LAM FACIAL PLASTICS

Hello Dr.Lam, exactly 2 months ago I fractured my nose playing basketball and not until about a month later i noticed a a dark spot on the right side in between the nasal bone and upper lateral cartilage area which i thought was a bruise but never went away. When i slide my finger tip in that area I feel a dent. Almost everyday for the past week the dent on my nose is the first thing i see in the mirror so i'm researching on corrective rhinoplasty and I found you. I'm seriously considering on going through with rhinoplasty and I'm hoping you can help me with that.

hi,
thanks for the question. here is how i would approach this: if you have a functional problem (breathing), then a formal revision rhinoplasty is preferred with attention toward breathing. however, in my opinion if the problem is purely cosmetic, i typically recommend a tiny bit of permanent filler to fix it unless the bones are clearly off kilter. the reason for this is that bone realignment to be dead center is not 100% reliable and sometimes i still need a drop or 2 of silicone to make it as straight as possible. plus, the area you are talking about (the scroll) is typically becomes subluxed or the upper lateral cartilage falls inward making just bony realignment not helpful in correcting the situation. hope that helps as a start.
best,
dr. sam lam

I forgot to mention my nose hasn't been clear since i injured it. It's been really congested sometimes I feel like its swollen and thumping. It's hard to breath through my nose so I breath through my mouth and my mouth get's dry I've had a lot of sleepless nights because of that. I feel discomfort wen I wash my face around my nose. Even when I'm not paying attention to my nose I feel a weird sensation especially on the tip of the nasal bone area.

ok, then you really need a rhinoplasty that may include the following osteotomies to straighten the bones, septoplasty and possible turbinoplasty (in general i do not believe in removing turbinates just moving them over if need be). as this sounds more functional than cosmetic with some cosmetic insurance will probably cover it. since i don't take insurance, i wouldn't be the most cost effective solution for you. probably would recommend an ENT who can do cosmetic nose work. if you don't have insurance or don't want to go through insurance then i could be a good option to help you.
best,
sml

First i just want to thank you for replying to all my questions everything u said has been a lot of help. Today I am breathing a lot better hopefully it was really just the cold and from being sick for the past two months. Let's take out the functional issue out the equation and say I just needed cosmetic surgery. A big question for me is how close to normal will my nose look after the surgery, the difficulty in the procedure and of course cost. I was snooping around some old photo's and luckily I found some that could help.

no problem. i don't see much difference but the angle of your nasal tip which most likely is due to photographic angulation. it will never be perfect but i think i can get you pretty close to where you want it to be. how close? i hate percentages because your 50% maybe my 80%, etc. that being said, i think i can help you with some silicone micro droplets if it is just a cosmetic issue based on the photos. i doubt you need surgery.
best,
sml

Hello again Dr.Lam, so i got my nose checked and I found out I have a deviated septum. I can breath perfectly fine through my right nose now that my cold is gone only some congestion on the left side. Would it be harder to fix if I hold off getting septoplasty? What's the cost of septoplasty from you?

if you are just getting a septoplasty, you don't need to fly in to see me. most docs out there who are ENT board certified are capable of doing this procedure well. however, if you are considering any tip plasty or other cosmetic changes to your nose other than just straightening the nose, then i would not do the septoplasty until you see me because i use the septal cartilage to design my nasal tip while at the same time straightening it. if you are interested in a formal rhinoplasty, you can contact my office: marcy@lamfacialplastics.com.
best,
dr. samuel lam