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Answer: yes, fluctuations ae the normal way things go, especially after an open procedure. I would not call it a set back in terms of healing, it just teased you with what you are going to look like in about one year, but then it took it away for awhile is all.Hang in there. JG 7.22.10
Answer: if done too aggressivley or too often, it might, but once the tissues have healed and readhered it should not occur. The massage is essentially compression with motion upward as there is no stiff hard spot to massage against. We have our patients massage three times per day for 1-23 minutes for 6 weeks after surgery. JG 7.18.10
Answer: Ice at this point will likely not do much, sorry. JG 7.17.10
Answer: just soften sacr tissue. Oral prednisone will have as many bad side effects as good so I would not suggest using it. JG 7.17.10
Answer: I rountinely use 5FU injections in regular scar tissue and it works well but has to be done every 2-3 weeks until better. I do not typically use it on the nose I almost never inject anything into the nose to help with swelling. The injections will soften scar tissue but not remove it. JG 7.16.10
Answer: a rhinoplasty should not cause a runny nose, assuming no complications. A runny nose might indicate a sinus problem or allergies, so I am nto sure what it is you will need. I doubt it is due to the surgical procedure, but I think checking to make sure there is no fluid coming from the sinus or other areas from the fracture needs to be ruled out. A very rare issue could be a cerebrospinal fluid leak from an ethmoid fracture. JG 7.7.10
Answer: I persoanlly do not know the injection practices of doctors in that area I am afraid. The 5FU injections can be given as soon as you find someone to do them for you, all the best. JG 7.7.10
Answer: well, another surgery will not affect swelling and that is what it sounds that it is, swelling goes up and down whereas structutal changes that would be made better with surgery to do not go up and down. Low dose steroids can be tried. All the best. JG 7.3.10
Answer: 3-4 weeks. JG 6.29.10
Answer: best thing is to call and ask them if they do revision rhinoplasties, there is no place to look that for that information. Best of lcuk. JG 6.27.10
Answer: the two fingers to push the fluid onto the cheeks.JG 6.8.10
Answer: twice per day for a couple of minutes is all you need to do. More than that will not help and can irritate the skin. JG 6.5.10
Answer: yes, that is very normal, will slowly decrease but you can occasionally get them even months later. JG 6.3.10
Answer: gentle massage after 8-10 days and more aggressive as the tenderness goes down. JG 6.3.10
Answer: can happen and swelling does cause discomfort I am afraid. Ice and keeping your head elevated for now and you might want to drop by your surgeon`s office in a week or so for a quick check to make sure all is OK. Best of luck. JG 6.2.10
Answer: the hardness is all normal from the swelling, that will also take a long time to resolve. I think you will be surprised at how much it will change over the next few months. Thanks for the kind words too. JG 6.2.10
Answer: it is not a simple thning and if the graft is removed it will likely go back to the way it was. I will say that swelling on the tip takes time to decrease and therefore a less than ideal appearance can take a long time to settle down, especially after a graft. I think that as long as the other things have gotten better I would suggest time and a little massage to help the swelling on the tip decrease, but it is a very slow process. Hang in there. JG 6.2.10
Answer: the acute swelling will take about 6 weeks and the rest of it might take up to one year. The tip wil drop soem in 4-6 weeks. Best of luck. JG 6.1.10
Answer: you can have a cartilage graft from a donor bank if you do not want the rib used. In most cases the size of the graft from the septum for this is small though. I think fillers have not done the job well for you and I would suggest the surgical option for you rather than silicone injections. Best of luck. JG 5.25.10
Answer: allergy medicine is OK to take and I think after 10 days Afrin can be used. JG 5.23.10
Answer: no, it will stay in place. JG 5.23.10
Answer: just a couple of days. JG 5.22.10
Answer: 2-3 days before. I have not seen bromelain thin the blood. JG 5.18.10
Answer: I will admit, I have not heard of that happening before, might be some acid that is made in your mouth with the food or vitamin and your saliva, not sure what you can do about it and I have never heard of that happening after a septoplasty either, sorry. JG 5.17.10
Answer: that is unusual, what vitamin are you dissolving? JG 5.17.10
Answer: the majority of the time what is broken in a nasal injury is cartilage and not bone, but when repairing the cartilage to straighten it out, the nasal dorsum part of the cartilage has to be pushed together and that usually requires the bones to be broken in order to push them together. Hope that explains it a bit more. JG 5.16.10
Answer: all should get better in time, hang in there, all normal at this point. JG 5.16.10
Answer: I have them wait 10 days, same for the nasal spray, the skin usuallly shrinks quite well in most cases, especially the higher up on the nose it is. JG 5.11.10
Answer: at three weeks there is still alot of swelling, the lower on your nose, the longer it takes for the swlling to go down. It wil take up to one year for the final result, so you need to be patient. JG 5.10.10
Answer: I am afraid there is likely not much that will help as the problem is long standing, I think the degree of improvement with steroid injections at this point is minimal and if any will likely be temporary. The steroid injections can inded cause thinning of the tisseus and also the broken blood vessels. JG 5.9.10
Answer: yes, cartilage can be injured without a bone injury. I think most likely it can be repaired without breaking the nasal bones. JG 5.4.10
Answer: I think it is too early to get worked up about things as you are still too close to the surgery date, I suggest giving it some time, at least 6 weeks before re-evaluating things. At this point there is lots of swelling that can cause distortions so I would not make any judgements at this time. Hang in there for a bit more. JG 5.4.10
Answer: an ENT should be able to perform that surgery, it is a common procedure for them. Best of luck. JG 4.24.10
Answer: kenalog might not work, surgery will be more effective. JG 4.23.10
Answer: should be able ot be done, or conversely you can use fillers to smooth the nasal dorsum out. Best of luck. JG 4.23.10
Answer: I think at this point ther is an enormous amount of swelling and I think it is very premature to even look at the nose to see how you like it, things will change for up to one year so you need to give it time. JG 4.21.10
Answer: it seems reasonable but I cannot say 100% without seeing you in person. As to the swelling, it will likely last longer than last time I am afraid. I would start the arnica nad bromelain 2 days before and continue for 2 weeks or so. Best of luck. JG 4.20.10
Answer: I think the percentage of it not resolving is maybe 5-7%, in most cases with time and massage the callus gets softer and smaller. Julio Garcia MD 4.19.10
Answer: the later the time, the less the effect, I suggest in the first 6 months, after that, the effects will be much less. I would not do it for at least 4 weeks after the surgery is performed. Best of luck. JG 4.18.10
Answer: the rhinoplasty can, in a small percentage of patients, alter the appearance of the lip, but that is not common. Fillers are commonly used for the lips and that might be a more predictable intervention for you to consider.Best of luck. JG 4.16.10
Answer: surgery will help change things that are static, but things that change, like your potential swelling, will not be improved with more surgery I am afriad. It is difficult to say why it is happening, thinsg normally heal and reattach, but some individuals, for some unknown reason, can have intermittent amounts of swelling. It could be allergies or other irritants that can trigger it, or even the position when sleeping, face down will cause more nasal swelling. Wish I had more to offer. JG 4.15.10
Answer: final result will be 12 months, yes, as the swelling is slow to resolve on the tip, the swelling only goes down when you are flat on your back. Ice helps but will not shorten the time by much. JG 4.13.10
Answer: It can take up to one year for things to settle down, it might be swelling and it might be scar tissue, I suggest not jumping the gun and giving it some time. Stay in close contact with your surgeon too. All the best. JG 4.13.10
Answer: in a small percentage of cases a small procedure in the office can be done, all depends on what is causing the bump. JG 4.12.10
Answer: I would see if he can get a culture of the infection so we can see what the bacteria is and what the sensitivity to the antibiotics are so we can treat it. At its worse, it migth need an operation to go in there and see if there is anything that can be drained or removed surgically, but that would be the last ditch effort. Best of luck and wish I had more to offer. JG 4.11.10
Answer: it can be, especially the first few months. Usually if I place a tip graft I do not have the patient massage for a couple of months to avoid the graft becoming displaced. JG 4.11.10
Answer: that is what he did and grafts poking through the skin are quite rare. JG 4.11.10
Answer: less than 20 lbs at 2 weeks, no limitations after 4 weeks. JG 4.11.10
Answer: I would refrain from any impact training where there is bouncing on a hard surface for one month, non-impact training such as walking on an treadmil or an elliptical trainer could be done after 2 weeks I feel. No special dietarty restrictions and I would avoid sleeping face down for at least one month. Best of luck. JG 4.11.10
Answer: should be like you saw it after the cast came off, yes. All the best. JG 4.11.10
Answer: not reallly, but it can slow the swelling`s resolution. Scar tissue is a stable material. Sounds like swelling in your case that comes and goes for some reason. JG 4.11.10
Answer: it is swelling but I have no good solution to correct the problem I am afraid, sorry. JG 4.7.10
Answer: most likely just swelling, do not think that pushing the cartilage around will do much good though. I suggest leaving the tip alone for now and letting the swelling go down on its own, if anything, just a little ice. All the best. JG 4.7.10
Answer: I had a wonderful time with family, thanks. As to the cast, and final shape, not really, it is more of a protection of displacing the bones right after surgery and an attmept to reduce swelling. I think the ultimate end results are not significantly influenced, although you might see the end result slightly sooner is all. All the best. JG 4.5.10
Answer: there is no risk of thinning skin and I feel it is as effective if not more than kenalog. JG 4.4.10
Answer: need surgery to trim the cartilage down is all. JG 4.4.10
Answer: Although those things happened, I do not think they have caused the polly beak deformity, that is usually due to the cartilage that has been altered. As much as I hate to say it, it might need more surgery to correct if it bothers you that much. The cast falling off will allow more swelling and possibly some widening of the bridge if the nasal bones were broken. The post operative activities are not too far different from what you would have likely been told, so that likely did not influece the issue.Sounds like you need more cartilage and septum work is all. Best of luck. JG 4.2.10
Answer: yes, it is reasonable. I think using your own intranasal cartilage would also be best. Good luck. JG 4.1.10
Answer: in that case it is likely secured to the front edge of the septum to push everthing down and out more, to gain projection. The graft should just place the tip more forward, not change its shape. Best of luck. JG 3.31.10
Answer: Jessner`s peels will not do anyhig for the thick nasal tip, only mild effects for recent brown spots. JG 3.30.10
Answer: it works by actually debulking the thickness of the Rosacea, like a sander. In most cases it is a one time thing, at least for a long time as the Rosacea does not grow quickly. Erbium can do it also but it is going to bleed lots more because it does not cauterize the tissues like a CO2 will. I think the Fractional is a waste of time, especially for this problem. The debulking can also be done with a loop hyfercator, an electrical cautery device. Best of luck. JG 3.30.10
Answer: correct, what you have after two years is scar tissue, not swelling. I think the kenalog will be of little help in most cases. Cutting the scar tissue out just allows new scar tissue to form, the only time that would not occur is if there had been an infection or excessive bleeding which could potentially be avoided the next go round, but if neither of those two things happened, more surgery will likely not help. Personally, I would leave it. All the best. JG 3.30.10
Answer: certainly worth a try or those breathing strips can be worn to see if they help. All the best. JG 3.30.10
Answer: from what you are describing, with the repeated surgeries, there is likely a significant amount of scar tissue on the tip that is limiting the defintion there. I think more surgery will likely not do much to reduce the thicker appearance and sensation you have there as any scar tissue that would be remvoed would be replaced with new scar tissue I am afraid. I hate to say it but, you might be stuck with things as they are. JG 3.29.10
Answer: it is only a mater of how it compares to what it used to be before, thin is not an absolute term, it is a relative term. JG 3.28.10
Answer: the nose skin on the tip gets thicker, all of the rest of the skin of the nose and face gets thinner, it is due to the concentration of the oil glans on the nose. Your doctor should be able to tell what the skin on the nose will behave. JG 3.28.10
Answer: the cost will depend greatly on what is done in total. JG 3.28.10
Answer: if it is a skin problem, surgery will not help. If it is Rosacea it can be controlled with topical creams and antibiotics and in severe cases the skin can be lasered to reduce the thickness, unfortunately, it will regrow slowly over time. It will likely be a continued treatment series. JG 3.28.10
Answer: not any safer or easier really. JG 3.25.10
Answer: smaller, yes,but it will still take a full year to see the final results. JG 3.25.10
Answer: might try some IPL treatments, sounds like a little mild Rosacea and the IPL along with some topical antibiotic Clindamycin should help. Best of luck. JG 3.24.10
Answer: it can be normal ,yes, but it might be like that from now on too.JG 3.23.10
Answer: I agree that at this point the massage will not do much, but I also do not think it will hurt much.I do not think compression will help at this point either. I am afraid you are likely at the final result, sorry. JG 3.20.10
Answer: do not think it will damage it but it likely will not make it any straighter this far out from the surgery, unless you broke the bones again, which I doubt you could do just by applying pressure. It will likely need more surgery to make it more straight. JG 3.3.10
Answer: hard to say, it might dissolve some of it. JG 2.28.10
Answer: it might just have not been a long enough period of time for the antibiotics to irradicate the infection, not all infections can be cleared with the anitbiotics. The grafts, in some cases, can be infected and might need to be removed, but that is rare. All the best. JG 2.27.10
Answer: it can take up to 6 months at times, give it a little more time. JG 2.13.10
Answer: well, I have never heard of addditional treatments making it more refined. I will say that as the carrier, in which the long lasting granules are suspended, is absobed, the size will go down and likely show more definition, but that is without more injections. I, at times, use more than one injection, but it is not meant to get better refinement but more to add more to the area where the carrier has dissolved and the degree of enlargement is not as much as I or the patient desired.I suggest waiting 2-3 months for the carrier to dissolve so you can evaluate the nsoe better. Best of luck. JG 2.13.10
Answer: well, it varies, the greater the swelling immediately after the surgery, the longer it takes, most patients should see changes starting at 6 weeks and they progressively see more for up to one year. Once the incisions on the inside have healed, it tends to fluctuate less and less, have to give it some more time. Hang in there. JG 2.12.10
Answer: most times that is covered by insurance and is done mostly by an ear, nose and throat specialist. JG 2.12.10
Answer: I do not think it is accurate as the human tissues of the nose cannot be predicted as to how they will shrink and heal. JG 2.11.10
Answer: I suggest you see an e,ar nose and thoat specialist to see if any surgery could help your condition, all the best. JG 2.9.10
Answer: might suggest using some nasal decongestant sprays until it heals a bit more. Best of luck. JG 2.5.10
Answer: if there is no exposed cartilage and no septal perforation, I have not seen it last longer than two years to get better. JG 2.5.10
Answer: what I mean is that the speed and degree of the thickening of the skin on the tip of your nose is variable and conrolled by genetics, so there is no way to predict how fast and to what degree it will happen. As to losing the detail, imagine placing a thin cotton sheet over a chair versus a goose down comforter, the sheet would allow most people to see that it is a chair where the comforter would only reveal a lump, that is how the thichkenss hides the detail of the tip. It is impossible to say how much of a change a person will see without feeling the tissues, and even then, it is an approximation. JG 2.3.10
Answer: not uncommon due to scar tissue and poor circulation on the mucosa covering the cartilage, warm normal saline sprays help, and using a humifier in your home too, it will get better, but very slowly, nothing to worry about though.JG 2.2.10
Answer: it can also help, it is more of an anti-inflammatory though. None of the three will affect your nose, they are for joint cartilage. JG 1.29.10
Answer: reported aid is with glucosamine sulfate and chondroiton sulfate supplements. JG 1.28.10
Answer: well, what grows is the thickness of the skin, not the cartilage, so in your case, if yoru skin is thin, it should not occur to any significant amount. As you get older the thicker skin, if it develops, would only make you lose some detail in the tip is about all I can think would happen in your case. Best of luck. JG 1.27.10
Answer: I think it would be difficult for the filler to shift a piece of cartilage. I think I would give it time for the filler to absorb and then re-evaluate things. I would wait a full year to let things heal and soften before contemplating another surgery. Best of luck. JG 1.19.10
Answer: that would be an extremely rare problem, only if too large a graft were placed under very thin skin. JG 1.15.10
Answer: that likely will need a graft from what you have told me, hopefully a small one. Best of luck. JG 1.15.10
Answer: a graft at times is placed in order to get better projection and give the tip more definition by stretching the skin, but by doing that, the tip will be larger. JG 1.15.10
Answer: it should not be, usually an l-shaped caudal septum remnant can be left to avoid the tip from plunging, it can likely be repaired by adding some cartilage support to the tip. If the septal cartilage was removed, then ear cartilage can be used for the grafting procedure. JG 1.14.10
Answer: it can be normal, yes. The palapable edges should get better and as to the air feeling dry or too much, you can use saline nasal spray until it settles down some. JG 1.13.10
Answer: you would need cartilage grafts placed in order to possibly achieve that and it would remove the elevation of th tip, the nostril got bigger likely because of the degree of tip elevation. JG 1.2.10
Answer: using tape at night is helpful in some cases, massage can help right after surgery, but massaging too hard can keep the skin mobile and that allows swelling to persist, so massage at this point, if done, has to be very mild and not aggressive. JG 12.29.09
Answer: it will yes, that type of swelling is not uncommon but if it comes and goes, as in your case, eventually it will stay away. The more times an incision is opened, the longer it takes to fade, I suggest using a little Mederma or ScarGuard, both OTC, to help it fade. All the best. JG 12.28.09
Answer: I think you need to give it a good 10-12 months I am afraid. Best of luck. JG 12.28.09
Answer: liklyl because of the collapsed nasal valve potentially getting worse with the kenalog. JG 12.28.09
Answer: it is normal and there really is not much you can do, it is a matter of the tissues healing, some doctors try kenalog but it helps only for short periods of time. It will end eventually though. It comes and gose because the tissues have not totally reattached so when there is motion on the tip, new swelling appears, just like when you sprain an ankle and then start moving too soon. Hang in there. Merry Christmas and a Properous New Year. JG 12.24.09
Answer: well, repeat excision and then following about 6 weeks later doing some 5FU and kenalog injections is possible. Best of luck. Merry Christmas and a Prosperous New Year. JG 12.22.09
Answer: might be, I suggest using an open rhinoplasty technique so all the cartilage components can be seen and made sure to make the correction you desire. All the best. Merry Christmas, Happy Channukah and Prosperous New Year. JG 12.18.09
Answer: numbness is an indirect measure of swelling but I would estimate there will likely be small degrees of swelling there for up to one year. As to open rhinoplasties and swelling, it is common for them to stay swollen for longer than closed procedures and the more rhinoplasties you have doen the longer the swelling takes to resolve due to scar tissue. Cartilage is certainly one of the components of the size of the tip but the thickness of the skin is also involved, you migth just have so much scar tissue that even if they removed all of the cartilage, your tip might not have the size and definition you desire. Give it some more time. All the best. Merry Christmas, Happy Channukah and Happy New Year. JG 12.17.09
Answer: possible but rare, there might be some area of the septum that has lost its mucosal covering allowing the underlying cartilage to be exposed and to dry out, so saline spray every hour while awake might help, even some vaseline applied to the septum with a Q-tip can help too. Not much more I can offer, sorry. JG 12.10.09
Answer: excellent surgeon, and I have known him a very long time. You are in good hands. Please give him my regards when you go. JG 12.9.09
Answer: most of the time it is due from changes from a previous rhinoplasty where cartilage was reduced and the deformity then shows up. I do not think Retin-A will correct a V deformity of the nose as it is not a skin problem. It is a partial collapse of the internal nasal structures but it does not mean it will all collapse. JG 12.1.09
Answer: it only helps swelling, it does nothing to the cartilage. If it does not help you might need a revision that occurs with closed rhinoplasties as the visualization is less than an open procedure. JG 11.30.09
Answer: only for recent swelling, sorry. 11.30.09
Answer: usually where there is thin skin between the middle and lower third of the nose, what it would take to fix varies, it could be merely injections of a filler and it could also involve a revision rhinoplasty, impossible to tell without seeing you in person. JG 11.29.09
Answer: it is more of a septoplasty and turbinate modification that you need, rather than arhinoplasty, which generally refers to a cosmetic enhancement of the nose. JG 11.25.09
Answer: I really think that an in person consultation is best, pictures give the surgeon an idea but for implants, measurements usually are done best in person, all the best. JG 11.24.09
Answer: It might, and I repeat, might help soften scar tissue but if a secondary rhinoplasty is needed, the Kenalog will not replace the surgery. Having said that, there are limitations to the tip refinement possible due to thicker skin and scar tissue, so one`s desires cannot always be met I am afraid. JG 11.23.09
Answer: no rebound swelling but if injected too large in amount and too close to the skin, it can cause skin atrophy and color changes, might be best to just leave it alone and let it get better on its own. JG 11.22.09
Answer: yes, very common, normal, and goes down slowly once the cold goes away. JG 11.21.09
Answer: In general it is safe, I do not think it will last that long but is quick and few side effects. Worth a try. JG 11.21.09
Answer: could try Radiesse or Artefill injections, they should last longer. JG 11.19.09
Answer: they can be started after 6 weeks if needed. The longer you wait the less the degree of improvement. JG 11.18.09
Answer: yes, it could be done. JG 11.18.09
Answer: the injections typically have to be doen a few times to make a difference and it might take up to one year in a thick skinned individual for the final resutls to be seen. The fact that it looked good right at the begining is a good sign for the eventual end result though, just need to give it some time. JG 11.17.09
Answer: it might be thin tissue over the cartilage, yes, but at this time I suggest waiting as it likely will get better with time, I am not familiar with Dr Palmer though. JG 11.17.09
Answer: I think what you see at one year is likely the final result. JG 11.9.09
Answer: I do not think you are at any higher risk than other patients and in general the risks are small JG 11.8.09
Answer: all normal and can take up to one year to totally resolve I am afraid. JG 11.7.09
Answer: go see Stacy Folk MD and tell her I sent you. JG 11.7.09
Answer: it should be able to be fixed but I do not perform septoplasties any longer, just purely cosmetic rhinoplasties, sorry. JG 11.6.09
Answer: could be scar and likely they are over the cartilage part of the nose and not the bone, they could have been affected during any of the previous surgeries and can take years to arise in some cases. I would leave it alone for one year and see what transpires. JG 11.6.09
Answer: between those I suggest Kelocote, best of luck. JG 11.2.09
Answer: correct. JG 11.2.09
Answer: scar tissue never is totally gone, but in time it gets smaller and softer. JG 11.2.09
Answer: I would not do another surgery and I think after 5 years I would stop the kenalog injections too for fear of long term side efects. JG 11.1.09
Answer: I certainly think it could be scar tissue and might be difficult to make better. Just lifting the skin to access areas can cause swelling and scar tissue. I think it best to leave well enough alone. JG 11.1.09
Answer: sounds like sun exposure hyperpigmentation with fragile broken capillaries of the face that appear with age, and maybe a light case of Rosacea, unfortunately, all normal. I suggest no irritants on your skin like retinols and you need IPL or microdermabrasions for the pores and the spots and sunblock, not sunscreen, from now on. JG 10.30.09
Answer: all normal, it is just swelling that while the cast was on was controlled, that will take up to one year to totally go down, have to be patient. Continue the massage though, we do for 3-6 months. Best of luck. JG 10.28.09
Answer: the cartilage will not grow back but the skin of the tip does get thicker with age. JG 10.8.09
Answer: yes, a pimple there can certainly cause that, I would stop the massaging at this point. JG 10.3.09
Answer: if ther are fluctuatiosn on the size, that is due to swelling and with more time, it will settle to the smaller size, revision rhinoplasties always take longer to heal than the first go round. All normal in revision rhinos, got to hang in there for a full year at least. All the best. JG 9.22.09
Answer: all normal, it takes up to one year for all to soften up, got to hang in there. JG 9.09.09
Answer: no, I have not and I am not sure if it would help, sorry. JG 9.8.09
Answer: if it is going to happen it usually takes a few weeks for that to show up. If it happens right after it is a bruise. JG 8.9.09
Answer: not much to do except wait, secondary revisons will take more time to heeal then the first, migth take a year or more to tighten up, and laser will not do the trick, sorry. JG 8.7.09
Answer: the amount of dissolving it will do is unpredictable I am afraid. JG 8.3.09
Answer: I have never seen an allergic reaction nor any negative side effects from hyaluronidase injections in my practice. JG 8.3.09
Answer: it is a satandard dose per area and it will dissolve some of the natural hyaluronic acid but yoru body remakes that part very quickly. JG 8.1.09
Answer: it all depends on how much kenalog was injected and if they hit a small vein, both can cause prolonged swelling. The tip can show swelling longer as it takes longer for it to decrease there due to its anatomical position. JG 7.31.09
Answer: yes, usually it is just the fluid of the kenalog, that should go down in a few more days. JG 7.29.09
Answer: do not think there would be an interaction between the two. It is likely due to the Kenalog and might last a couple of weeks or so. JG 7.29.09
Answer: rib cartilage. JG 7.25.09
Answer: usually 12 months but some people take as long as 18 months at times. JG 7.25.09
Answer: nope, just time, sorry. JG 7.13.09
Answer: the tip is definitely the last place to feel better, yes, it can take up to one year. Best of luck. JG 7.13.09
Answer: I think Michael Jackson`s case is different due to the multiple prior surgeries performed, I do think in many cases the rib graft is successful but will make the nose potentially larger or thicker. Best of luck. JG 6.29.09
Answer: I would only do 2-4 sessions. JG 7.1.09
Answer: can be attempted with cartilage grafts but does not work in 100% of cases. JG 6.28.09
Answer: in some cases, if the revision is small it can be done closed the second go round. I would not consider a revision for at least 12 months after the last surgery. Best of luck. JG 6.23.09
Answer: yes, not uncommon for that to happen, even without the surgery, but an open rhinoplasty can make it more visible. JG 6.21.09
Answer: might have slipped and is pulling the skin down, I suggest seeing the last surgeon and assessing if they can relocate it higher. Best of luck. JG 6.12.09
Answer: should be OK to do so. JG 6.10.09
Answer: there will be a small scar and can be relatively easy to do that way, all depends on your pain tolerance. JG 6.6.09
Answer: lasers will not help and I think in time the skin should readhere, if it does not and you are not happy with it, it can be filled in with the same fillers we use for nasolabial folds or lips to elevate the skin. JG 6.4.09
Answer: sorry, but it would not help and I advise against it. JG 6.4.09
Answer: with Restylane it will swell about 30% more after the injection so what you see after 5-7 days should last a few months. JG 5.31.09
Answer: it will have no positive effect on bent cartilage whatsoever. JG 5.27.09
Answer: not sure why you would get kenalog injections if you are doing the fillers as the kenalog can likely create more indentations that will need more fillers. JG 5.27.09
Answer: you got me, have never seen that used and cannot imagine what they can accomplish with that except pad their wallet. JG 5.27.09
Answer: silicone struts or Gortex. JG 5.17.09
Answer: no, it will twist, not resorb like fat. As to ear cartilage, it depends on how big of a piece you need for the nose, but that cna also warp. Tissue from the rib is last as it is very stiff and the nose is normally not as stiff as a rib. JG 5.17.09
Answer: rare to be neded, can warp with time too. JG 5.16.09
Answer: all normal at this time, yes. JG 5.12.09
Answer: well, in Nevada, where I practice, silicone is illegal to inject so I think that should tell you something, regardless of what he promotes. JG 4.30.09
Answer: in some difficult and swollen tips, yes, it can take that long. JG 4.28.09
Answer: I wish you the best, your are in skilled hand with him, and thank you for the kind words. JG 4.24.09
Answer: have not had it happen but is should be OK, the tissues have some semblence of being glued together by then. JG 4.22.09
Answer: I normally suggest you wait until you are done breast feeding so the medicine used before and after the surgery is not transfered to the baby through your milk. Best of luck with the baby! JG 4.22.09
Answer: nothing to worry about, since there is scar tissue there prompting the need for the shot to begin with, that slows the absorption. JG 4.20.09
Answer: I think revision rhinoplasties take a long time to soften and shrink, very frustrating. I do think getting three shots of kenalog by two months is a bit much as it takes weeks for the changes to be seen or evaluated. I do think you will get smaller, no way to tell how much more though. I think taping effects at this point a e transient and not long lasting, but it will not hurt, wish I had more to offer. JG 4.20.09
Answer: it is just due to the shot and will get better in a few more hours. JG 4.20.09
Answer: nothing bad, likely the cartilage moving over another piece of cartilage, surgery might and might not be able to fix that. JG 4.15.09
Answer: might take a full year, can consider using some saline nasal spray, it might help. JG 4.14.09
Answer: it is hard for me to say without seeing you and feeling the tissues, but I think the nasal bones will likely need to be broken in order the thin the bridge of your nose. Cartilage grafts will give the tip more definition but will not stop the muscles that pull the tip down. As to the silicone, it might be able to be removed during the other surgery but it can be difficult at times to perform that. I wish you the best. JG 4.13.09
Answer: can try Radiesse, might last a little longer in some patients. It can be done as often as desired and it was coming out the pores because it was injected too superficially is all. No danger with your nose falling off. JG 4.9.09
Answer: hard to say without actually seeing you in person, I will say that swelling in revision rhinoplasties can take a very long time, I suggest giving it some time and following your surgeons instructions and seeing what happens over the next 2-4 months. Best of luck. JG 4.5.09
Answer: maybe 4-6 months or so to get close to the final result. All the best. JG 4.5.09
Answer: only time will help and it is because it is the most dependent part of the nose and harbors the swelling for the longest time. JG 4.2.09
Answer: do not think it will shrink on its own and there is nothing injectable that will dissolve the cartilage, sorry. JG 3.31.09
Answer: yes, it is true, give it some time and have a little more patience. JG 3.31.09
Answer: at this point I would expect to see a little change if it was the first time, the degree of swelling on a second go round is significantly more. On a secondary rhinoplasty I would estimate 30% of the swelling in two months, maybe a little more. JG 3.30.09
Answer: I do not think copper peptide will help the stitich marks, that is usually a matter of time, and in some cases it requires a laser to smooth it out. I will say that in most cases, insurance will not cover the laser for that because it is deemed cosmetic in nature. Sorry. JG 3.12.09
Answer: normal and we have our patients do the same thing. Should not damage things. Best of luck. JG 3.12.09
Answer: can be normal, yes. Ice and keep her head elevated on some pillows and it will go down. JG 3.7.09
Answer: that can be done and the thicker skin might limit the degree of how much smaller or defined the tip can be made. Fees for all of that, all inclusive wouls be about $6300, see you soon. JG 3.6.09
Answer: no. JG 3.5.09
Answer: it is worth a try but I would not expect much change at this point. JG 3.5.09
Answer: I am sorry but at present, due to my schedule, I am not undertaking revision surgery of any kind that has been done elsewhere. JG 3.4.09
Answer: well, the biggest thing is that the tip shape and size is controlled by the cartilage but also by the thickness of your nasal skin, so in some cases a smaller tip cannot be achieved in thicker skinned individuala, even if most of the cartilage is removed. JG 3.4.09
Answer: I think those are issues you need to discuss with the surgoen that will do your surgery and we all have different opinions on how to do it, there is no single correct answer. JG 3.1.09
Answer: well the twist is due to the cartilage being twisted so the tip cartilage and in most cases the septum needs to be straightened also. Scar tissue can typically be cut and carved without too much problem, but scar tissue can also reform too. JG 3.1.09
Answer: he might have done work on the tip but the improvement on the tip can take months and even up to one year for the final resutl so it is not uncommon when other things are changed that the tip looks out of proportion until the swelling dissiaptes. I would not suggest any type of revision until one year has passsed to allow the swelling to go down and the tissues to soften up, what will be required at that time is too hard to predict at this time, sorry. JG 2.27.09
Answer: it is common and will help the end result to a degree. The inside of the nose is commonly swollen and congested and can take time to breathe better. If there is swelling it will definitely affect your ability to breathe. Best of luck. JG 2.26.09
Answer: should not be happening at this point in time, some of the things that can cause it is a septal perforation or overresection of the turbinates causing excessive intranasal dryness and therefore bleeding and crusting, or a retained suture. I think you are having complications from the surgery and the ENT surgeon needs to see you again as it is certainly not normal to still have those issues. JG 2.24.09
Answer: all the best. JG 2.23.09
Answer: I would use some saline spary for your nose, it might just be a costra that is stuck to one of the old incisiosn, I hope you do not have a hole in your septum, that would be another cause. See your surgeon after the holiday is done. Best of luck. JG 2.23.09
Answer: I think the pulling and pain is due to scarring that will get better with time, as to the nose bleeds, might want to try some saline nose spray to keep the moisture up inside the nose. JG 2.23.09
Answer: likley just swelling, give it time, things are going to change quite a bit, hang in there. JG 2.21.09
Answer: the ability to mold it after it is injected is small, so the shaping is done with the individual shots.JG 2.20.09
Answer: it can be tried but injecting into the nose is difficult as the skin is thicker and may not distend and fill the way you desire. JG 2.20.09
Answer: I think your thought process is correct, the L-shaped one will have more of a point on the tip. JG 2.18.09
Answer: never, that is not needed and not the standard of care. JG 2.16.09
Answer: not much that cna be done, injections of kenalog are tried but do not always work. JG 2.15.09
Answer: no, it should not. JG 2.9.09
Answer: it can cause the symptoms you are having due to the excessively dry air,and it is worse when it is cold. Using some saline nasal spray and a humidifier in your bedroom should help. I think if it is not better in another 6-8 weeks I would see your surgeon to make sure all is healing well inside with the turbinates. Best of luck. JG 2.9.09
Answer: It can to some degree. But it cannot be used more frequently than as described by the manufacturer. I think what you are describing though is swelling between the skin and the internal mucosa and the Flonase really helps only the mucosa, so I would not think it would be too helpful. JG 2.5.09
Answer: it is not unusual for the edges to be uneven at this point from swelling and there is much more swelling after the third rhinoplasty than the first two, so I would say to give it some time. If it does not, revising those scars is pretty easy. JG 1.28.09
Answer: the tip takes a very long time for the swelling to resolve, so at this point I would not expect to see much of a difference, in fact it might be a few months before you do and final shrinking can take up to one year. JG 1.28.09
Answer: a week or so would be good. It applys to all alcohol. JG 1.24.09
Answer: I will get back to you after I have reviewed them. JG 1.24.09
Answer: no, just apply ice for a little while. JG 1.22.09
Answer: no damage, just rinse it out with water. JG 1.22.09
Answer: just because the other is less expensive does not mean he will not do a good job, the more expensive one might have a little more experience though. Best of luck. JG 1.22.09
Answer: certainly. Please send them to drgarcia@lvcosmeticsurgery.com
Answer: I think if you can wait, I suggest that rather than injecting the steroids. JG 1.20.09
Answer: I think you are likely as strong as it is going to get, hopefully it is just swollen and nothing shifted. All the best. JG 1.20.09
Answer: yes, I have heard of it, they work, we have been using them for many years in ourr practice. They are safe to use. We apply the gel for about two weeks and the Bromelain we use 2 capsules twice daily.Best of luck. JG 1.20.09
Answer: please send it to drgarcia@lvcosmeticsurgery.com it will remain confidential. JG 1.18.09
Answer: about half is gone in about 6 weeks and the other half takes months. JG 1.18.09
Answer: no, as long as it is intermittent use you do not want to get frostbite. I think the benefit after 48 hours is small though. JG 1.15.09
Answer: yes, 24-48 hours. JG 1.14.09
Answer: those are questions for your ENT surgoen, this is a cosmetic surgery site, sorry. JG 1.12.09
Answer: most likely swelling, yes. Maasage is good for tip swelling, just a light pinch of the tip and then press it up and over onto the cheeks. All the best. JG 1.11.09
Answer: the final result is 12 months after the surgery but after 3-6 months you should see some significant improvement. It is very common when the hump is reduced and the bones not broken for it to look wider, that is why the bones need to be broken and pushed narrower to avoid that if any significant hump reduction is performed. JG 1.11.09
Answer: the swelling will visibly start to show a difference in 4-6 weeks in most cases. I am not sure taping will do mcuh as there is stil swelling internally that cannot be improved with the taping. As to the indentation, it can happen on repeat rhinoplasties, the laser should help though. Best of luck. JG 1.8.09
Answer: surgery is the only way, and the amount of fat is really small. JG 1.6.09
Answer: no, the MTV and biotin are OK. JG 1.3.09
Answer: the fluid that is there is impossible to aspirate, that can only be done in a localized area where a seroma would form and that does not happen in the nose, it is diffuse in the skin and tissues I am afraid. I think the best thing after the touch up will be to apply ice and minimize anything that can cause bleeding, all the best. JG 1.3.09
Answer: that is OK to do together, yes, and Happy New Year to you also. JG 1.3.09
Answer: recovery is easy but swelling persists for months. Breathing should not be affected from the surgery. There are no doctors that specialize in one aspect of rhinoplasties though. Best of luck. JG 1.2.09
Answer: impossible to tell, it hopefully is just swelling and will get better, but it is so soon after the surgery that bones might have shifted, not much you can do except to let the swelling go down and see how it looks. JG 1.2.09
Answer: we show pictures of our previous patients but we do not use computer imaging as what you can do on a computer cannto always be reproduced in real life. As to the number of rhinoplasties I have perforemd, it is about 400-450. JG 12.29.08
Answer: very small to no negative effects if used just a few times, in long term use you could develop broken blood vessels. The effects on the tip are usually small. JG 12.29.08
Answer: unless ther is a intra-nasal splint there is no need to suction anything, most times, even then, it is just removed with no suctioning. The smaller the surgery, typically the shorter the recovery in terms of swelling, yes. You had a pretty standard rhinoplasty though, it will take months to see the final result. Merry Christmas and Happy New Year. JG 12.27.08
Answer: it is stil worth trying, yes. Not sure how dramatic of a change it would make though, especially in thicker skin. Merry Christmas and Happy New Year. JG 12.27.08
Answer: well, it can be common, certainly not unusual, especially when turbinates are trimmed. I do not think anything bad would have happened by staying at home though. Merry Christmas and Happy New Year. JG 12.27.08
Answer: would not do it for at least 6 weeks. Merry Christmas and Happy New Year. JG 12.27.08
Answer: I am sorry but that skin cannot be thinned out safely. JG 12.21.08
Answer: sometimes it requires cartilage reshaping to include a graft of cartilage to push on the skin to give hte appearance of more definition but it can be larger then. JG 12.20.08
Answer: I am sorry but I do not perform septoplasty surgery when doing a cosmetic rhinoplasty, your best results would be with an ENT surgeon for that. JG 12.18.08
Answer: the more surgeries you have had the more difficult it is to correct the problem I am afraid. JG 12.16.08
Answer: I think more surgery will likely not help or could make it worse and I think the injections might be worth trying once or twice more but if no change by then, it will not help. JG 12.15.08
Answer: diode lasers are used for many different things but swelling is common after that treatment, I do not think anything permanent has happened nor anything negative. JG 12.12.08
Answer: well, it usually does not alter your appearance much but in a small number of cases the area where the spreader graft is placed will look a little wider in a straight on shot, but it is needed to allow you to breathe. Best of luck. JG 12.9.08
Answer: I am not sure the kenalog will help and a laser for sure will not help, sorry. I do not think massage will help either, I wish I had something to offer but I think anymore would be risky. JG 12.7.08
Answer: in an extremely small number of patients will that ever work. Fillers will not do anything I am afraid. JG 12.5.08
Answer: well, there are many options, a dermal graft is certainly one of them, the skin can be taken from behind the ears at times but is thinner, also in some cases injectable fillers can be used, a surgen will typically use what has given them the best results over time in their hands, I think much of the irregularity will get better in time though. JG 12.4.08
Answer: well to lift the tip it is usually a trimming of the cartilage that is done and in many cases when a hump is removed and the bones are not broken and pushed together then the bridge looks wider. I think recovery will be short but final result might be months although you wil look better in a few weeks. JG 12.2.08
Answer: might give you some information but it will not affect what can be done. JG 12.2.08
Answer: well, thre might be a small callus underneath, but the fact that it changes in size means there is also swelling because callus does not fluctuate in size. The swelling normally totally abates after one year. I do not think massage will help and I am in general opposed to steroid injections. If the callus persisitas after one year, the only remedy is surgery, but any scraping of the callus can result in further callus. JG 12.1.08
Answer: sorry but I do not think there is anything short of the arm tuck that will help. More liposuction, if it failed the first time, will not help and can make it worse. JG 12.1.08
Answer: hard to advise you without seeing you in person I am afraid. JG 12.1.08
Answer: I think it best to give it 6 months and the see what if anything is needed, I think the bumps of Radiesse are a low risk on the nose part, hopefully you will not need it. Best of luck. JG 11.26.08
Answer: sorry but I do not know of any place. JG 11.24.08
Answer: in over 21 years of private practice doing rhinoplasties I have never widened nostrils on a patient. JG 11.22.08
Answer: it is OK to do subsequent surgeries clsoed, it is at times easier to perform as an open procedure in order to visualize things but if the needed revision is small, the closed technique is stil fine to use. JG 11.20.08
Answer: the illusion of such can be done by reducing the septal cartilage so to allow the skin to shrink up some, although this will be limited by the amount of work on the cartilage. JG 11.19.08
Answer: certainly, please send them to drgarcia@lvcosmeticsurgery.com, include as much information as to what was done and the problems now as you can, all the best. JG 11.17.08
Answer: I really cannot see how adding material, no matter the source, to the tip can ever make it smaller, it might give it better shape, but not make it smaller, also the end result of the tip in many cases is limiteed by the thickness of the skin and scar tissue, so the more times you operate on it, the harder it is to make it smaller. Hope you are well too.JG 11.17.08
Answer: CO2 would not be my choice, I sugest a YAG laser for the redness. JG 11.16.08
Answer: as to the Rhinophyma, a CO2 laser used to trim the thickness down works well, IPL will usually control it after that is doen. Best of luck. JG 11.16.08
Answer: all normal, especially in revision rhinoplasties and for open technique, all you can do is wait, the fact that it looks nice some days is a good sign, hang in there for a little longer. JG 11.14.08
Answer: at this point it is due to swelling and the sutures that are still in place, give it time, nothing to do for awhile until it all settles down. JG 11.14.08
Answer: could be a little of the medicine, but mostly coincidence. JG 11.12.08
Answer: well it can be done but you might get a little more swollen during those hours, I prefer to leave it on. I think you will have some small amount of swelling and likely some bruising so they will probably be able to tell something was done with or without the tape. JG 11.11.08
Answer: cannot do any damage but it will have small improvements for another couple of months in most cases. JG 11.3.08
Answer: could be some small nerves that were trapped in scar tissue from the septoplasy it is a hassle but not a dangerous thing, not much you can do about it though. JG 10.27.08
Answer: it usually goes down on its own, no need for antibiotics unless there is an infection. Warm packs and tylenol will make it feel better in time. JG 10.23.08
Answer: I think they would be safe, the Botox might even help the twitching. all the best. JG 10.21.08
Answer: I think a little paleness is OK at this point, not unusual, and at 4 days if it was going to go bad, it would be hard and black by now, so just give it some time. Best of luck!JG 10.19.08
Answer: the easiest way is to make a little mark there with an eye liner pencil so you can both agree, it washes off very easily. Without seeing you in person I cannot tell if that is acheivable in your case or able to be maintained. JG 10.17.08
Answer: in most cases it is cartilage. Bone and cartilage can both be shaved. Widening nostrila requires cartilage support and at times external incisions, as to a closed technique, some of it is done by feel. JG 10.17.08
Answer: you can contact the state medical board. JG 10.15.08
Answer: ask to speak to his patients, check with the state medical board to see if he has had any complaints are good places to start. JG 10.15.08
Answer: I think if he is not going to break the bones the reason he is using the splint is to try to reduce the swelling, it will work, for a week as long as you have the splint but that is about it. No harm in using it though. JG 10.15.08
Answer: it can be puffiness, yes, and it can also be a small amount of callus that forms when the cartilage is scraped and might take months to flatten and remodel. In time it usually goes away. JG 10.14.08
Answer: I usually use an outer splint only if I am breaking the bones to narrow the nose, if it is a small hump, I only use tape on the nose. I think you will be able to breathe out of the nostril soon after surgery but not perfectly due to swelling. Black eye risk is less but not zero. Best of luck. JG 10.14.08
Answer: the spasms are not related to the surgery, sounds like the allergies are still making your turbinates swollen, likely not due to the surgery. JG 10.12.08
Answer: clean it gently with half strength peroxide and apply neosporin until they can see you on Monday, should not be a big problem. JG 10.10.08
Answer: it is part of the surgery after effects in terms of the anesthesia, the medicines and the having to do nothing for awhile, it will get better in time. JG 10.10.08
Answer: I think with what you are describing, that is not uncommon, give it time, the nasal skin is very resilient. JG 10.9.08
Answer: yes, tips are the last to change after a rhinoplasty of any sort. JG 10.8.08
Answer: no, all the normal response and it should slowly get better wth time. JG 10.8.08
Answer: once you are done breast feeding is OK. JG 10.6.08
Answer: it can stay thing if they break the bones to keep it narrow. JG 10.6.08
Answer: rarely, but it can. The quickest way to check for a leaf of CSF is made by checking the glucose content in the nasal fluid. JG 10.6.08
Answer: yes, but not that far afterwards. JG 10.6.08
Answer: it could be the nerves and if it is it might take months I am afraid. Best of luck. JG 10.6.08
Answer: if it is a seroma it could be aspirated with a needle, but dermal grafts get very hard during their normal healing due to the body`s normal response to that type of graft. Warm packs and light massage might help. Best of luck.JG 10.6.08
Answer: could be swelling, yes, or a small callus on the bone that should settle down. Can take months to get to see a difference. JG 10.6.08
Answer: I think in Chicago it should be about $8000, go see someone else. JG 10.6.08
Answer: yes, I think that would be safe, best of luck. JG 10.5.8
Answer: it can do that during the healing process during the first year. JG 10.5.8
Answer: you can bleed under the skin, around the cartilage and cause visible nasal swelling. JG 10.3.08
Answer: it can increase the swelling. JG 10.3.08
Answer: go somewhere else. JG 10.2.08
Answer: I think the old one does not feel confident he can help the small problem and the new one is an arrogant idiot, find someone else. JG 10.2.08
Answer: in many cases at three months it can look the same as before, yes. JG 9.30.08
Answer: it can happen when cartilage is removed and the remaining cartilage is too weak and it then twists, or it can be from stitches placed in the cartilage to try to obtain a certian shape and the sutures are tighter on side side than the other, also if grafts were placed they can shift and give a twisted appearance. It is most common though to have a twisted tip if the septum is deviated. If one has a twisted tip due to the septum being deviated adnd the septum is nor corrected, it can be difficult to straighten the tip. Twisted tips, the majority of the time, require repeat surgery if it persists for months after the intial surgery. Best of luck. JG 9.29.08
Answer: bulbous can mean wide, or round or ill-defined, it is difficult as many people describe bulbous nasal tips differenlty. I think you can show him a picture of what you want, not that they can give you that nose because they cannot, but it will give them an idea of what you desire and then they can tell you if it is achievable. JG 9.29.08
Answer: yes, by placing some type of implant, either your own cartilage or a synthetic material. JG 9.29.08
Answer: well, I am afriad not, they might encounter it more often and might employ more dramatic techniques to get a desired result, but they do not have special magic for scar tissue. The nose collapsing is due to loss of structure so as long as they leave the supporting cartilage it should not collapse. Septum surgery should not affect the cartilage on the outer parts of the nose typically. It is impossible to tell whether what you desire is acheivable, but I will say that a bulbous tip can be commonly caused by scar tissue and thick nasal skin and that might not be changed with more surgery. Best of luck. JG 9.29.08
Answer: still swelling and might take another few weeks to see a noticeable difference. I would not do cortisone injections for swelling in that location, just wait it out. JG 9.27.08
Answer: I think in revision cases I would not make a determination for one full year. JG 9.27.08
Answer: well, it can cause some bleeding at times but if you need to blow it then proceed. I think you can go ahead and use the Nasonex too. I do not think this will affect your tip. Taping can be done but likely not needed. JG 9.27.08
Answer: the liniing of the nose on the inside should provide adequate protection for the implant. Picking your nose should not change the results of your rhinoplasty but I am not sure why you are picking your nose to begin with. JG 9.27.08
Answer: well, although simple to do I will say that the smaller the hump is the less likely of a significant change because as it heals there is no callus that forms. JG 9.27.08
Answer: can take 6 months or more. JG 9.27.08
Answer: there can be callus that forms that will make it look the same, or if too much is taken out then there can be a depression. JG 9.27.08
Answer: no way to tell, but if it is swelling it will go up and down throught the day and with activity, the callus or bone cannot be distinguished from one another. Massage will help and that is normal after a rhinoplasty, need to give it a full year. JG 9.27.08
Answer: well, it can take weeks to get better, when you use a dermal graft it goes through a significant amount of swelling and it can last a while, the redness might also benefit from a course of antibiotics to make sure it is not infected. The end result will take up to one year. JG 9.25.08
Answer: the ball could be scar tissue and the dent could be where too much tissue was removed. It would be really rare for a rhinoplasty to decrease nasal mucosa production. JG 9.24.08
Answer: try to apply some mild pressure with a Q-tip to see if you can get them to open up and drain, otherwise the surgeon can open them with a needle for you. Nothing dangerous though. JG 9.21.08
Answer: I can take 6-8 weeks in some cases. I would give it to the end of the second month and then see your surgeon. JG 9.20.08
Answer: collapse of the bones and valves are different and both can cause difficulty on forceful inhalation, you should g back and see your surgeon to see what is going on. JG 9.18.08
Answer: I doubt it. JG 9.16.08
Answer: I have to be honest and say I have never seen nor heard of that, I guess a filler could be used for when the line is there but I am afraid what it would look like when warm then. JG 9.10.08
Answer: I do not think so, no. JG 9.9.08
Answer: As to the kenalog, no, just need to wait and see how the body responds. As to the graft, it would be red and swollen usually. JG 9.7.08
Answer: still too early, got to give it some time. JG 9.5.08
Answer: it can become calicified and boney, yes. I do not think the callus would be changed to any significant degree with an acidic diet but your bones might be affected as they have much better blood flow and cell turnover is greater. There are no supplements that will help the callus go down, sorry. Got to hang in there for a bit more. JG 9.3.08
Answer: it is relatively straightforward to perform. JG 8.30.08
Answer: massage is about all, best of luck with it. JG 8.27.08
Answer: I thik in most cases it will go down, slowly though. If it does not, in a small percentage of cases, it might need more surgery and I prefer to wait one full year. There is a possibility though that a callus will form again, yes. JG 8.28.08
Answer: no as there is no functional problem involving the tip scar tissue. JG 8.22.08
Answer: if no lifting is invovled 7-10 days. JG 8.22.08
Answer: I think with revision rhinoplasties that the swelling is more likely the culprit, I think scar formation can happen but it usually takes at least 6 weeks to even start forming, patience at this time is indicated. I think that the pigment loss from the first one if stil there is likely to be permanent I am afraid. JG 8.22.08
Answer: it can be scar tissue and I think kenalog is about all you can do, repeat surgery does not remove the scar tissue as new scar tissue will form. It can be swelling and to some extent the kenalog would help that also. JG 8.15.08
Answer: in some cases with thick skin I will say to leave it alone, especially on the tip, but up higher it might be worth doing a little more, best of luck to her. JG 8.15.08
Answer: not necessarilly. JG 8.14.08
Answer: there are occasions where surgery can be done to make them look more even, usually they will end up closing them off a bit. JG 8.14.08
Answer: if it bothers you every day then it might be a good idea to see a surgen to see what can be done, when they explain what would be needed and the risks, then you can make an educated decision. JG 8.13.08
Answer: I think if you started taping your nose one year after the surgery that it will not make anything shift or move araound. We use tape for the first week and then remove it as I have seen little help with it after that time period and it can irritate the skin, it is difficult to dislodge things below the skin after a few weeks. JG 8.13.08
Answer: well, if the roundedness is due to swelling it should get beterr, the tip of the nose is the last to get better, but if they put in grafts, it might not be any smaller and might stay round, impossible for me to say without knowing what they did and what you had to start off with. The Renacort will help if it is swelling. JG 8.13.08
Answer: well, in most cases if a significant hump on the dorsum is removed the nasal bones need to be fractured and pushed in to close the top dorsum of the nose in order to narrow it, not sure whether that was done, it can be done now though if it was not done then. JG 8.8.08
Answer: that will help a good amount, yes. JG 8.6.08
Answer: well, without knowing more about what they did in there I really cannot tell you much, but I will say that although at this point you are quite swollen, many patients can see a sizeable change during the second and third week, the tissue will help get the swelling down, give it some time before begining to worry. JG 8.6.08
Answer: I think in open techniques it takes longer and the more work is done the longer it takes, in your case with grafts being used it adds to the time. Got to give it more time I am afraid. JG 8.4.08
Answer: soonest change will usually be seen at 6-8 weeks, final results one year. JG 7.31.08
Answer: might cause a bump but would not make it larger really. JG 7.30.08
Answer: wish I had something to offer, hard to say without seeing you in person though. JG 7.30.08
Answer: injecting something like Radiesse would be a good option to avoid surgery. JG 7.30.08
Answer: I have not seen that happen that far out from surgery. Not sure what would cause that. JG 7.28.08
Answer: scar tissue does not come and go, as to the swelling, that is also unusual after this much time. The thing also is that you might not ever have a smaller tip due to thicker skin there and also the repeated surgeries can make achieving a thinner tip difficult at times. More surgery might help in some cases but not all. JG 7.26.08
Answer: you can start now. Should be all safe now. JG 7.24.08
Answer: I am sorry but there is no one in that area that I know well enough to send you to and feel comfortable. Might want to look on www.surgery.org for a board certified surgeon. All the best. JG 7.20.08
Answer: all the best. JG 7.18.08
Answer: no, it just might start bleeding and that can be hard to control at times after a rhinoplsty, need to be careful for about 7-10 days or so. JG 7.18.08
Answer: well, a second visit will be required in order to perform the preoperative visit, if you have questions then you can ask them then, or if not then a second consultation can be performed. As to doing certain things prior to the surgery, your pre-op visit should alert you to all of that, all surgeons have their special things they do. JG 7.13.08
Answer: I do not think that what you have now is due to any swelling. It might require more surgery though. JG 7.12.08
Answer: I do not think a surgical rhinoplasty should be done while pregnant. As to fillers, they have not been studied for safety in pregnant females so I would hold off on those also. JG 7.10.08
Answer: it all depends on what it is you need, it sounds like it should be enough, but I will say that New Jersey prices are higher, close to New York City prices at times. If you have insurnace, that might cover some of the issues. JG 7.10.08
Answer: all could still be due to swelling, a little massage and head elevation will help it decrease, but slowly. That type of asymmetry is common at this point in time. Final results will take up to one year but you should start seeing things looking better after three months, got to hang in there for a bit. JG 7.7.08
Answer: a laser is better. Nothing will remove the freckle on a permanent basis. JG 7.5.08
Answer: it is not common and it is not a minor revision to resuspend or graft the nose to help with breathing due to collapse. Tenderness can persist in some patients for up to one year. Best of luck. JG 7.5.08
Answer: it is a common dose but it can still cause atrophy, what you have at this point might fill in on its own over a few months too, so give it some time. JG 7.3.08
Answer: I certainly think that elevating your head above the level of your heart will help with swelling on the face, yes, and would continue it for 6 weeks after surgery. JG 7.3.08
Answer: the certification in general plastic surgery includes all of those procedures. One can do additional training and get additional certifications but the board certification in plastic surgery includes all of that. I will say that Ear Nose and Throat specialists like to claim what you have just decribed to imply that they are the only ones that can do facelifts and rhinoplasties, etc. whereas the plastic surgeon should not but that is a self-agrandizing claim. I know because I was certified first by the plastic surgery board, the generla one, and then I was invited, one of a very small number, to take the certifying examination in Facial Plastic and Reconstructive surgery so I am certified by both. Having said that, there are ear nose and throat specialists that take a weekend course on breast augmentation and liposuction and then perform those procedures too, so they are guilty of cross pollination also. JG 7.2.08
Answer: well, two dose packs is not alot,but in general it is not used post rhinoplasty as the swelling goes down in time on its own. That is pretty strong stiuff and its effects do not last long. JG 7.1.08
Answer: well, fillers can be used to smooth profiles out but understand that will make the nose larger, or higher if you will as the low areas are being filed up to meet the higher spots. I do perform it on patients that desire it. JG 6.30.08
Answer: Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 6.30.08 www.surgery.org/public/findasurgeon.
Answer: thank you for the kind words and best of luck. JG 6.30.08
Answer: 2 weeks.3-4 weeks before the gym. JG 6.30.08
Answer: that would still be surgery and stil leave a scar. I have used fillers for the nose and Radiesse can give a good improvement in certian cases, I have no referrals for that in Florida though. JG 6.29.08
Answer: I have never seen that work, in time some of the atrophied tissue does grow back on its own though. No risks to the saline injections that I have heard of. JG 6.27.08
Answer: all normal and too early to get worried, there is lots of swelling right now and things are going to change lots with time. JG 6.24.08
Answer: I do not think that is possible, cartilage cannot be altered in that way. JG 6.24.08
Answer: should be OK to do, all the best. JG 6.24.08
Answer: not truly trauma but can cause more swelling than normal or desired, prolonging the time to end result. JG 6.23.08
Answer: nothing from the outside will do that I am afraid. No harm in taping it, but the forces of the cartilage are too strong typically to be affected from the outside of the skin. JG 6.23.08
Answer: if it was smooth after the surgery and then the tip got larger after the cast came off there is a good chance it will get better in time. It might take a full year though to get back there I am afraid. Steroid injections do help and massage helps some with swelling only, but it is relatively small. Massage should not hurt anything as long as it is done lightly. All the best. JG 6.23.08
Answer: well, if it is scar tissue it might improve over the next 2-6 months, if it is loss of cartilage and therefore lack of support, that will not get better and usually requires repeat surgery with cartilage grafts to restablish the support. It is not common, but at times can be predicted depending on what is done for the nose at the original surgery. Some people have weak valves to begin with, or even normal ones, and certain maneuvers we do while performing a rhinoplasty can cause loss of support. In many case we will put grafts in at the first surgery if we intend to perform maneuvers that will potentially weaken the valves. JG 6.11.08
Answer: could be scar tissue or collapse of the internal structures that support your nose, hard to say without seeing and examining you in person. I suggest going back to the surgeon who saw you and letting them examine you to determine what is needed. JG 6.11.08
Answer: I doubt it will worsen and actually might improve with time, but I am not so sure about the loss of pigmentation though. The atrophy can progress for 6 months in some cases. Scar tissue can reform in most locations, yes. As to what can be placed there if it does not regenerate, it varies, could be cartilage grafts or Alloderm or just a filler in some cases, got to hang in there for a bit. JG 6.10.08
Answer: do not pick it as it will bleed, just do some normal saline sprays and let them fall out on their own. You can use a Q-tip soaked in hydrogen peroxide at the rim only, not deeply inside though. JG 6.9.08
Answer: many times due to swelling at the location where the tear duct empties into your nose that can happen, but it is temporary. JG 6.3.08
Answer: Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 6.1.08 www.surgery.org/public/findasurgeon.
Answer: it is not always something we can tell from the outside unless there is a large amount of motion. JG 5.30.08
Answer: all normal and we allow patients to wear sunglasses in 4 weeks. JG 5.29.08
Answer: if the doctor does not see the problem, you might need to be seen by someone else. JG 5.26.08
Answer: you are very welcome. JG 5.26.08
Answer: it will slow it down some, but it will not make as much of a difference as in a facelift. JG 5.26.08
Answer: I am afraid that what you describe is going to need more surgery. JG 5.26.08
Answer: it could have broken the bone, but if you say it goes down wen you press on it and then it rises up again, it is not a broken bone issue it is a temporary displaceemnt of the silicone and then it returns when the pressure is relieved. JG 5.24.08
Answer: it might last a few years. JG 5.22.08
Answer: back to light duty in 1-2 weeks and full duty in one month usually. JG 5.21.08
Answer: you would need to call the office. JG 5.21.08
Answer: at this point it is all due to swelling, not scar tissue, that takes time to form. In terms of reducing the nostril size, in some cases the base of the nose or the lateral part of the nose can be reduced some, it involves an external incision and can be done in many patients. As to a revision of the rhinoplasty, I think you should wait 10-12 months and let the swelling go down so a surgeon can evaluate your tissues and see what can be done to improve your appearance. JG 5.21.08
Answer: I am sorry, the previous posting you made I thought you said 4 weeks, at four years I think it is enough time that you can see a surgeon for a discussion about the revision, and in many cases the nostrils can be made smaller but it involves external incisions and I will say that in thicker skinned individuals, making the tip smaller is not always possible. JG 5.21.08
Answer: I do not think a skin graft will help and at times fillers can help it. It sounds though that with the collapse you will need something surgical and involved, not an easy operation I fear. JG 5.20.08
Answer: In most cases it will not cause any problems, it can cause some swelling or brusing but that goes away in time. The silicone is placed in a pocket and typically is not secured with any sutures or anything like that. I doubt the injury would push the silicone out or down. Normally we place the silicone directly on the bone, yes. JG 5.19.08
Answer: I am afraid it all sounds normal, it will take months for the swelling on the tip to get better, give it some time. JG 5.18.08
Answer: in most cases, yes. JG 5.16.08
Answer: I do not think there is any damage, might just be some scar tissue loosening up. All I can suggest is seeing the doctor who did the surgery, they would know the best as they have seen your nose before. JG 5.14.08
Answer: I am not sure what is causing it, I do not think there is any necrosis as that would be deep blue or black. Not sure what is going on in your case, sorry. JG 5.14.08
Answer: hard to say, I do not think it is related to the previous surgery unless an implant was placed and has gotten infected. JG 5.13.08
Answer: it certainly could be, some sutures placed in the tip can take months to totally dissolve, should not have any repercussions from it coming out though. JG 5.12.08
Answer: the medication would be absorbed into the blood stream and not reach the tissue below the skin if applied onto the skin directly. JG 5.12.08
Answer: it starts after one day but for it to be true formed scar tissue it will take at least 6 weeks to consolidate. Once the injury has occured, avoiding excessive bleeding is about the only thing that can be done in terms of prevention. JG 5.10.08
Answer: I do not think there has been any damage if you have not seen it by now. JG 5.8.08
Answer: I think it best to let nature take its course so that the kenalog will not affect the graft that was placed. Kenalog typically takes a few weeks to start to work and continues for weeks after. JG 5.8.08
Answer: if still there after one year it will need to be removed. JG 5.8.08
Answer: there should not be any necrosis, no. JG 5.7.08
Answer: it will usually require a graft of some sort but it can be done, yes. JG 5.6.08
Answer: I think at this point the changes will not occur in most patients. JG 5.6.08
Answer: more likely the implant will need to be removed to allow the infection to abate, and then replace it in 6 months I am afraid. JG 5.6.08
Answer: way too early to tell, it should shrink quite a bit over the next few months. JG 5.6.08
Answer: in some individuals it could be done under local anesthesia and if the lateral nasal bones are not cut the splint might not be needed, but it does help lessen swelling in some cases. JG 5.6.08
Answer: if the bones are going to be manipulated I strongly suggest it. JG 5.4.08
Answer: Medrol pack can help. JG 5.4.08
Answer: I have to say that I have nor heard of tha being a problem after a rhinoplasty, sorry, not much I can offer. JG 5.3.08
Answer: I think seeing the patients at 3-6 months and then again at 1 year is the standard follow up. Hard for me to tell why the did not ask the patient to come back, it would be all speculation. I could see her, but without the operative report and the before pictures I may not be able to tell much. JG 4.30.08
Answer: I would wait at least 8 weeks to allow the carrier gel in the Radiesse to dissolve. JG 4.28.08
Answer: it does stay, it lasts likely a little less time than Radiesse but can be injected more superficially than Radiesse. I think for the nose it might be wise to use the Restylane first to make sure what is needed can be accomplished with a lesser longevity filler and then move to the Radiesse if it works well. JG 4.28.08
Answer: I think for rhinoplasties most surgeons would like to wait 12 months. I think at that time, honesty is the best policy, ask to have the before and after pictures printed on the same piece of paper and then discuus what has occurred and what he suggesst could be done for further improvement. Best of luck. JG 4.28.08
Answer: you are very welcome. JG 4.25.08
Answer: OK.
Answer: I think just try to keep some antibiotic ointment on the piece inside and see your doctor as soon as he returns. JG 4.25.08
Answer: the swelling will extend to the other side and it can take a full year to go down all the way. JG 4.23.08
Answer: under the derpression. JG 4.20.08
Answer: it depends on what the patient desires it to look like. JG 4.19.08
Answer: Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 4.19.08 www.surgery.org/public/findasurgeon
Answer: I do perfrom it but I cannot give you a price unless I see you and deiscuss what all needs to be done as that will affect the fees. JG 4.17.08
Answer: kenalog injections might help a small percentage, but nothing dramatic. JG 4.15.08
Answer: if it is larger now than at two months, then it is likely scar tissue and not swelling and the swelling would not increase after two months. It takes a long time to see the final result because the tip swelling only goes down when you are flat on your back. The thicker skin on the tip is certainly aggravating the issue. JG 4.15.08
Answer: well, fisrtly, it might take a full year for all to settle in and heal, secondly, if it still looks that same after that time, in most cases the doctor want you to be happy and if he thinks it can be altered safely, they will usually go ahead and do it, all doctors have policies on touch ups though and some offer it for free while others offer it at a reduced fee. I wil also say that some desires the patient wants are either not able to be achieved due to underlying structure problems or are too risky, but they should be able to explain that to you. Best of luck. JG 4.14.08
Answer: it is highly unlikely that it would not dissolve in time. I do not think it will make it permanently larger than it was before the injection. JG 4.8.08
Answer: sorry, I thought I had, yes, it is almost universal to see asymmetry. JG 4.7.08
Answer: I have been doing rhinoplasties for over 20 years and I think the swelling will decrease but it will not be by 80% in 3-4 weeks, more like 6 months, especially on the tip, there it can take a full year to resolve. Give it some more time. JG 4.6.08
Answer: you are correct on all of it, it wil take time, up to one year to get it all to decrease, and irritating it will make it stay swollen longer. JG 4.6.08
Answer: to a small degree, yes. I think the difference from a third rhinoplasy will likely be quite small to none. JG 4.6.08
Answer: it will flatten it a small amount, but not to flatten it totally. I do not think lifting will shift the Radiesse. JG 4.6.08
Answer: possibly. JG 4.5.08
Answer: bleeding and shifting of the bones, and excessive swelling. JG 4.5.08
Answer: the spray might make it all worse I am afraid. JG 4.5.08
Answer: injections into the nose can be very tricky due to the scar tissue from the surgery, I think the material can be hard to get to stay in one place and having a good result one time is no guarantee it will go as well the next time, I think small touch ups are a reasonable thing to consider though to get it smoother. JG 4.3.08
Answer: in most cases they should. All the best. JG 4.3.08
Answer: the bones are not held in place with sutures so that cannot cause it, cartilage can be sutured to maitain its shape but not its position, so I do not think sutures are or were the problem. JG 4.3.08
Answer: the bones might not have healed well enough and they are floating. Not sure what they can do though. JG 4.3.08
Answer: I have used Gortex for that purpose. JG 4.1.08
Answer: they can break but in most cases tissue is removed at the same time to prevent that from spreading. It should not cause any further damage to the nose though. JG 3.26.08
Answer: I feel the Gortex is better as it will not warp. JG 3.25.08
Answer: I do not think it will help thin out thick skin, it might help soften scar tissue ia about all. No other options I am afraid. JG 3.10.08
Answer: if it is going to help it likely takes 4-6 weeks but many times one shot is not enough. The only way I can see to change the nostril orientation without surgery would be a filler to the tip to elongate it but it will make it larger too. From what you are describing I feel that your desires will likely never be met, the skin on your nasal tip is probably thick, that will limit much of what is troubling you, and there is not much that can be done for that and repeat surgeries can thicken it with more scar tissue. There are limitations to the end result that can be predicted before the inital operation. JG 3.8.08
Answer: nor risky, I do not think there will be much scar tissue making it worse. JG 3.8.08
Answer: no, it is possible, but it will require your nasal bones to be broken in order to narrow the bridge. At times when the hump is taken of, some doctors will not break the bone to narrow the bridge and then it needs to be done later. JG 3.7.08
Answer: I prefer GoreTex and may you can see Dr Sam Kao, best of luck. JG 3.4.08
Answer: possibly but it would need to be made larger at the same time. JG 3.2.08
Answer: well, I doubt you caused any of the problems, it is well known that that nasal implants that extend to the tip will occasionally break through the skin due to pressure from the implant and in those cases they have to be removed. I would finish the antibiotics and not massage it and hope for the best. JG 3.1.08
Answer: it might take a year in some people for it to dissolve. It stays stable for a long time and then when it starts to dissolve it goes fast. JG 2.28.08
Answer: it can alst a year at times, and in some cases longer, but the gel carrier dissolves in 6-8 weeks so there should be a reduction after that time. Not mch that will speed it along though. JG 2.24.08
Answer: I think it best to let it dissolve on its own, it is hard to remove the small amounts injected. If he persists in not agreeing with your vision I do not think you should keep allowing him to proceed with his desires. JG 2.24.08
Answer: a pressure ulcer is when the pressure applied over tissue is greater than the pressure in the blood vessels and then the blood vessels and the blood flow is lessened and then the skin can break open. JG 2.22.08
Answer: I do not think it will affect the graft at this point. JG 2.20.08
Answer: could inject a filler to lift it up until the healing is done and then re-evaluate it. JG 2.19.08
Answer: could use Restylane or Juvederm to fill it in. Might last 6-12 months, costs will vary from surgeon to surgeon but likely in the $500-600 range. JG 2.10.08
Answer: I do not think it would make any difference. JG 2.7.08
Answer: very low risk, might last a year or two. JG 2.5.08
Answer: it does not shrink in cold weather but it becomes more stiff and less pliable. I think your issue is more of the cold just getting blood vessels and posssibly swelling to go down but not a change in scar tissue. JG 1.30.08
Answer: the thicker the skin potentially the greater degree of limitation in getting a greater refinement of the tip. JG 1.28.08
Answer: well, the negative effect with thicker skin is that the degree of refinement of the tip is less dramatic. I do not think it will look any wider but it might not yield as dramatic of a change as you desire. Swelling seems to be more in thciker skin too and that might be what certain people see afterwards for a period of time. JG 1.28.08
Answer: sorry but I have not, sorry. JG 1.28.08
Answer: yes, that is allowed. JG 1.24.08
Answer: you should not be putting a Q tip inside your nose that deep, just do not do it again, it is just from you tearing the tissues in side and it should heal on its own. JG 1.20.08
Answer: you would likely not be able to pull the tip down if the muscle were cut.JG 1.16.08
Answer: the profile can be left alone, yes. As to the bottom of the nose flaring when out smile, that can be reduced some by cutting the muscles that insert on the skin but there will still be some widening after it heals, just less. JG 1.16.08
Answer: no effect on the naolabial folds, sorry. JG 1.15.08
Answer: I think you need to see your surgeon and discuss when it is possible to reposition it, best of luck. JG 1.14.08
Answer: sorry but nothing safe. JG 1.14.08
Answer: the more times you have had surgery, the less differences in general that can be made due to scar tissue I am afraid. JG 1.7.08
Answer: I doubt the redness will be permanent, just sun damage and should go away like a sunburn would in time. To treat it now, just use some aloe and avoid the sun and use what you have been using. I would wait for the skin to heal some before any massages though. Be well. JG 1.7.08
Answer: There are only a handful of reconstructive rhinoplaty surgeons in the US, all depends on where you live. JG 1.3.08
Answer: I feel it is worth a try, best of luck. JG 1.3.08
Answer: I prefer a total sunblock and SPF 30 is a sunscreen, so it is only a partial block. Need a real Sunblock or an SPF of at least 50. Swelling can be quite extensive after a septorhinoplasty and can take months to get better I ma afraid. There will be small amounts of swelling for up to one year after the surgery. You only need to saline nasal spray if your nose feels dry. If you need it, it cna be used every two hours without a problem. All the best. JG 1.2.08
Answer: it can happen and the best way to correc it is for the area to be shaved down, he is correct about that, all the best for the touch up. Happy New Year. JG 1.1.08
Answer: nasal implants to the bridge are relatively safe, safer than those meant to lift the tip. There is a risk of infection and movement of the implant but it is a low risk in experienced hands. JG 12.31.07
Answer: actually the splints keep the septum straight but their bulk does cause the sides to push out in some individuals. At this point in time the difference in sides is most likely due to swelling, yes, so just hang in there. JG 12.30.07
Answer: pinch the difference between the tip and the bridge, also if you can see pores and there is also no definition of the cartilage, it is thicker. JG 12.30.07
Answer: in general it will be about the same healing time, yes. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 12.29.07 www.surgery.org/public/findasurgeon.
Answer: unskilled manipualtion at this point will not do any harm, as to the massage, start at the bridge and press the skin down onto the bridge of the nose and then towards your cheeks with your thumb and index finger or using both index fingers, do that ten times, then gently squeeze the tip and then slide the finger up to the bridge and down again onto the cheeks, again ten times. Do that twice per day, morning and night. JG 12.29.07
Answer: There is a product called Fascian but it does not last too long. Alloderm is thicker and more stable and longer lasting than Fascian. Using your own tissue is also possible but then leaves a scar where the tissue was harvested from. JG 12.29.07
Answer: to avoid elevations in blood pressure that can lead to nose bleeds and excessive swelling. JG 12.29.07
Answer: swelling alone can certainly give one the appearance of a polly beak deformity, yes, especially in thicker skinned people. I would keep your head elevated, apply some ice, and do some light massage until he/she comes back, likely it will improve, albeit slowly, and in some cases it requires some kenalog shots into the area to help the swelling go down, hang in there. JG 12.27.07
Answer: the tapes are a personal preference and I think the swelling does form to a lesser extent with the tapes but the swelling will eventually go away, so the differences you see early on are typically just short term ones. I would not tape it until you see your surgeon. Best of luck. JG 12.22.07
Answer: really no way to tell, need to wait for the swelling to go down. What you are describing sounds more like swelling though. JG 12.20.07
Answer: correct, due to swelling/ edema and it will go up and down, that fluctuation will be less in time. I think in time it will be smaller, yes. The other area of concern is not an uncommon thing and it dissolves and does well without aspiration, the needle placed to remove it can cause bleeding too, so unless it is very large we refrain from aspirating it on the nose. Should be better in 4-6 weeks. JG 12.19.07
Answer: should be OK to do so now, if they bother you, then get a lighter pair or wear those Croakies straps on the legs and keep it tight to keep pressure off of the nose. JG 12.18.07
Answer: the lump can be reduced but the scar is forever. JG 12.17.07
Answer: please send them to drgarcia@lvcosmeticsurgery.com and please include what they did to your nose during the operation as best as you can. JG 12.14.07
Answer: well there is swelling that will come and go after a septoplasty,it typically is worse at nigth when lying down, but if it persists and is always on one side, an evaluation by another surgeon, possibly and ear nose and throat specialist, might be a good idea. If the breathing difficulty alternates between the two sides it is likely due to swelling and might benefit from some nasal spray. JG 12.12.07
Answer: hard to say wihtout seeing you I am afraid, could be a fold in the cartilage, or a cyst. JG 12.12.07
Answer: I would prefer 7 days if possible and take some decongestants prior to the flight. JG 12.12.07
Answer: likely will get better on its own in time, might be some small amount of blood under the skin where the rasping was done, if not, I think it best to wait 6-12 months before deciding if a touch is needed, most likely it will be fine without anything further. JG 12.12.07
Answer: a filler migth be an option, the syringes usually go for about $500, and I do think you need to see a surgeon about the breathing problems if they are still there, best of luck. JG 12.12.07
Answer: yes, it returns without scar tissue. JG 12.9.07
Answer: there are alternate ares to treat extended bunny lines. JG 12.9.07
Answer: semi-final result in maybe 6-8 weeks. Still early to be dissapointed. I think you can do the eye brow tatooing at any time. JG 12.9.07
Answer: hematomas are not seen on X-ray, it is a diagnosis made by looking and examining. The small crust inside of your nose will fall off when the incision inside have healed, using the steam to remove them should not increase the swelling. I would not use the Q-tips as that might knock the scab off before it is ready to fall off. JG 12.5.07
Answer: it is normal for some swelling to increase after the splint is removed but you might want to see the surgeon to make sure there is not a hematoma that needs to be drained, all of that can cause the pain, yes. I think getting over a sink with running hot water and a towel over your head to let the steam soften the custs inside your nose is the best for now. Good luck. JG 12.5.07
Answer: sorry, but no. JG 12.5.07
Answer: the chances of poor scars on the nose is small, as to the implant versus cartilage, the cartilage can warp so thee implant might be easier. If the nostrils are too wide there is no other way to reduce them besides an alarplasty. JG 12.5.07
Answer: at least one year. JG 12.4.07
Answer: I do not think they will fix it for free and if it is still numb there is a chance of further shrinking possibly. JG 12.4.07
Answer: Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I now I have made exceptions in the past but those are cases where there are certain circumstances prevailng.I wish you all the best. JG 12.2.07 www.surgery.org/public/findasurgeon.
Answer: well, let me first say that in 19 years of practice in Las Vegas, I have never heard of him, never heard his name even mentioned. As to injecting liquid silicone into lips, I will say it like this, I think it is illegal to use that product in that way, the purchasing of liquid silicone intended for a different use and then using it for a cosmetic reason when other well-proven safer products are available is likely based on an attempt to get an edge over other physicians who will not do un-approved procedures. In Nevada it can result in the loss of your medical license. If it is not safe here, I cannot see how it could be safe 350 miles away. So my question would be, where else has a physician like this compromised on some other issue in order to make money and potentially put a patient`s health at risk? JG 12.2.07
Answer: if injected in the correct place it will limit the amount of flare, correct. A larger tip will require surgery to reduce it though. I think if the flare is reduced during exertion there will be a limition of the ability to take a deep breath though. JG 11.28.07
Answer: hard to say how complicated it would be without seeing you in person, I wil say that particular portion of the nose after a rhinoplasty can stay swollen for one year and the swelling can cause apparent asymmetries that correct themselves in time. I seriously doubt that anything you did could have caused any damage. JG 11.28.07
Answer: I think they might help and in an otherwise healthy person will yield very little downside. It would have been nice to leave the cast on in the sense that your final result might have shown up earlier but I think eventually when the short increase in time of swelling abates it will look better. JG 11.26.07
Answer: yes, it is doable, best of luck. JG 11.25.07
Answer: it might make it a little more swollen short term but likely not negatve effects long term. Leaving it on could have caused greater problems. JG 11.24.07
Answer: just surgery I am afraid. JG 11.22.07
Answer: a reasonable thing to try. I think in many cases a CO2 laser smoothing of a scar can give a nice result too. JG 11.21.07
Answer: not familar with that doctor, and I do think experience is important so I think someone who at least does a large number of them is a good idea, look for at least 20 per year. JG 11.21.07
Answer: well, doing it with a filler will make the bridge higher to hide the bump, but will likely not be able to do much for the bulbous nature of the tip as it looks worse because the skin has gotten thicker. JG 11.19.07
Answer: I do about 25 primary rhinoplasties per year and I no longer accept patients for secondary rhinoplasties where the first was done elsewhere. JG 11.19.07
Answer: I do not know of any filler that would prevent a revision surgery being performed down the road. JG 11.18.07
Answer: may want to see the surgeon and see if kenalog injections might help. JG 11.16.07
Answer: I think it is hard for me to say what could be done but it sounds like some surgery might be required I would say, all the best. JG 11.13.07
Answer: if the scar tissue becomes thick it can make you lose the definition you are hoping for in the tip. The tape will help control swelling in the very short term but I do not think it will influence scar tiisue formation. No exercise either that will help. JG 11.12.07
Answer: way too early to tell, lots of swelling at this point, give it time, it will look better soon. JG 11.12.07
Answer: well it can be increased with Radiesse or Artefill. JG 11.10.07
Answer: one year for a final appearance. JG 11.8.07
Answer: Ron Gruber but he is up in northern California, or maybe Steve Hoefflin in Santa Monica. JG 11.6.07
Answer: might want to see Rollin Daniels MD in New Port Beach,Ca. he is a great revision rhinoplasty surgeon, sounds like you need what are called spreader grafts. As to the creams, I am getting there, I made it too strong and people were getting irritated so I am slowly decreasing it to see what will be effective, all the best. JG 11.6.07
Answer: 48-72 hours afterwards is OK I feel. But not too hot, just warm is OK. JG 11.5.07
Answer: nope, it will need to be larger if it is being done with a filler, no way around that. Bringing the bridge up can make the tip look smaller in relation but it is not truly smaller, as to being out of this planet, sometimes I feel a little alien, yes, but I am an alien as I was born in Cuba, but thanks. JG 11.5.07
Answer: will not do much, sorry. JG 11.4.07
Answer: I would wait until the tissues have softened some to also make sure it will not get better on its own as the swelling goes down. JG 11.4.07
Answer: I think there is likely lots of swelling and the flaring should get markedly better, keep up what you are doing and give it some time, worst case scenario they could do a small flap rotation and replace some of the skin that was removed but I do not think that will be needed, all the best. JG 11.3.07
Answer: the only thing is to do microdermabrasions on a regular basis to keep the pores clean, or beta hydroxy acid peel, and nothing is long term, can also try Retin-A too. JG 11.3.07
Answer: I really do not think the silicone which is solid would be causing it, might be somethig else, like allergies. JG 11.2.07
Answer: I think it will be hard to keep it that way as it is likely scar tissue forming that makes it lose the appearance and that is almost impossible to control, especially after that many surgeries. Let`s hope the scar tissue has maxed out in its formation. JG 11.2.07
Answer: at this point so soon after the surgery I would not be concerned, things are still healing and will take time to settle down. JG 11.1.07
Answer: I would stop it and let nature take its course. Yes, stop the ginger brew. JG 10.31.07
Answer: I think scar tissue would still have been created but since tissue would have been removed it likely would be smaller, the trade off is the small scar. JG 10.31.07
Answer: best of luck. JG 10.30.07
Answer: for a day or so, couple of times per day. JG 10.30.07
Answer: It could be cut out but it could return, kenalog works by slowing the creation of new collagen. The kenalog can take weeks to work and in many cases requires more than one shot. I think likely the hemangioma has made the formation of scar tissue worse. JG 10.30.07
Answer: can all be done the same day, the bruising should last no more than 2-5 days. JG 10.29.07
Answer: sorry but it does not work and can actually cause problems with the skin. JG 10.25.07
Answer: not much that will speed it up I am afraid. JG 10.25.07
Answer: I doubt it, I think it should be fine. JG 10.23.07
Answer: all normal, just swelling, it will get better over the next few weeks. JG 10.20.07
Answer: yes, OK to do if you need it for breathing or allergies but it will not affect the scar tissue, swelliing or healing. JG 10.20.07
Answer: please call my office and speak with Kerry, explain to her we have spoken via the message board and she can get you in when it is possible for both of us, see you soon. JG 10.18.07
Answer: I think Radiesse or Artefil are options, yes. They both should stay put. Best of luck. JG 10.18.07
Answer: to be honest I do not think kenalog will help and I do not think it is swelling. You likely, at this point since it persists, have a space where there is no cartilage and the skin, due to it being scarred, cannot shrink or contract so it is bridging the gap rather than lying supple into the dperession. There is likely little to do I am afraid. JG 10.17.07
Answer: possibly some kenalog injections inside to soften the scar tissue. JG 10.17.07
Answer: revision surgery might not help, could try small injections of kenalog or 5FU into the tip. JG 10.17.07
Answer: I would wait 6 months at least before doing anything else just hang in there. JG 10.16.07
Answer: low risk if injected deeply as he says. JG 10.15.07
Answer: I think it is probably safe. JG 10.14.07
Answer: no it does not. JG 10.11.07
Answer: most likely it will go away, probably a little blood under the ksin that will take time to settle down. JG 10.8.07
Answer: hard for me to tell, it might be able to be done closed but it will vary depending on what needs to be done. JG 10.7.07
Answer: have never heard of that effect happening, not sure what has caused it. JG 10.7.07
Answer: no home remedies for a cyst, it can be lanced but if the wall is not cut out it will recur and eventually will likely need to be cut out if it is a cyst and not a mole. JG 10.4.07
Answer: it probably looked straight due to the swelling and as it decreased the dent became more visible. A cartilage graft to the tip would not cause a dent on the bridge. Could use a small amount of filler to fill in the dent. JG 10.3.07
Answer: can try ScarGuard or Mederma. JG 10.2.07
Answer: everything will be OK. JG 10.2.07
Answer: no, I do not think the clothespin did that. I think you just got used to it being thinner and when it went back it looks wider from what you got accustomed to. JG 10.2.07
Answer: not a problem. JG 10.1.07
Answer: have to cut them somehow. JG 10.1.07
Answer: migth take a month or sometimes a little more on the inside. Removing them after 3 weeks will not be a problem. It is possible you clipped one of hte stitches, yes. JG 10.1.07
Answer: no I do not think they should cause that. Stress can though, or a nervous tick. JG 10.1.07
Answer: possible but doubtful unless it was quite a strong blow. JG 9.30.07
Answer: it can be, but twitching comes form either irritated nerves or also a nervous twitch form stress, so it might not be related. JG 9.29.07
Answer: should not be dangerous, no. I doubt there is a bone or sinus infection but you should see your surgeon for some antibiotics to help it heal better and faster. JG 9.29.07
Answer: Rollin Daniels MD. JG 9.27.07
Answer: doubtful it is an infection, could have come from something as innocent as blowing your nose, it should all go back down in time. JG 9.27.07
Answer: all normal, nothing to worry about, nose swelling is a long term issue but does get better, final results will not be there for 10-12 months though. Glad the droop is getting better. JG 9.27.07
Answer: scar tissue is difficult to compress so that area is likely swelling, the scar tissue should feel firm. Well the surgery might have been a walk in the park for the surgeon, but the end result is you have to cut the grass and heal and that takes time. I think steroid shot should help though. Just not too big of a dose to avoid tissue atrophy, your surgoen will be aware of that, best of luck. JG 9.26.07
Answer: it likely will, sounds like just a lot of swelling due to frequent surgeries close together, but to get to the look you had in the photo may take a year or more, just give it some time, best of luck. JG 9.25.07
Answer: it can be normal, and cartilage usually does not hurt too much. It likely is the edge of the incision inside is just still swollen. JG 9.25.07
Answer: I think it is a straightforward thing for any surgoen to do. I would certainly be willing to do it for people that would benefit from it. JG 9.24.07
Answer: heat can increase swelling a tiny amount but nothing excessive. It cannot cause anything permanent nor cause scar tissue.JG 9.23.07
Answer: let me look at the picture and then we can see, but the fillers are all about the $650 range or so if we use Perlane or Radiesse, they woudl last about one year, maybe a little more. JG 9.23.07
Answer: depends on filler chosen. JG 9.22.07
Answer: well we charge in accordance with the filler used so it is by syringe, approximate cost would be $650 or so. JG 9.22.07
Answer: nothing permanent should happen. JG 9.22.07
Answer: got it. JG 9.21.07
Answer: I do not think Restylane will become permanent with scar tissue. There are permanent fillers that can be used off-label like Artefil, but Restylane is a good place to start to see if what needs to be corrected can be done with fillers. JG 9.21.07
Answer: not that I know of. JG 9.19.07
Answer: it is called mucosa and is not as strong as skin. Just leave it alone. I think the lifting is coincidence. JG 9.19.07
Answer: should not if you have not had a chronic problem with it. It will not affect the thickness. JG 9.19.07
Answer: it might need to be cut out. Topical therapy will not help a cyst. JG 9.19.07
Answer: the most common cause for a septal perforation is either cocaine abuse or a traumatic septal hematoma that was large and went undrained, so they can at times tell, yes. JG 9.17.07
Answer: could be, hard for me to tell mroe without feeling it, could be a cyst also. JG 9.17.07
Answer: potentially yes, especially if it bleeds. JG 9.17.07
Answer: I would not do anything to it for 6 months and see what happens, hang in there for a little longer. JG 9.17.07
Answer: in time it usually flattens and softens in the healing phase, it never totally goes away though. JG 9.17.07
Answer: it can happen form the Botox migrating, it can happen if you lie on your side after the injections, should all wear off and not be permanent. JG 9.17.07
Answer: final softening and shrinking will be 12-18 months. JG 9.16.07
Answer: no, sunlight does not affect it, it just happens with age as the oil glands tend to enlarge and thicken the skin with time. JG 9.16.07
Answer: well some doctors do use prolene in the tip, I think you should ask the surgeon who did it and try to get the answers from him as they are the best to know what is in there. JG 9.16.07
Answer: it might narrow some in time but not a large amount, the narrower bridge can cause difficulty in breathing though. JG 9.16.07
Answer: it can come from treatment of the cartilage, it is usually noticed after the swelling starts to go down. JG 9.16.07
Answer: callus is extra cartilage after treatment of the bone or cartilage, it can fell and look just like a hump. The ice does not affect callus, just swelling. JG 9.16.07
Answer: yes, very likley due to the extensive nature that there is still swelling, might take up to 18 months after surgery to slow down. Hang in there. JG 9.6.07
Answer: I would give it a few months and I think the bump from the shot will go away, but what was there before the shot might not. JG 9.5.07
Answer: I think just giving it some time and light massage is all I would suggest. JG 9.4.07
Answer: I think the longer one waits the less effective they will be. JG 9.3.07
Answer: it takes months for the swelling to go down so the skin will not really re-attach to the cartilage for a long time, you are safe. JG 9.2.07
Answer: I do not think the tape coming off will cause any long term problems. Just peel it from one side ot the other. The detachol or nail polish remover will get the glue off. JG 9.2.07
Answer: I always learn from all of the questions. Glad your issue is improving and best of luck. JG 8.31.07
Answer: well it is probably best to see if it dissolves, but it will not cause any problems. JG 8.27.07
Answer: yes, it should fill in over time. Give it some time. JG 8.26.07
Answer: trauma can cause humps too. If it is hard most likely it is permanent and would need to be surgical reduced. JG 8.24.07
Answer: I think you are in great and talented hands. Best of luck. JG 8.23.07
Answer: I would try the Restylane first and then switch to the other once the Restylane has absorbed, just to make sure it can be filled in to your liking. JG 8.21.07
Answer: For that it might require more surgery to balance the cartilage out. JG 8.20.07
Answer: yes, I think it is a good option. JG 8.20.07
Answer: I think it is better to do it from the outside so the muscle does not have to be cut through. JG 8.20.07
Answer: no probelm if they came off, they just help minimize the swelling. JG 8.17.07
Answer: the only thing you can do to avoid the implant form getting infected is to not pierce the skin with anything. I think since there is more bacteria in the nose the chances of infection are higher than in other places of the body. The pocket around the silicone gets infected when bacteria gets into from a surrounding infection. JG 8.15.07
Answer: that can happen in some people for up to 18 months I am afraid. JG 8.13.07
Answer: please send them to drgarcia@lvcosmeticsurgery.com
Answer: it all depends on the dose given each time. JG 8.11.07
Answer: might need both I fear but hard to say witout seeing pictures. JG 8.11.07
Answer: I am sorry but i really cannot say awhy that is happening, a puzzle for me too. JG 8.11.07
Answer: in most cases it can. JG 8.10.07
Answer: taping will only help a smal amount, I think you should return to the surgeon and be examined. JG 8.10.07
Answer: I think waiting is OK and in many cases the septum can be straightened but not in all. Cartilage grafts are commonly used to raise the bridge of the nose. JG 8.10.07
Answer: I think at this point it is likely due to the selling and the cast and should settle down quite abit, just hang in there. JG 8.9.07
Answer: well the only thing to remember is if your skin is thick it might not show the detail of the cartilag2e cahnges so your skin will limit the end result as much as the surgery. JG 8.7.07
Answer: in our office it can range from $4000 to $6300, depending on what is done. JG 8.6.07
Answer: 2-4 weeks. JG 8.6.07
Answer: well in experienced hands it should be OK to proceed. JG 8.3.07
Answer: well I think the issues might be loose skin after the liposuction and at times a pec implant can have an unnatural appearance when your own pec muscle flexes. JG 8.3.07
Answer: constant pain and the skin would look very white. JG 8.3.07
Answer: could be from the cartilage or boens caving in, yes. JG 8.3.07
Answer: all temporary, will all go away, you did not do anything to the tissue below the skin. JG 8.3.07
Answer: all depends on how thick you skin is, the thicker the better. JG 8.2.07
Answer: I think the potential of skin damage is small so I think you are safe in waiting a bit, but I understand your concerns, hopefully with time they will settle in without further surgery. The skin will tend to thicken up in time and some of what you are seeing now will look better but I am unsure as to the deviation getting better, hang in there. JG 8.2.07
Answer: yes we do, please feel free to call the office for a consultation appointment. JG 8.1.07
Answer: I think just a good moisturizer and stay out of the sun is the best. JG 8.1.07
Answer: sounds like swelling, need to give it a number of months for all of that top go down. JG 8.1.07
Answer: I only do general anesthesia for my rhinoplasties, especially complex ones like yours. JG 7.30.07
Answer: placing the alloderm can be done closed too. I do not think the closed technique caused the cartilage to show though. An open technique has longer swelling time on the tip. JG 7.30.07
Answer: well I think if the cartilage is easily seen something will need to be added, not taken away, maybe a sheet of alloderm to thicken the tissues over the cartilage, I think going on a prolonged vacation so soon after surgery might limit your activites during the vacation too. All the best and thanks for visiting and also for the kind words. JG 7.30.07
Answer: OK on the contact lenses. JG 7.15.07
Answer: yes, OK on the contact lenses. JG 7.15.07
Answer: at 18 you can have it but we must determine that your are psychologically stable in order to do it for you. JG 7.13.07
Answer: it could be done at the same time,yes. JG 7.12.07
Answer: no damage in most cases, you just should not leave it in direct contact for long periods of time to avoid frostbite. JG 7.12.07
Answer: it can, it is more involved, it might require some cartilage grafts to maintian it too. All the best. JG 7.11.07
Answer: it might, if you can get the skin to readhere and create a thin layer of scar tissue that will hold it there. Need to see your surgeon to see if it is possible. JG 7.9.07
Answer: If it gets better with tape then it is not scar tissue causing the appearance so I do not feel Kenalog will help. I think the issue is your ksin is thick and will not re-attach and adhere to show the underlying definition you desire. JG 7.9.07
Answer: I am afraid it might be, yes. JG 7.9.07
Answer: I do not think the kenalog will do much to reduce skin thickness and I feel that is the limiting factor in your end result. The desired end resualt you have pictured in your mind might not be possible due to the thickness of the skin and more surgey may not be abe to achieve it as more surgery can only reshape the underlying structures but cannot thin the skin. JG 7.7.07
Answer: I think taping it at night might help some. JG 7.6.07
Answer: it is mostly swelling as it will take one year for all of that to go down and the reaction on the cartilage to soften andd flatten. Light pressure massage is OK, daily, and tincture of time. JG 7.6.07
Answer: well swelling form revisions can take months to go away, it is hard for me to tell you why you look that way without knowing everything the surgeon did. JG 7.5.07
Answer: It would likely be less but I would need to see you to give you an accurate quote. Sorry. JG 7.2.07
Answer: normal, it is from the marterial injected, it does not mean it is working though. JG 6.28.07
Answer: well, no, I have never used it nor heard of it being used and really see no reason to use scalp for something like that, I think the potential negatives are too high, like anbormal hair growth if it survives. JG 6.25.07
Answer: it is more difficult because there is scar tissue and much of what was done at the first surgery might not be able to be reversed. I do peform it but I would need to see you in person to determine a fee. JG 6.15.07
Answer: the shot should not complicate the revison. As to massage, a little maybe three times per day for a few days is all. I think the swelling unfortunately will be at least as bad for the revision. JG 6.15.07
Answer: IPL and topical antibiotics will help. JG 6.15.07
Answer: well, not common, but not uncommon, there are limitations and at times those are not surmountable, such as thick skin. It might require more surgery at this point. As to the nose growing, what does grow is the thickness of the skin of the tip and that can give the appearance of a larger tip that droops with time. JG 6.15.07
Answer: most likley it is the Alloderm and in most cases in a year or so it dissolves, otherwise they would need to go in and remove it. JG 6.13.07
Answer: no photo releases from those patients, sorry. JG 6.12.07
Answer: Q-tip will not create much swelling I feel. A large blow to the outside could though. JG 6.12.07
Answer: I have not been impressed with the amount if improvement with the balloon surgery. As to the septum, you are correct, it does not always stay straight, and the septum is not causing the gagging and coughing, tough call, but as long as he is willing to live with it he can continue to do so. JG 3.7.07
Answer: hard to say without seeing you, doubtful a steroid shot will help though. JG 2.2.8.07
Answer: I think at this point the surgery might be better. JG 2.25.07
Answer: it will affect all the tissues in the area. Cutting scar tissue out will heal with new but possibly less scar tissue. It is cut out with a scalpel or scissors. JG 2.25.07
Answer: the radius that kenalog will cover depends entirely on the amount or volume injected. I think one or two shots migth be a good idea though, as otherwise it might need more surgery. I usually use 5 the first time and ten the second. As to the skin not being lifted for the rasping, that is not entirely correct, the rasp will not fit if the skin is not lifted, it can from from blood pooling there and creating scar tissue or from the production of callus which is how the cartilage heals when rasped. JG 2.22.07
Answer: sorry but no, topical creams will not help the swelling below the skin. It needs to be injected. JG 2.21.07
Answer: it would normally take months for that to smooth out. JG 2.19.07
Answer: sounds likes one type of surgery will be needed, it might be a place on the turbinates that has a non-healing area that scabs and bleeds. I think you need to see an ENT and have them examine you after they have numbed you up, posssibly they can cauterize it at that time. Best of luck. JG 2.15.07
Answer: silicone is permanent and most likely the only thing that can be doen is to surgically remove the silicone. JG 2.14.07
Answer: if too much cartilage is removed, yes. JG 2.13.07
Answer: it might get worse for a while, yes. JG 2.13.07
Answer: shoudl be straight forward and should not affect your breathing. Cartilage can shift due to scarring for years after the surgery. Best of luck. JG 2.13.07
Answer: the septum is made out of cartilage so commonly it will spring back to the old shape, might need some more cartilage taken out. If it is a septal procedure and the outside straightens because of the septum it is not considered cosmetic. JG 2.11.07
Answer: I think that is a very reasosnable approach, just go slow with the injections, you can always put in a little more, that is easier than taking too much out. JG 2.10.07
Answer: hard to say without seeing here, I think in most cases with time the surface does even out. JG 2.8.07
Answer: I think once every 4-6 weeks for 4-6 times is OK, all depends on how much they inject. The biggest fear is to thin the skin. Hang in there. JG 2.8.07
Answer: I will speak with my webmaster and see if we can set it up to give repeat visitors a passwaord to make it easy, but in short we had to start the email issue because the site was getting spammed by unsavory sites. As to insurance coverage for a rhinoplasty, if the nose has suffered a fracture AND there is a breathing problem, then at times the insurnace will cover the correction of that and only that. If the fracture has not limited the breathing and only the appearance it will not be covered. Hope that explains it. JG 11.29.06
Answer: stretching of the breast skin is not dangerous and at times with passing years some cartilage warping can occur after a rhinoplasty. I think you can certainly be sat upright on the gurney in the recovery room. JG 11.28.06
Answer: yes, that is possible, by refining the lower lateral cartilages and by trimming the caudal septum. JG 11.28.06
Answer: firstly, thank you for the kind words. As to the tip of the nose, yes, those issues should be able to be achieved. Not far out and certainly within the realm of Dr Toriumi`s talents. I think in certain cases the tip needs some skin stretching to have more definition. JG 11.27.06
Answer: yes, it all depends on how you carve it. JG 11.27.06
Answer: all normal and should all settle down in time, best of luck. JG 11.27.06
Answer: that risk is very low with the techniques used now, but still a very small possiblity. If it is going to happen it happens in the operating room and is usually recognized there and treated. JG 11.26.06
Answer: at times when the swelling goes down it can make it appear more visible. JG 11.23.06
Answer: not mentally but as she grows she might, and I stress might, encounter some breathing problems, only time will tell, not much I would suggets now unless she cannot breathe as it could stunt the growth of her nose to have surgery at this age. Best of luck. JG 11.21.06
Answer: I am afraid it is just a matter of time and a little masage might help. JG 11.20.06
Answer: correct. JG 11.18.06
Answer: I am afraid that as there is no medical probelm with the nose in terms of breathing that you will need to pay for it I am afraid. JG 11.24.06
Answer: I do not think that type of injury would cause tip necrosis, the worst case scenario is that the tip graft might have shifted. Should have no efect on future surgeries. JG 11.17.06
Answer: I think you need to see your surgeon, maybe they can just trim it off. Should not pose a big problem. JG 11.16.06
Answer: might be allergies, I would suggest seeing your ear nose and throat specialist. JG 11.16.06
Answer: I think the biggest risk is that since the tissues are swollen they may not be able to be accurate in what they do and it might end up not different enough or too dramatic of a change. JG 11.16.06
Answer: I am sorry but not that I am aware of. JG 11.15.06
Answer: I agree wholeheartedly with your doctor, best of luck. JG 11.13.06
Answer: the hard lumps may be swelling or scar tiisue and it can take a long time to soften. It is possible to widen the tip at times by placing cartilage grafts onto it. JG 11.13.06
Answer: well, I think that is a matter of likes and dislikes, at times, to correct a previous problem one needs to add cartilage support and that can make the nose look a bit longer. As to the risks, he wil need to tell you what he can do after he examines you. Best of luck. JG 11.12.06
Answer: might need a wider cut to remove the cyst, let it heal and then maybe 6 months later a light laser to fade and smooth the scar. I seriously doubt the cyst is due to the prior rhinoplasty though. Cartilage shaving do not cause cysts in the skin. JG 11.9.06
Answer: should not be permanent, warm packs might help, and also avoid sun exposure. JG 11.9.06
Answer: I think you will need something added there, either a cartilage graft or a small short implant, either silicone or gortex can be used. Another alternative would be an injectable filler like Radiesse to build the area up and that could also be injected to give you a hump. JG 11.7.06
Answer: humps can be replaced, it does not always have to be a straight dorsum. I do not think the open approach is any riskier than the closed approach. Best of luck and keep me posted. JG 11.5.06
Answer: necrosis if it is going to happen would have happened a long time ago, it is not uncommon for the swelling in the tip to make it look darker and should get better in time. JG 11.5.06
Answer: please send the photos to drgarcia@lvcosmeticsurgery.com JG 11.4.06
Answer: yes, I think that is pretty accurate. JG 11.4.06
Answer: insurance should cover it and you should be back to normal in 4 weeks or so. JG 11.3.06
Answer: all it does is reduce the swelling but long term it has no effect. JG 11.2.06
Answer: it is the the best way to remove it. JG 11.2.06
Answer: a facial mask can very often dehydrate the tissues and that can make it look smaller until the swelling returns. Thick nasal skin, especially on the tip cannot be changed with topical treatments, the oil can but not the thickness and that will limit the eventual look of the tip of the nose. JG 11.1.06
Answer: cartilage grafts can be removed and it might or might not affect the tip, all depends on what it was placed for and where it was placed. With all the surgeries you have had I will be honest and tell you that some of your desires may not be possible due to the scar tissue that has developed below the skin and there is nothing safe that can be done to remove it. On whether anything can be done to make it look better, I am afraid I cannot say without physically examining you. JG 11.1.06
Answer: Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 10.31.06 www.surgery.org/public/findasurgeon.
Answer: well, if time has passed and it does not fill in on its own then you can inject collagen or Restylane. JG 10.29.06
Answer: if it is silicone it is permanent unless you have it cut out. No way a laser or an abrasion will help. JG 10.29.06
Answer: those are areas where the heat of the light got more intense due to the hair follicles, might heal like a sunburn, too early to tell if there will be hyperpigmentation, that would take weeks to see. All that can be doen in the future is to turn the intensity down when treating the beard area as there is no Rosacea there. JG 10.28.06
Answer: hard to say, at times that is all that is needed, but in most cases it requires much more, there is not much that can be done through a limited incision in 15 minutes, but it is possible in some cases. JG 10.27.06
Answer: I do not think that the kenalog will dissolve all of that, I know some good plastic surgeons in SLC so there really is no need to come all the way here. JG 10.25.06
Answer: it does sound like scar tissue and you could not feel it initially due to the surrouding swelling, but now as that has gone down you can feel it more. Kenalog injections can still be done at this point. Kenalog works best when the tissues are fresher. Kenalog can dissolve all of the grafts and normal tissue too. JG 10.25.07
Answer: well, it all depends on what is done, how aggressive of a nose surgery, what was done afterwards to control the swelling and then there is make up and PhotoShop on computers. JG 10.25.06
Answer: just a little firm, hard in severe cases. Cortisone can be injected but it can also cause loss of the surroundg normal tissue so it is not always a possiblity, fees vary from doctor to doctor and the amount needed to be injected. JG 10.25.06
Answer: all due to swelling, it will literally take months to see some of the changes so you need to give it time. JG 10.25.06
Answer: I have never seen any good results form Hylexin for any cause of dark circles. JG 10.24.06
Answer: a filler like Radiesse might be an option there. I would wait at least 3-6 months to allow all the swelling to resolve so you can get it done with the least touch up risk. All the best and thanks for the kind words. JG 10.24.06
Answer: probably some skin staining from the blood, avoid the sun and apply some Arnica gel available at the health food store and it should go away in time. JG 10.23.06
Answer: it cannot differentiate but it will help both. JG 10.21.06
Answer: well, they might, no way to tell without requestiong a pre-authorization from the insurance carrier. JG 10.20.06
Answer: they might help but not as fast or as dramatic as the pimples. JG 10.20.06
Answer: I do perform revision rhinoplasties and have been doing rhinoplasties for over 18 years. I think other surgeons may have different ideas as to what can be done but I will say that what you have been told is true, the nostril assymetry is one of the hardest things to repair. JG 10.18.06
Answer: it can take as long as one year, if the size and shape change during the day it tells you that there is still alot of swelling, hang in there a litle longer. JG 10.18.06
Answer: teh bone is taken form the skull. Due to potential legal issues, and some doctors wanting to know why I referred a patient to someone else and not them, I think you are best to go to this website and look for a plastic surgeon in the area you desire. I wish you all the best. JG 10.18.06 www.surgery.org/public/findasurgeon.
Answer: well the surgery can be done under local but most people use general anesthesia. JG 10.18.06
Answer: the only thing that will help is to have the cartilage repositioned or cut off. JG 10.18.06
Answer: may need another rib graft or bone from your skull, tough tough problem I am afraid. JG 10.17.06
Answer: I have not heard of silicone causing atrophy. As to being reversible, it all depends on what caused it and I am not sure why it has occured. Now if it had been kenalog to the nose, that could cause atrophy. JG 10.17.06