Posted on July 08, 2010 8:29 AM in General

Dr. Naderi,

I came across this site while researching rhinoplasty. I am 20 years old and have a prominent profile because of my dorsal hump, which I have been frequently teased about. Still, I've been hesitant to commit to a surgical procedure because of my pride in having a unique appearance and avoiding a "cookie-cutter" alternative.  However, a few years ago, I chipped a corner of the bridge of my nose, though I didn't suffer from any external injury to the skin, I could feel a sharp edge on the left side of my bridge, and feel slight pain when pressure is applied to the location. As the years have gone by, I think the chip has grown in size, and I am able to see a slight point on my bridge at certain angles. Though it is a minor visual distraction, I'm worried the chip could increase further in size, if not eventually cause a major medical concern to my nose. I've also come to the decision that I would like to alter my nose so that it doesn't take away from my other features, but still looks appropriate for my face. What would my best option be to attain a less distracting profile without further damaging my nose? I'm also uncertain as to how to pay for rhinoplasty, if it could be done in multiple payments, and if there's a possibility of my circumstances allowing for insurance to cover part of the procedure, given if they are of medical concern. I feel that you're the best surgeon to consult on this matter because of your success, concentration in rhonoplasty and versatility for doing both reconstruction and subtractive surgeries.

Thanks for your time,
Amanda

Answer

Dear Amanda,

I dont like a cookie cutter nose because no one's face is a cookie! Each patients face is unique and so each patient would need a unique nose to fit their face and blend in naturally without being another type of distraction.  A nose that is too small is just as distracting as a nose that is too large!

I would have to examine you and perform computer imaging to show you what nose would fit your face best and still look pretty and natural.

The area that you are feeling may be bone or cartilage or both or scar tissue.  I would have to examine you to tell. 

Insurance may cover a small portion of the surgery if its medically necessary such as for breathing issues.  Insurance does not cover cosmetic changes.  Payment plans are available through Care Credit or Chase Bank as well as other cosmetic surgery lending sources. 

While I am flattered by your kind words and my practice is definitely dedicated to Rhinoplasty, there are a handfull of other great surgeons as well around the United States who have similar passion and dedication to Rhinoplasty. 

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Posted on March 03, 2010 1:40 AM in General

dear dr. naderi,
i had a rhinoplasty about 32 years ago when i was only 23.  my nose was quite large for my face (or so i thought) and was bulbous on the end.  i had been teased about it all my young life and was convinced that a new nose would stop the teasing.   the doctor told me he was only going to remove the hump (deformity) and straighten the deviated septum.  however, it seems that he did much more than that. when it was done and healed, i liked it better than the nose i was born with because i thought that anything was better at that time.  but as i have aged, the nose just doesn't fit my facial maturity.  the nostrils are way to large in comparison to the size of the new nose, and the nose was shaved down too much on the front edge and is very sharp to the touch.  the tip is asymmetrical and shows up that way in photographs.  am i a hopeless case?   

i would like to have my nose put back as near as possible to my original nose.  i am a 3 year survivor of throat cancer and am doing very well and going about life as before.  now that i have a second chance at life, i'd like to do something about my original mistake. 

i'm looking forward to hearing from you. 

thanks,
linda

Answer

Dear Linda,

First off congratulations on beating throat cancer.  I hope you continue to be cancer free.  A life threatening illness like cancer certainly should make you see what is important in life.  Health, love, happiness, good friends and relatives, these are the important things in life.  An imperfect nose is just that......an imperfect nose.........nothing more, nothing less.

I see people every week who feel the way you do.  People who went through a Rhinoplasty somewhere else and regret it and now come to see me to ask me to help give them back as close as possible - their old nose.

Most such cases could have been avoided if patients and surgeons communicated better so that the surgeons would thoroughly explain to the patients the changes that are planned.  Both surgeons and patients are to blame!  Many surgeons don’t take the time and many patients just don’t listen.

Today, Computer Imaging, should be the gold standard in communication so that patients see what their new nose and new face will look like BEFORE going through the surgery.  That way they can choose to avoid surgery and if they choose to proceed, the results won’t be a major surprise.  Unfortunately most plastic surgeons still do not offer computer imaging. 

But in your situation, 32 years ago, computer imaging wasn't even an option.

Thinking about your decision to go through a rhinoplasty 32 years ago (or 32 days ago in other patients' situations) as a mistake is not helpful or healthy.  Whats done is done.  No point regretting it.  You stated that at the time you thought it was a good decision and you had been so bothered by your previous nose that something needed to be done anyway.  Think of it this way, if you weren’t bothered by your old nose then great.  But since the old nose brought you so much stress and mental anguish then you relieved it by your decision to have the original rhinoplasty.  If you had not had the rhinoplasty, you may have been stressed and bothered by your old nose for an additional 20-30 years!  Who knows?  But you have to look at both sides of the decision and move forward and not look back.

Are you a "hopeless case?"  No. 

Can you get your old nose back? Not likely.

Can you improve your current nose?  Most certainly if you see a Rhinoplasty Specialist and have proper expectations. 

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Posted on February 03, 2010 9:48 AM in General

iMy husband has been advised to have reconstrucitve surgery folowing an invasive exploration of his nose.  He has been diagnosed with a pre cancerous lentigo maligna.  It involves Mohs procedure which is quit disfiguring.  He saw a plastice surgent who uses enflap reconstruction( forehead cut and graft to pull over his nose.  It appears quit tramatic and his nose is cut off.  Is this the only procedure availble today?
He is 62 years old.  The spot has been there since about 1995.
Dianna Schwarz

Answer

Dear Dianna,

Skin cancers or more aggressive precancerous lesions on the face can be traumatic mentally and physically as well as disfiguring.  Despite this, proper treatment to eradicate these lesions should be carried out by experienced Dermatologist MOHS surgeons.  Following excision and eradication of these lesions, reconstruction by an experienced Plastic Surgeon or Facial Plastic Surgeon should be carried out. 

The method for nasal reconstruction depends on the size and location of the resulting post MOHS surgical defect.  Smaller nose defects can be reconstructed with local rotation flaps like the bilobed flap or the Rhomboid flap or melolabial flaps or sliding glabellar flaps.  Larger defects require forehead flap reconstruction and even larger ones may require free micro-vascular radial forearm flaps.  If the nose defect involves cartilage and bone and inner nasal lining then more complex reconstruction may be needed. 

Regardless, very acceptable results can be achieved by experienced plastic surgeons.  Dr. Gary Burget in Chicago and Dr. Frederick Menick in Arizona and Dr. Shan Baker in Michigan are some of the top nose reconstructive surgeons in the world.  The reconstructive process may take several stages for best results.  I wish you luck.

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Posted on January 06, 2010 12:01 PM in General

Answer

Hi Ashley,

Thanks for posting the question.  Many many women as well as men go through the same dilemma you are now going through. 

It is difficult deciding to go through elective cosmetic surgery - Rhinoplasty.  Its even tougher when you don't have your family's support. 

Throughout the years I have seen parents that belittle their children for wanting Rhinoplasty but I have seen a great number of moms and dads that make their children feel insecure about their appearance, pushing them towards a Rhinoplasty.  Both cases are undesirable.  The best situation is for you to make the decision yourself, after doing your homework and research while  having the support and guidance of your parents.  But that is not your case nor many other patients seeking Rhinoplasty.

From experience, the best way to deal with this is to involve them in the decision.  Make sure they know you are mature and have thought about this long and hard.  I often see parents or wives or husbands change their harsh stance and become supportive once they come to the consultation and see the computer imaging and see that the "after" version of you still looks natural and you will still be "you," only more balanced and in harmony. 

Make sure they don't think you expect them to pay for it.  Make sure they don't take this as an insult to them and their genetics and their appearance.

But if after all your effort, they are still against it, then you have to make the decision of whether to honor their wishes or proceed with your wishes. 

I wish you luck.

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Posted on October 16, 2009 2:24 AM in General

Dr. Naderi,

    I am considering a rhinoplasty procedure with your spa.  I am currently doing research on what is possible.  I am actually quite attached to my nose..lol.  Although, there are a few things that bother me.  My glabella and naison are not very symmetrical with my face or my nose.  I believe the way they are structured makes my resting face look angry, therefore making me unapproachable and to myself unlikable.  Are these areas workable in the rhinoplasty surgical procedures that you do?  I would also like to lengthen my nose so that it rest a half inch closer to my lip and refine my nose...is this possible?

Answer

Hi,

I would be happy to see you for a Rhinoplasty consultation to examine you, perform computer imaging and go over your options.  Many changes can be made during a rhinoplasty.  The Glabella itself is not routinely changed during rhinoplasty but the "look" can change when other parts of the nose are changed.  For example, building up the nasal starting point at the radix can often make the glabella look softer and the eyes less "angry." 

Again, there are just general statements and until I see you I cannot tell you what the best options for you are going to be.  But you will be able to visualize changes on the computer before proceeding with any Rhinoplasty.  The length of the nose can also be changed and we can discuss that after I examine you.

Regards,

SN

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Posted on October 14, 2009 10:15 PM in General

Dear Dr. Naderi,
In answer to another question you stated that Burget, Menick and Baker were the best at nasal reconstruction. Perhaps, thats reflected in their fees and it may also take time to get in to see them. I need a reconstruction of a botched flap that followed Mohs more than two years ago. I'm not sure if it can be salvaged or if it would have to be done all over again. I need to have this done soon because, among other reasons, my insurance will be expiring at the end of the year and I don't have a lot of money either.
So please tell me who, in your opinion, are some other nasal reconstruction surgeons that, although they may not be the very best, are also very good, perhaps up and coming surgeons that have extensive experience with this? Thanks for your reply!

Answer

Hi,

I understand your situation.  Try making an appointment with Dr. Patrick Byrne at Johns Hopkins University in Baltimore, Maryland.  He is the head of the Facial Plastics division there and he is trained in free flaps as well as other nasal reconstructions.  I cannot tell you to have him do your surgery but he would be a good doctor to see as a starting point and see what he has to offer then you can make the final decision.

I wish you luck.

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