k-couture Posted February 17, 2014 Share Posted February 17, 2014 So i literally just came back from seeing Bryan Mendelson. He was the one who told me to go get consultations in Korea since they have more expertise in asian noses. I basically wanted his opinion of the procedure the surgeon i selected in Seoul would be performing on me. Hrmmm it left me with more worries but i'm glad i went to seek his opinion because he always gives me the pros and cons in an empirical manner. First we discussed cartilage grafts. He said western surgeons prefer it because their patients tend to be Caucasian who do not do as well with silicone implants as Asians do, and therefore tend to have less experience with the use of silicone for noses. He also said only a select few should be doing the cartilage grafts as they are very difficult to perfect. That's the reason why he would send his more complicated nose cases to other surgeons is because he is aware that his expertise lies in hydroxyapatite implants and facial bone and muscle contouring and acknowledges that there are better surgeons for noses than himself. Then i asked him about what Dr Park from Dream's suggestion of my rhino revision. Dr park was the only surgeon i consulted with who wanted to do my revision via closed rhino and place the ultra soft silicone under the muscle between the bone to hold it in place. I was very concerned because the top part of my bridge is permanently a reddish bruised colour due to a botched surgery in Los Angeles. And I know that silicone is more suitable to asians because of the thicker skin however mine has clearly thinned out. But Dr Park felt that the muscle would protect it. So here is Dr Mendelson's opinion. He said that closed rhino is less invasive but requires more skill. Most surgeons prefer the open because they were trained in that method and it is therefore easier for them to get a good result. But if a surgeon has the skill to do a closed rhino revision then I should let him as it is less invasive and causes much less scarring. With regards to placing the implant under the muscle Dr mendelson has some reservations. He said most surgeons will not place it under the muscle because its not as simple but doing so successful would yield better results. While this method will protect my skin from experiencing potential protrusion because its already so weak from previous surgeries, he feels that because this is my 3rd rhino, the muscle may already be damaged so it may not offer the protection i require. We won't know until they go in basically. Finally I asked him about a possible dermal graft which Dr Park suggested in the event the silicone doesn't work out. Dr Mendelson said that would be a safer option but I may be the unevenness common in cartilage. That is IF it is a harvested dermal graft. A manufactured one from donor tissue would have a better shape however because dr mendelson does not know the biological make up of the manufactured product he could not advise more on that. !!!!!! Decisions!!!!!! I wish I never went to stinking Charles Lee. WHO THE HELL PUTS GORTEX AND CARTILAGE IN YOUR NOSE AT THE SAME TIME ANYWAY!!! Now i can't decide whether to get my nose done a 3rd time and risk these complications. But i am glad tho that I went to see Dr Mendelson. At least he made me aware the muscle may be damaged so the silicone may not work. I guess i'll have to address these concerns with Dr Park. Btw anyone here has had dermal graft with a manufactured donor implant done before for the nose? Any advise would be greatly appreciated Link to comment Share on other sites More sharing options...
rapid Posted February 17, 2014 Share Posted February 17, 2014 That really is a tough decision and I wish I could chime in with useful information but is there anyway to tell if the muscle is strong enough to place the implant under it before having the surgery? Link to comment Share on other sites More sharing options...
k-couture Posted February 17, 2014 Author Share Posted February 17, 2014 nope xrays and cts won't show that. So its basically a cut me open thing now im freaking out and im usually quite calm when it comes to surgery cos im used to it by now Link to comment Share on other sites More sharing options...
doublezz Posted April 9, 2014 Share Posted April 9, 2014 Hi K Couture, I understand how you feel. Im planning on my 3rd rhinoplastry and super worried if I'm going to another unsuccessful surgery... is costing more cause is a revision.. Link to comment Share on other sites More sharing options...
shinyglittery Posted April 10, 2014 Share Posted April 10, 2014 i'm sorry to hear that. please try to calm down! i think staying positive is important i hope it goes really well xx Link to comment Share on other sites More sharing options...
nini93 Posted April 29, 2014 Share Posted April 29, 2014 Hi, so it's not advisable to use goretex with cartilage? I'm visiting Korea soon, still have yet to decide which method, or which clinic to visit. Emailed a few, Dr Park from Oz clinic suggested silicone for augmentation of my nose bridge, then septal cartilage for the tip. But I have read many things about silicone.. It will show under certain lighting and it is not permanent right? I'm initially quite persistent about using my rib cartilage for nose bridge, but I went on the other forum (RS) and the doctors said cartilage should be used in this order (septal > ear > rib) But asians may not have enough septal, and ear is not a good material for nose bridge because it's curved and has little effect. I'm really quite lost now, someone do advice! Please add me on kakao at genieet because my pm feature has not been activated! Link to comment Share on other sites More sharing options...
k-couture Posted April 29, 2014 Author Share Posted April 29, 2014 goretex for bridge and cartilage for tip is ok. Just remember that there may be difficulty removing the goretex should you need to for a revision. I would not recommend Dr Park from Oz to anyone. i detailed my experience here.# The order you mentioned is based on level of invasiveness. There's also different ways of using septum, ear and rib cartilage. And silicone is permanent and does not show under certain lighting. In some cases the implant may deviate or be visible but this has got to do with the type of silicone used as there's many different kinds of silicone. Visibility of the implant depends on how thin the nose skin tissue is. A normal undamaged nose will have no visibility unless the implant used is too hard. Again there's many different kinds of silicone. The most effective kind available at the moment is the ultra soft silicone, which provides the perfect shape and is very soft and flexible. If you feel it, it will be as soft as a sponge. Link to comment Share on other sites More sharing options...
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