LAM FACIAL PLASTICS

Dr. Lam,

I had a revision rhinoplast done 6 months ago. Since the surgery, I have noticed how much my eyes have changed and sucken in. They look absolutly horrible and feel very different too. Like they are always tired, but I am not! Please tell me if this is commom after rhinoplasty and if it will every go away. I am feeling just horrible about this.

Thanks so much,
Stevee

hmmm, i have never heard of such a thing. obviously, anything is possible. worst case scenario you can have restylane or fat transfer to fix the problem.

Thanks for the quick Reply Dr. Lam. This forum is really a wonderful place for patients to turn to, THANK YOU.

I know that the internet can give some very different information which is why I wanted to ask "YOU, a doctor!" about this issue. Just to confirm, you have never had a patient "lose fatt under their eyes" after a revision rhinoplasty? Do you have pateitns that stay black and blue or have hollow eyes for several months, but then it gets better? This seems to be a common complaint on the internet for several patients (but half of us are crazy, so your never know;)

Also, 6 months after a closed revision it is still common for your nose to feel VERY stiff and senstive?

Thanks again,
Stevee

1. as far as bruising, i typically have none. if i have any it is barely a wisp. i do not get total black and blue after a rhinoplasty. that may be a different experience.
2. numbness/sensitivity and stiffness are normal for many months after a rhinoplasty but you really need to ask your doctor that question since i did not operate on you.
hope that helps.
best,
sml

Please give me advice, My plastic surgeon in Boise Idaho, used part of my septum to cover a bump on my nose. During recovery my septum skin did not heal properly over the hole so I am left with a large, dime size oblong hole in my septum. I am so terribly depressed as people continue to tell me I look sick now and have sunken eyes and a sunken face. My wrinkles around my nose, mouth and eyes have increased 10 fold. I look 20 years older and I use to be told I was a very beautiful 40 year old. I don’t know why this is happening? Why does my face look sunken? I can’t find any correlation to this and I don’t know if there is any hope for me as I am worried he cut a nerve or something. I am also aware that repair for this is usually impossible. Help me please, any advice would help. Thank-you so much.

hi,
1. septal perforations can be fixed but they take quite a bit of work. i stopped doing it because it is a multi-hour procedure even though my success rate is high. the reason that i stopped is not that it does not work but that my back was sore for a month after my last case and i cannot do it for my health reasons. but you should be able to find someone that can help you with that.
2. as far as the fat loss to your face, i do not know the correlation with a rhinoplasty but at 40 years of age you are losing volume anyway. i would look at it this way: instead of seeing the negative of the fat loss i would say that if you had a fat transfer procedure then that could correct the mild aging that was already there plus the additional aging from whatever reason you got it all in one stroke so that there was no sin committed so to speak. if you are interested in discussing that with me i would be happy to do that.
best,
sml

I hope this helps others out there going through this. I have almost been suicidle since my rhinoplasty because i look so much worse. I look about 20 years older and can't find any info about this because everyone thinks this is crazy. I started thinking I must be imagining this. I had rhinoplasty and had a procedure known as septum recession. Well, there ended up being a hole in my septum afterwards. When I told my doctor I looked so much older he said that was impossible and the septum would have nothing to do with looking older. I have been a mess ever since. Welll, the other day on a total whim, I put a small sponge in the hole of my septum. I freaked!!! It was the old me!! my cheekbones were fuller, my orbital holes no longer stood out, I looked like my old self and young again! I have a theory as to why this is working. My surgeon took too much from my nose and disrupted the sensitive organ that it is. The sponge seems to be warming it, also stimulating a part of the nose that should be permanantly a bit swollen. It is tha part of the nose that sneeezes when stimulated.I believe this part of the nose when disrutpted too much can die, thus leaving the sides of the nose wall dead and flat, whereas normally it is a bit swollen supporing the cheeks and eyes. We are not crazy!!!! Doctors are doing too much to the center of our noses and it is affecting all support in the middle of our faces, including the wrinkles in the uppper lip! I am going to continue using this sponge until I can get someone to take accoutability for this and am going to fight it tooth and nail for all of us who are claimed to be "crazy and stressed" Please, fight this too! You are not crazy, there is a huge support system in our noses that is disrupted with overly aggressive surgery! I look 20 years younger with this uncomfortable sponge up there, like my old self...I cried for like 5 hours from relief of seeing the old me!!! I will update you when I find someone to take this seriously and fix my nose so I can take out this ridiculous, uncomforable sponge! keep asking....you are not crazy...more research needs to be done about this horrible side effect and doctors who care should be doing it.

hmmm, i have never heard of such a thing. however, i always say anything is possible. clearly, it does not sound as if you are a surgical candidate at this point until both your emotions are better and you find what is the physical ailment that is causing your problem. i hope that you find resolution to your situation and can then lead a normal life again. perhaps if your truly believe your septal perforation is causing your problem then a septal repair sounds like something that may kill two birds with one stone.
best,
sml

Hello Sodepressed, I'm hoping you can help me. I had a Revision Rhinoplasty last July and ever since all the fat has gone from my cheeks and under my eyes. It seems the same thing has happened to you. I cannot see any hole in my septum but I'm wondering if you have somehow managed to fix yours I might be able to. I am considering having a fat transfer but if you have managed to fix yours without doing this I might have a chance. Any advice you can give me??

hi badrhino,
sorry but i do not allow public exchange of information on here. this forum is just intended for posters to ask me questions. you can PM him/her though.
best,
sml

Ok, I'm sorry.

I do have a question for you. My malar fat has died after my revision rhinoplasty making my cheeks etc look awful and hollow. Will a fat transfer fix this? And will it be perminant?

the answer is yes and yes. how old are you may i ask? that will help me decide on your candidacy. also, is your weight stable?
best,
sml

I am 31 years old and 8 1/2 stone. And yes my weight is stable. I am quite slim so will they still be able to get enough fat from me to put in my face??

31 is on the young side of age. are you a man or a woman? what is a stone in pounds? i am always cautious in younger people that the fat will age well. if you maintain your weight during your lifetime there really is not much risk. if you gain weight then the face can look fat, which is obviously something i want to avoid for you.
best,
sml

I am a woman. I think there is 14 lbs to 1 stone. I have always been quite slim and look after myself. I don't plan putting any weight on in the future if I can help it. I'm not sure what other choice I have to get rid of these awful hollow cheeks.