LAM FACIAL PLASTICS

Hello Dr. Lam,

I am in the process of identifying a surgeon for a revision rhinoplasty. I believe my original surgery was an improvement but that there is still room for significant improvement with some adjustments.

I've been doing research on possibly having my surgery abroad as I used to have typical AA/ Southeast Asian nose. I could not find American based surgeons that had great pictures of successful AA rhinoplasty, in fact some of what is posted on the internet scared me. The pictures I found on your website were successful but seemed to be very subtle. I found several surgeons in southeast asia that had performed beautifully sculpted noses on women that had noses like my own. Many of them suggest an alar trim of the nostril, (along with Gortex implant and tip refinement) which is what made a significant difference in the rhinoplasty. It seems as though alar trim is not typically practiced in the US, but I hoping to find a American based surgeon that has experience with this procedure. Please let m eknow if you have experience with this procedure.

Thank you

MsDalila

what i have found is that the subtlety of the results in photographs translates into a beautiful view when i see the patient. the trick is to go less with the total degree of augmentation. i have found that when i used to augment the noses where the profile looked good on a photo in a more substantial way the person looked too augmented, overly defined in person. therefore, i truly believe less is more.

when it comes to alar base reductions, i truly believe they are way over done for many reasons. here they are:
1. first most Asians do not need them. when the nasal tip is bulbous and the sides are reduced the tip can look even rounder. try that by squeezing the sides of your nose in halfway, if the tip looks better, then you could be a candidate. if it looks rounder and fuller, then you are not. that is my basic technique to show patients who is and who is not a potential candidate.
2. no matter how good an alar base is reduced it can still have visible scarring on the sides of the nose. there is simply no way around not having scars on the sides of the nose. typically, some makeup covers about 85% of the scarring but if someone is looking very carefully they will see it.

the technique that i use is known as a Sheen flap, which allows me to reduce the sides of the nostrils without the risk of the nostrils looking slit like with the sides being amputated looking and losing the natural sill (or wall that follows the curve of the nose onto the face). this unnatural look is what you see unfortunately in most doctors' results because they do not respect the continuity of the sill. think janet jackson's nose. the sill is gone. hope that helps as a start.
best,
sml