Liz: So it’s less than 24 hours before my surgery. I haven’t had my nose done in eight years. So I’m excited for Dr. Nassif to fix it. I’ve seen his work and I really think he’s the one that’s going to be able to do the job. My trust is in his hands and I really am looking forward to taking off the bandages next week and being happy with what I see for once. So, here we go.
[At Dr. Nassif’s office]
Liz: The first time the doctor made my tip too narrow and I didn’t look like myself. And then the second time, the doctor made my tip too wide and then actually took out extra bone out of the side of my nose that didn’t need to be taken out. My initial consultation with Dr. Nassif, it was really caring and thorough, and he went over everything and he treated me like I was his daughter.
Dr. Nassif: Liz came into me for a revision rhinoplasty consult and she told me that she’s had two previous rhinoplasties, she was unhappy with the way that her nose appeared on her face. She felt that it was asymmetric, the tip was still kind of bulbous or large appearing and, especially when she looked up from this view, it was very asymmetric. Her whole goal was to make it look better, hopefully make it her last surgery, and also want to help with her breathing.
Liz: Desired outcome would be put the bone back in the side of my nose and to make the tip more narrow so it’s not just so bulbous, and make it just even. It’s not even right now, so that’s just, that’s the goal.
Dr. Nassif: With my examination of Liz, I found that most of the septo cartilage, which is the septum inside here between the two nostrils, which is a great source of cartilage, was gone. The next thing we can go to is the ear. The problem with the ear cartilage, it’s too soft and too curved. And if you really want to try to do something strong for the nose and give it really good shape, you can’t use the ear. So we had a talk about using rib cartilage.
Doctor: Obviously we need tissue to help with the nasal procedure and the cartilage down here is ideal. You don’t need the cartilage and some of the bony structures down here. You’re not going to miss them.
Dr. Nassif: Liz understood exactly what we needed to do. The decision was made to harvest rib cartilage and then to go ahead and perform the revision rhinoplasty.
Liz: I am really ready for this surgery. I’m just getting more excited than nervous. Wish me good luck, here we go.
Dr. Nassif: One of the things that’s very important about revision rhinoplasty that you always have to consider is what are you going to find in there. Your first uphill battle is to see how much scar tissue you’re going to identify with. When you have to open up the nose, you have to remove the scar tissue and identify what’s there, what’s present, what’s been removed. And then after you do that and you have cartilage now for grafting or fascia or perichondrium, you have to start rebuilding it. Rebuilding it is the second big stage after we’ve already carved everything. We’ve carved all the cartilage. In that scenario, when I’m playing with the nose in regards to staring at the profile and staring at the front of the nose, I go back and forth and look inside and outside the nose to make sure it’s as symmetric as possible. One of Liz’s main complaints was that on her profile that her tip stuck out too far. And so one of the things I had to do in surgery is called a medial crura tuck up, I had to push the tip back. By pushing the tip back, it can even make the tip look a little bit wider. But in this situation, I was able to bring everything in as much as I can. After I’m finished with everything and I’m happy, then we go in and we start to close the nose. And that’s putting ever little small stitch in perfectly so that the scar will be minimally visible.
Liz: So it’s the day after my surgery. My nose really hasn’t hurt at all during the whole process of this. It’s just, I feel like I have a cold, it’s just a little stuffy, that’s all. It is worth to get your nose done because it doesn’t hurt.
Liz: I’m very happy with my revision rhinoplasty. It just keeps getting better. Every week I feel like it transforms and it gets smaller and it becomes more and more even, in which before it was just so uneven.
Liz: If you want to look really close, that’s what it looks like at the very bottom of my nose. Right now, not too bad.
[At the office]
Liz: And the side of my nose being indented, on either side, just being opposite to now having it be completely even and straight. My profile is fantastic. It’s transformed me night and day so I’m just very excited with how it’s come this far.
Dr. Nassif: Today it’s her three-month post-op. She looks great. She’s still healing and she’s still swollen. She can breathe a lot better than before surgery.
Liz: My airway’s completely straight. Breathing is great.
Dr. Nassif: Would I like to have seen Liz’s tip a little bit smaller now? Yes, but because this being her third surgery, because it’s only been three months, because the surgery was very difficult, she’s exactly where she should be. When you think about a revision rhinoplasty, you’re wondering, am I going to have to do something else on this nose? And right now the way it looks, I think this hopefully will be her last surgery.
Liz: I’m so happy with what he’s done, the way I look. He’s far exceeded any expectations I ever had. He’s fantastic. I just couldn’t say enough great things about him and the work he’s done.
Liz: As you can see, the swelling has gone down tremendously.
[At the office]
Liz: I don’t see any need for another one. So far, so good. It looks fantastic. I have no complaints whatsoever. So this’ll be my last, thank God.