went on a mission to convince my parents this was the one. @&*# Allure!! I was looking at Thailand too. That hospital and name came up. Very limited before & afters for what i want so it deters me. They sure do make some pretty boys, but I'm assuming they're better at full body work. What's discouraging is you can go to someone people consider "the best" then come out with subpar results or completely botched. My doctor only did rhinoplasties. No lipo or injections and even dermatologists here do some plastic surgery work. However, he did two other patients the morning of my surgery. Granted being the only Asian for miles, I was likely the only rib case but wtf!! Link to comment Share on other sites More sharing options...
sammyy Posted July 29, 2014 Share Posted July 29, 2014 Hey guys, So I'm post op (Dermal fat for bridge and septal and donor rib for tip) 9 days today. Did surgery with Dr Suh from JW. The tip has deswelled alot and when i went to see Dr Suh yesterday, he mentioned that for the tip, the result is more or less finalised. Still swelling quite a bit on the bridge though. Will wait until the bridge deswells to comment on the result but i love the tip so far.More about JW On the many days i was there for follow up, the clinic was really crowded. I met many locals, thais, chinese and also this korean american girl who ended up really really pretty after her nose surgery with dr suh. Aftercare was also pretty good and the people there were all really friendly. There were of course, a few areas in which i felt could have been better but i would not mention here (PM or kakao [sammyy122] me if you want to find out) Link to comment Share on other sites More sharing options...
moreen Posted July 30, 2014 Share Posted July 30, 2014 Yes I could not get good extraction also when I go to have facial. When they push down my nose will feel too much pressure like the implant was going to move so I scared something bad happen and then I tell them be more gentle. But my black head very tough and need pressure. Gentle cannot work on my extraction because rib very hard. Anybody know if dermal back fat got this kind of problem? Link to comment Share on other sites More sharing options...
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