LAM FACIAL PLASTICS

Dr. Lam,

I've had multiple surgeries (6) to reconstruct a botched nose job from a really bad surgery 5 years ago. Each time I had surgery my nose became worse and worse and more different each time with each succesive surgery. My first surgery doctor removed to many tissues from my nose and left me with a V deformity, that was the only problem area that I did not like. SO in 2005 I went to this surgeon who botched me, my goal was to fix the V thing but he left me without cartilages on my tip, my tip lost complete countour and definition and left me with a very retracted columnella, he basically screwed my entire nose. So I went to other doctors, the following doctor tried to fix/and reconstruct my nose and tip with ear cartilage, the surgery was unsuccessful because he didnt really fix any problems except make my nose extra wide, the next doctor used rib to reconstruct my tip and bridge but unfortunately he made it worse, he made my nose CROOKED!!!! the bridge and tip crooked and twisted!bridge goes one side, tip the other side and it was never like that, my nose used to be straight and more aligned with my face. So my latest surgery which was last year, I went to a Dr. who would fix my nose and make it more cosmetically and functionally better. It is better and I am happier with the nose BUT not completely, my nose is still crooked, my tip veers to one side and my bridge to the other, which throws my facial features out of proportion, which is quite noticeable in pictures. The supratip should be more convex to my taste but he made it more concave and scooped and my tip looks pointy (and I am Hispanic so it doesnt really suit me), in conclusion I think generally what I dont like about my nose right now is the crookedness because it throws things out of proportion, my tip should be in more align with my bridge, and plus I think he made my nasal bones too skinny now. I dont know what to do, I was thinking of maybe fillers as an option, another surgery (i am sick of surgeries), or just learn to live with this flaw, I dont know, its upsetting going froma straight nose to a crooked nose . Any advice. Thanks so much. .

hi,
first, i am sorry to hear of your story. it sounds as if you have gone through quite a bit. fillers can help make the supratip convex and make the nose in many cases look a lot straighter. however, it won't make the tip straight. i can use the micro silicone to give you a permanent corrections. oftentimes that takes 1 to 2 rounds for minor issues and 2 to 3 rounds for major issues. it is not perfect and if you are a candidate and willing to accept some imperfections, to me it is the safest route to fix a nose that has been over and repeatedly operated on. however, it will not fix everything. further, if you are going to elect to do nose revision surgery in the future, it is not great to muck things up with silicone in there. in short, if you are almost certain that you do not want to entertain a revision nose, then silicone may help minimize 2 of the 3 problems you expressed.
best,
sml

Thank you so much for your response and your advice! its very helpful. You are right this has been quite an ordeal for me, and a really bad one unfornutately. I am really considering the fillers, not sure about getting another surgery though but would love to see you and hear your opinion about what options will be more suitable for me at this point. I'm also having skin problems and scar tissue problems because of all the surgeries, I have thick nasal skin, and my current surgeon has been injecting Kenalog shots to make it better, especially the supratip because the skin is "saggy" and weird looking. So right now I'm just waiting to see whats going to happen, if things will get better or not, I'm sure the scoop look wont go away though. I'm 6 months from surgery and I will probably come see you at the 8th month mark to see what your opinion is but thank you so much for answering my question. I really appreciate. Take care. - Mel

no problem mel. look forward to meeting you in the future.
best,
sml