nelluellu Posted January 8, 2015 Share Posted January 8, 2015 Here are two photos of my nose. As I smile, the nose looks even bigger. I really feel that I dont need further tip extension. The shape of my nose is peculiar, it protrudes outwards a lot but is flat at the tip at the same time. A scan would determine everything of course, but I believe correcting my hump from sides and top in addition with reducing the length of my alar and columella is what I need. I havent heard of osteo before, though. Really appreciate your time! Link to comment Share on other sites More sharing options...
k-couture Posted January 8, 2015 Author Share Posted January 8, 2015 actually your procedures will most likely be osteo. I don't believe implants are required for you. For caucasians reductions are the norm whilst for asians augmentation are the norm. And btw....everyone's nose gets bigger when they smile Link to comment Share on other sites More sharing options...
nelluellu Posted January 12, 2015 Share Posted January 12, 2015 Yes, a reduction is exactly what I seek, but the consultants keep coming back to me with augmentation and tip plasty. What is this osteo procedure called in full? I tried finding osteo rhinoplasty, and only found articles on osteoarthritis Thanks again! Link to comment Share on other sites More sharing options...
nelluellu Posted January 12, 2015 Share Posted January 12, 2015 Found it! Did you mean osteotomy? Reading about it, it sounds exactly what I need. My mother had a nose job 15 years ago and she has the same nose as me. She ended up with exactly that problem- a flat looking nose from the front after removing the hump. Would you happen to know, if Dream clinic, and Dr Park in partucular, are good with this procedure? I emailed them about the price just now. Link to comment Share on other sites More sharing options...
k-couture Posted January 12, 2015 Author Share Posted January 12, 2015 I know lots of people who had osteo with him but not the same type that ure having since they were all asian lol. Ummmmm there was a post long ago, by a caucasian guy i think back in 2013 or 2012? He had osteo done with Dr Park and was happy with his results. I read that like a year ago so I can't remember his username sorry Link to comment Share on other sites More sharing options...
nelluellu Posted January 13, 2015 Share Posted January 13, 2015 Ok, that is good to know! By the way, in your opinion, why is alar and columella reduction not recommended more often? I read about scars on the side of the nose but it would be worth for me. I dont think I have a way out of it, the tip is just too protruding. And reducing the alars would also give the doctor the opportunity to make the tip of my nose more pointy. The only concern I have is that when I try to imitate the size of the nose I want, I can feel the airways becoming obstructed and wonder whether I need septoplasty as well. Also, my mother had thick skin on her nose, so 18 years ago her doctor refused to work on her tip, exasperating her flat look. I really hope that technology has advanced enough that I qualify despite my possible genetic thick skin. I dont currently have an option to see a good doctor for a consultation. Link to comment Share on other sites More sharing options...
k-couture Posted January 13, 2015 Author Share Posted January 13, 2015 Caucasians usually don't require alar reduction because they have much more narrow nostrils than asians. You certainly are not a candidate for alar reduction. Even if you smile and your nose gets wider, that's ok! Because its part of the physics involved. It happens to everyone unless they have an abnormally restrictive nose which lacks elasticity. Collumela reduction is for people, example who have a hanging collumela. Which I don't believe you have from the angles of the pictures you have shown. Also reducing the collumela and alars unnecessarily will make you lose elasticity which is not healthy for you or your nose. For asian patients, surgeons would want to maximise elasticity by not excising the alars or collumela in order to allow for more tip projection. Anyway I feel you only require osteo, nothing more. Its best you speak to the surgeons and listen to their advice. x Link to comment Share on other sites More sharing options...
nelluellu Posted January 13, 2015 Share Posted January 13, 2015 Thanks girl! Ill book a trip to Korea soon! I also found a really good website for rhinoplasty tutorials, it really gave me a deep overview of how rhinoplasty works. Have you come across this? I think it would help other beginners understand the procedure better and make better decisions as a result http://www.facialsurgery.com/ClkoffTPgt_01xmh.html Link to comment Share on other sites More sharing options...
k-couture Posted January 15, 2015 Author Share Posted January 15, 2015 thanks for such an informative link! Reading the section about the nasal septum leads me to believe that that open rhino can cause assymetry not just from internal scarring but from unintentional shifting from the lower lateral cartilages. Perhaps that is what happened to me before when I experienced a lopsided tip during my second nose job in los angeles with charles lee. Anyways good luck in your korea trip! Link to comment Share on other sites More sharing options...
sevenseas Posted January 17, 2015 Share Posted January 17, 2015 Hi K Couture, First of all, i would like to thank you for creating this post. This truly helps me a lot by providing information, which otherwise will require me months to find, but you made it all into one very informative thread. Thanks a lot. I am wondering, in your opinion, when is the "better" time to have a plastic surgery in Korea? I mean, i know that it has become such a trend there that most students will have the procedures done during the vacations, thus it will be harder for us to request for a specific surgeon. Link to comment Share on other sites More sharing options...
k-couture Posted January 19, 2015 Author Share Posted January 19, 2015 Obviously better time would be non peak season...........tho to be honest I don't know when students in asia get their holidays so I'm not sure when that is haha. I did mine is May and it wasn't too busy. I also went for my first lot of consultation with various clinics the year before in Oct and none of the clinics were too busy either. In Dec tho a couple of clinics i visited were absolutely swamped lol. I think usually it wouldn't be that big an issue getting the specific surgeon during peak period. You just need to wait a 2-3 days. As long as u select a reputable surgeon and reputable clinic your aftercare service should not be affected by the larger volume of patients during peak season. Link to comment Share on other sites More sharing options...
maryodallac Posted February 5, 2015 Share Posted February 5, 2015 Thanks for the post K couture ! i learned a lot! This will help me to know more about the procedures =) ------------------------------- Nelluellu, i have the same problem when i smile...i know its ''normal'', but i dont like it how my nose looks..=/ Link to comment Share on other sites More sharing options...
sunshine89 Posted February 6, 2015 Share Posted February 6, 2015 Wow thanks K couture for the detailed explanation. It's helpful reading this from someone whose had first hand experience with different materials and surgical methods done. I'm glad that your last rhino was successful! I've only had one failed rhino so far, but that's enough to make me even more nervous about a revision. Do you mind explaining a little bit about your last rhino? I understand that you used ultra soft silicone on the bridge. Did you have something placed on top of that as an extra cushion? And your tip, it's using cartilage and dermis? What kind of cartilage? I currently have rib cartilage ( one hard piece all the way down my nose). After reading your explanation I'm thinking of getting ultra soft silicone for bridge ( since my current bridge is crooked as you explained when using rib cartilage). But I'm wondering if I should use the current rib cartilage at the tip. I have really thin skin too. Another question is: how's your recovery with silicone in comparison to rib cartilage? It took me 7 months for most swelling to go down even though my nose bridge still looks fake stiff and excessively high. It's prevented me from wanting to step outside of my house. Also, what is a reasonably good price range from a big clinic for augmentation with silicone and tip plasty with rib cartilage? Thank you. I really appreciate your time helping all of us make more informed decisions. Link to comment Share on other sites More sharing options...
k-couture Posted February 6, 2015 Author Share Posted February 6, 2015 I actually detailed my last rhino in this thread LOL. Seems like i've been redirecting u haha. # Anyways just a breakdown, my rhino is using ultra soft silicone placed under the periostieum above the bone. Because I have extrusion from my cartilage graft on the bridge, Dr Park used tutelage above the periostiem to seal and at the same time grow into the damage tissues, thus healing my extrusion. My tipplasty is done using irradiated cartilage because I did not want any harvesting from myself. Just a personal choice tho perhaps not the best option, I have thus far not experienced any issues with it and really love my nose. I also have a piece of auto dermis placed on the tip in front of the cartilage to add as a protection for my tip. All this was done via closed rhino so I healed extremely quickly. Minimal swelling compared to my previous rhino where autologous grafts was used for the entire nose. Immediatedly after the surgery I was showed a mirror and my nose looked very defined. I believe my lack of swelling is also in part to do with my thinner tissues, along with the less invasive closed rhino method and surgical skill in minimizing tissue damage during the procedure. You could keep ure same cartilage in the tip area HOWEVER, I will cite that while I requested Dr Park do that too, during the operation he found too much resorption in my cartilage grafts to be able to reuse them efficiently. So perhaps that might be the case for you. Its always good to discuss a plan A and plan B with the surgeon for more complicated cases, which is what I did. Its also helpful to be awake during the procedure so you can discuss with the surgeon should a problem arise. During my procedure the issue was our initial plan A and plan B didn't work because of my tissue damage. So Dr park discussed with me on what he planned to do, sort of like a last minute plan C. So the surgery really felt like a team effort in some ways. Pricing wise it would depend on how complicated your revision is. Without seeing your nose I cannot gauge. However I would advise that it is better to go to a mid sized clinic rather than a large one. Large clinics tend to have inexperienced and training surgeons amongst their medical team. What you want is a specialised clinic where the protocol prevents any surgeon from performing procedures out of their speciality. This ensures that the surgeon is constantly honing their skill and not a jack of all trades. If you do insist on going to a large clinic do make sure you know who the senior surgeons are and what their speciality is. And make sure you are going in sedated rather than general anesthesia. Sedation you will be aware that the surgeon performing on you is in fact your selected surgeon. Link to comment Share on other sites More sharing options...
sunshine89 Posted February 6, 2015 Share Posted February 6, 2015 Thanks for your explanation. You are really brave to be awake during the procedure! Unfortunately, I get anxiety if I'm awake during any invasive procedure so I'll have to discuss a plan B prior to surgery. Sorry this may sound stupid, but I was wondering if the periosteum and dermis had to be taken from another area or are they already part of the nose? I recall that for rib rhino, the doctor also extracted my rib perichondrium to use as a cushion over the hard rib cartilage. I'm guessing it's a similar idea, but do you know what's the difference between using perichondrium or periosteum over the silicone implant? And since you advise to not have silicone over the tip, so that means avoid S-shape implant? Currently I'm thinking of consulting with Dr Suh at JW for revision using silicone. But I'll also contact Dr Park also for a comparison. And I think the condition of my nose is well. I didn't have any complication with my rhino. If I took a close up picture of just my nose alone, it will look decently nice shaped and well defined. BUT when looking at my face as a whole, the nose does not match AT ALL because the angle of the nose does not match the angle of my jawline from profile view. It could've been a miscommunication between me and the doctor. He asked if I wanted a straight or curved shaped nose. I said straight (straight to me meant a straight slant similar to Megan Fox's nose where the tip is still prominent and points outward.) however, the doctor made my nose straight like a wall (bridge almost the same height as tip). It is not aesthetically pleasing at all and looks kind of like an Avatar. I don't doubt my surgeon's skill as he specializes in nose jobs, but I would rather go to a doctor that achieves complete facial balance and symmetry using appropriate angle measurements. That's why I'd rather pay the entire cost of rhino again to another surgeon after careful research, than having a free revision with the risk of being unproportional again. Link to comment Share on other sites More sharing options...
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