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Old 12-06-2010, 02:06 AM   #1
 
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Default Searching for revision doctor for Asian Nose

Hi, I'm new to the forum and wish I had found this ages ago. I have had two prior rhinoplasties. I am Asian and was desiring a taller bridge and slightly narrower base. First surgery was 12 yrs ago, cartilage was taken from behind my ears to give me a slight bridge and I ended up with a very bulbous tip. My second revision was done 2 yrs after that by Dr. Gunter. He did a rib graft (which left an unpleasant scar near under my left breast) but anyways, after this surgery, I had a slight bump on the top bridge of my nose (right where the graft ends and my forehead meet) in other words it does not blend and give me a smooth profile. Sorry, i dont know the exact terminology. It started of as minor and Dr. Gunter just told me to press on it to train it to go down. But now it has definitely warped and become more prominent and given a more pinched bridge look and a monstrous bump, and it is crooked to one side, and my nostrils are irregular (one is more arched than the other).

My desire is to take down the hump and have it blend and be more of a smooth transition of bridge to forehead.

I did a consultation with Dr. Cochran, who shares the same office as Dr.Gunter. He wants to avoid my tip and go around it, as he says I have some scarring and webbing on my nostril from previous surgeries. The incision would be made under my lip and he wants to take septal cartilage as it doesn't warp as much as rib, and then take fascia from behind my ear area to drape over the graft to ensure smoothness. He said if I would like, he can slip a small piece of cartilage to bring down the arched nostril.

I felt pretty good with what he had to say, he was very patient with me and answered all my questions, but still I have doubts since I've already had two NJ's I want this to be my last of course.

Anyhow, that's my background, now I'm looking for a doctor who is experienced in revisions that are familiar with Dr. Gunter's rib graft and k-wire technique.

My questions are:
1. Does anyone have experience with using fascia?
2. Any other recommendations on revision doctors that would fit my case?
3. Thoughts on using silicone implants (Sllastic, Alloderm, Goretex...) for the bridge? I know not to use silicone in the tip for fear of rejection and possible extrusion.
4. Has anyone had experience with under lip incisions?

I am also considering the following Doctors, so please advise me of anything in regards to them:
Bay Area:
Dr. David E. Kim
Dr. James C. Wu
Dr. David C. Mabrie
Dr. Albert W. Chow

LA area:
Dr. Andrew Frankel
Dr. David W. Kim

And of course Dr. Cochran

Thanks in advance!


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Old 12-08-2010, 01:40 AM   #2
 
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Tags
fascia , revision nose , rhinoplasty , rib graft warp , silicone

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