Gift autologous rib no-implant rhinoplasty (first surgery), 1-month review

I had first-time tip rhinoplasty with autologous rib cartilage at Gift. Before surgery I got a lot of help from this community, and after a successful operation I wanted to leave information here too, so I’m writing this. I hated the bony hump and blunt shape of my nose, so in my late 20s, 15 years ago, I had fat grafting above and below the hump (between the eyebrows and the nasal tip). At the time I was satisfied just because the hump was gone, but while this fat grafting has the advantage of not migrating like filler and lasting for life, it also felt a bit blunt compared with filler, so I wanted to improve that part. Have you ever seen a lead actor with an ugly nose? For a man, the nose matters most. It took me far too long to realize that. Once you decide on surgery, you have to decide on the hospital, right? Like everyone else, I consulted at several places. Some hospitals said nothing at all about nose design and only showed surgery videos while bragging about technique, and some places were so famous that their prices were absurdly high. There were also places that just proposed standardized designs without much soul. (Actually, that might be better for some people. A nose that suits anyone and offends no one. But I had a specific design in mind, not just a simple high nose.) When buying even one item, you compare and consider many factors before purchasing. This is your face for life, and among that, the nose is the center of the face, so comparing different places is only natural. The reason I chose Gift was that I felt the consulting director’s skillful consultation, coming from years of experience, and the lead surgeon’s seriousness. From the entrance onward it did not feel like a marketplace; it felt like entering a luxury hotel, and I liked that too. I understand that nose surgery usually takes longer to consult than other cosmetic procedures. Depending on the material used for the bridge, the tip, and the central support, the design outcome changes, but the durability, longevity, and the discomfort and risks you have to endure because of that are all different, so that must be why. I also liked that it was a one-surgeon hospital with no visiting doctor. And for someone like me who hates a long midface and looking older, I liked that the surgeon diagnosed a pencil-thin nose descending too far from the T-zone as something that could make the face look longer and older too, or, put positively, more mature. After the first consultation at Gift, I visited several other hospitals and gathered information from them. Then I visited Gift one last time and had a second round of consultations in the order of consulting director - lead surgeon - consulting director. During the first consultation, the consulting director immediately realized within 1 second, as soon as they touched my glabella, that I had filler or fat in that area. The surgeon said that because of the fat grafting in my glabella from 15 years ago, if silicone were inserted into the bridge it could become bumpy, and cosmetically it could also make the face look longer or more mature. So they recommended cartilage grafting or dermal grafting for the dead zone just below the hump created by raising the tip and the tip itself, plus correction of the nasolabial angle. For both the first and second consultations, I brought a Photoshop mockup of the design I wanted, and also a few photos of celebrities whose look I liked. Some hospitals first asked whether I preferred any material, while others recommended materials first. In my case, at most hospitals they said my septal cartilage was about 1.5 times more abundant than average, so surgery could be done with septal cartilage alone, and many recommended septal cartilage as the material for raising the tip. Gift was the same. Even though, like any hospital, they could have charged extra if they used autologous rib or donated rib, the fact that they kept recommending septal cartilage actually made me trust them more. The design I wanted was not a blunt look from the side, but a shape that kept the tip looking defined while still feeling youthful and lively. At the same time, I did not want it to look obviously operated on, so I wanted the columella as rounded as possible, and I also wanted to lift the philtrum slightly just below the nasal support so the protruding mouth would not look old-fashioned, and to create a pretty Ricketts line. From the front, I wanted clear three-dimensional presence starting from the nasal tip. Once the design was decided, I had to choose the materials. After 4 consultations with the consulting director and 3 with the lead surgeon before entering the operating room, the materials I chose were: nasal support - autologous costal cartilage / nasal tip - ear cartilage / dead zone - autologous rib / nasolabial angle correction - autologous rib. Of course it depends on the situation, but some surgeons also use autologous rib for the tip, and some prefer dermis for the dead zone, so consultations at several places are essential. A surgeon’s clear preference for a material means they use it a lot, which also means they know how to handle it well. Honestly, I agree that using thin silicone would look prettier from both the front and the side. But while not everyone who uses silicone gets a contracture, every contracture nose is caused by a foreign material. So for this surgery I set the goal of creating the design I wanted as much as possible without silicone, and I told the hospital that too. Since the rise of L-shaped silicone, people say that cartilage-based rhinoplasty eventually makes the tip drop. That is because skin keeps wanting to descend. That is the reason I used the most stable and least complication-prone autologous rib from the first surgery. In my view, the lead surgeon’s philosophy at Gift also seemed to be that a little lacking is better than overdoing it, and I liked that too. Now I’m writing this a little over a month after surgery. If I could go back in time and return to one month ago, and ask whether I’d do the surgery again, I would answer yes without hesitation. Actually, the more accurate answer would be that I wish I had tried nose surgery even earlier, when I was a little younger. There is no such thing as 100% satisfaction with surgery, and my skin is not thin either. Also, since no implant was used this time, the before/after difference may feel a little less dramatic. Even so, it is much better than before surgery, so I think I made the right choice. Actually, because of the height near the glabella from the side and the three-dimensional effect from the front, I’m even considering a second surgery with thin silicone, but as a heavy smoker I’m not confident I can go without smoking for another month, so I’m not sure whether I’ll really go through with a second surgery. Right now the sensation in my nasal tip is gradually returning, and I’m applying scar ointment and waiting out the 6-month stabilization period. As time passes, the hospital says the contour of the nose will become more defined and look better, and I’m a little excited about that too. This post is not an advertisement. I wrote every single character myself, and I hope everyone finds a good surgeon and has a healthy, satisfying surgery. If you’re just before surgery, you really need a lot of sterile gauze and sterile cotton swabs, so please have them ready, and please don’t send private messages. Thanks for reading my post.