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Avoid Cartilage for your rhinoplasty!


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uhh i never had osteo nor was scalp tissue used in my most recent surgery. I had donor thigh tissue used for my nose as an internal skin graft. The purpose was not for augmentation but to protect my damaged skin due to extrusion from a cartilage graft in my previous rhino. When scalp tissue is used for cartilage grafts it is usually used in conjuncture with diced cartilage as a means to give some form of structure to the fragmented implants. Risk of deviation is not black and white such in the case of closed vs open rhino. There's different placement techniques and different implant materials which affect the possibility of deviation, along with the surgeon's skill and specialty.
 
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Not sure if its fair to write off a medical procedure based on ur personal experience and experiences of people u know. Using the same analogy, I wouldnt recommend people buying volkswagens. There are plenty of bad cases of people who have used implants. Not being a medical professional, I wont advise people to go for one way or the other. Consult plenty of p.surgeons and get a consensus. Having studied science and anatomy, I understand the basis for preference given to cartilages by vast majority of facial plastic surgeons.

Ps - who knows what may have happened to these silicone implanters? As u said, NONE of them contacted u.
 
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olskool,

You have been quite vocal on a couple of topics in the forum, and for the most part, I agree with you. But what you said above is something I can't agree at all. I don't see it the way you did, and I think your message is rather unfair to someone like K Couture who has spent lots of her own time sharing her personal experience, opinions, knowledge she aquired along her journey and has in fact helped many here, myself included. We all can find lots of official info on PS procedures from doctors, books, good web sites if we do our homework, what's missing is past patients personal testimonies about procedures or doctors, and most PS patients will not bother to take the time and share their experience AFTER the surgery. Few will, and we are lucky that they do. So be grateful for that.

As far as I know K Couture has never presented herself in this forum as a medical professional, and that's not what most here are looking for anyway if you haven't figured that out. It's perfectly fine if someone, like yourself, disagrees with her opinion on what is the best material for rhino, but its entirely different when you start questioning her right to share the personal opinions based on her experience and data.

I hope K will continue to post more here. I for one will look forward to reading them :smile:

Peace :smile:
 
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I agree with u on most points mrsking. But I think ur missing the point re my reply to kcouture. She has every right to share her experiences and opinions here, and as matter of fact, she definitely has a wealth of knowledge when it comes to ps which def should be applauded. Im not criticizing her personally. Im disagreeing with her reasoning for her conclusion against cartilaginous implants. Hell i'd even disagree with aung sung suu kyi if her resoning was incorrect. Its just plain wrong. Using her analogy, i shouldnt undergo ps at all, as im coming across more people in this forum who have had unsuccessful outcomes than successful ones. Even kcouture herself is against writing off a ps clinic based on few negative reviews. One shouldnt call for an abandonment of a well established medical procedure (not a clinic) when its backed by plenty of SCIENTIFIC RESEARCH. More importantly however, one DEFINITELY shouldnt advocate a procedure based on few personal testimonies that goes against majority of PUBLISHED MEDICAL SCIENTIFIC evidence out there. I want all the forummers here to receive the scientific facts BEFORE finetuning their decisions based on few people's experiences as no two people will ever experience same outcomes by a same surgeon. Please remember, im not in anyway discouraging kcouture's right to post her comments here. But lets not advocate procedures which potentially has greater chance of harm than ones that have the same purpose with less chance of causing harm. I for one wouldnt advocate anything over anything based just on personal testimonies as I dont want anybody to be harmed by my unqualified recommendations. There are many board certified and experienced medicos for that.
 
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Yes, im vocal about few topics here mrsking. But u'd notice that majority are my expressions of disgust and pure anger towards docs/clinics that dont have time for patient follow up, I.e. towards greedy arrogant heartless scums masquerading as surgeons that see patients as easy money. Im all for setting up of special bureau to round them up and throw em into pig pens.
 
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I'm not gonna engage in any kind of back-n-forth here, that is not my style. So this is my last post on this. I've made it clear - one is entitled to advocate what s/he believes in on PS procedures based on experience, as long as the person follows the forum rule and stays on topic. Its up to the readers to use their own discretion when making PS decisions. As far as I am concerned, the more advocacy the better. You don't think K should advocate in this particular case, I do and would like to respectfully ask her to do more. Lets just agree to disagree :smile:.
 
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Thanks for that MrsKing :smile:. I'll try to avoid making a long post in reply to this particular conversation because the admins actually requested I limit interaction with olskool because of the way he sometimes tends to communicate with others.

But basically, there is nothing incorrect regarding what i stated about autologous cartilage. The limitations concerning those forms of implants which I've mentioned are factual. I also never said ride it off completely, but rather avoid it if possible for its aesthetic limitations. Because one thing when surgeons advocate the use of autologous grafts for the bridge area is that they omit to advise the patients of these potential side effects. For example, I was told repeatedly by different surgeons that using cartilage will pose no risk of extrusion. I've even read medical journals regarding the use of cartilage which suggest extrusion as a risk is negated. Is that true? Not at all as extrusion, along with bumps and humps and asymmetry are what happened to me. Admittedly tho, extrusion from cartilage does occur less often than that of artificial implants. Risk of extrusion aside, the aesthetic side effects are of concern with autologous grafts as I explained in common sense terms why they occur more so than we realize. But in response to me advocating procedures which potentially has greater chance of harm than ones that have the same purpose with less chance of causing harm, we first need to acknowledge that there's different forms of artificial implants out there. Much of the data concerning infection and extrusion rates are related to the hard implants and the L shaped implants and does not differentiate findings between the softer forms and most notably the ultra soft. Comparatively, the softer implant types poses far lower risks. Now with irradiated materials the aesthetic side effects are lower because of production method however absorption rates is what's debated amongst surgeons who advocate autologous over irradiated. Hence, would I advise anyone to use L shaped or harder implants? No because that would be knowingly causing harm unto others. Would I suggest the use of softer silicones? Definitely because of their aesthetic superiority and low rate of complication. But when i do so i would also additionally advise the placement method as that also plays a vital role for longevity.
 
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  • 2 years later...
As a consequence, for a week or two after nose job , you may feel that your smile feels less pronounced than usual. This feeling is often compounded by the fact that your nasal tip and upper lip can feel somewhat numb for a few weeks after surgery, so your smile may feel a little strange.
 
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I appreciate the info that k couture has given. She has v informative abt the different methods that plastic surgeons advocate. I myself have been a silent reader for years. And I really like the way she made me probe and let me ponder that not all methods that the surgeons suggested r all correct. I have heard from ppl much to know that the things that she shared are true.
 
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I don't advice for L implants since they can cause thinning of the nose tip, trust me. A lot of my Thai friends have done surgery with that implant, and it usually wears out years later. Its easy to use so surgery time is at a fraction. I have used my septal and ear cartilage for my nose. 7 years in, so far I'm ok.... I dont see much issues with people using their own cartilage though
 
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  • 6 months later...
i totally agree with this wonderful member K Couture who sacrified her time and effort in order to provide us real information from a patient´s view, and not from a surgeon´s view nor copied from a textbook.

Regarding what K Couture said that artificial implants are superior to cartilage I can only AGREE on that!
My personal experience with cartilage so far has been bad, it failed each time, either through shifting, resorbtion or infection. Among all the people I know that require revision rhinoplasty each one of them is due to cartilage grafting. Coincidence?

Unfortunately surgeons in the west still stubbornly insist on their old point of view "artificial implants are bad" despite all the reported failures within the past years among rhinoplasty patients who received cartilage grafts.
 
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Well in theory anything that is autologous is always safer. But for the bridge it poses the same aesthetic side effects as using rib. What you are talking about is where they use diced cartialged and fascia, wrap it up into a cigar shape and use it as an implant. The shape is irregular fyi and depending on placement technique and condition of your tissues, this irregularity can be visible. There's a reason why the vast majority of Korean surgeons always use silicone as the primary choice of implant where possible. Rib rhino or other autologous based materials like diced cartiage + fascia or dermal grafts are (often) only suggested IF the nasal tissues has sustained signficant damage from the previous surgery. Example, when ppl inject liquid silicone into their nose and has to be scrapped out or there's a really bad tear from extrusion. Those types of cases is when autologous grafts for the bridge is used because silicone is out of the question.
 
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This is largely due to differences in physiology. Caucasian patients, typically, have thinner nasal skin than Asians, and are less able to tolerate implants. They also tend to have more usable septal cartilage.

Additionally, Western patients usually undergo reduction rhinoplasty to make the nose smaller, as opposed to augmentation rhinoplasty to make Asian noses larger. It makes a lot of sense that Western-trained surgeons who mostly treat Caucasian patients would want to avoid using nasal implants.
 
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This is not very true what you have just said , do you live in europe?

let me correct it:

Asian patients undergo augmentation rhinoplasty in order to get a narrower, more defined, and higher nose, their nose will not get "bigger" , who wants a bigger nose? They naturally have a wide nose and with the help of a silicone implant on the nasal bridge their nose will appear narrower/smaller

We in Europe also want a smaller nose just as asians- and I would say the whole world? - do. Surgeons in Europe put cartilage grafts - either ear or rib - onto the nasal dorsum in order to make it look more defined and narrow. The consequence of this is that unfortunately many will have to do revision surgery few years postop.

Once again surgeons in Europe claime that silicone implants are "very dangerous" and prone to infection/extrusion, but I have discovered that the infection/resorbtion rate of cartilage is higher. Just as K Couture mentioned before.
 
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