Today marks 6 weeks since the surgery. The swelling is still very much there. There’s no stinging sensation, and I can sleep comfortably too.. The ear pain has also improved a lot. I went in for a checkup recently to see whether there were any stitches left, and got an explanation of the precautions going forward. They said to come back around next summer.
There were a lot of people sending me DMs asking about the removal of donated rib cartilage, so I wanted to leave a brief consultation review. I remember feeling frustrated before my own surgery too, because I couldn’t find many people who had the donated rib cartilage removed..
------ Before removal: nose ----- I’m not sure how well it’ll show in the pre-removal photos.. From the forehead to the nasal tip and ear cartilage, it was a nose that dropped in a straight line rather than a curve. (The photo wasn’t stretched... the nose had been riding up as far as the forehead.) Looking at the post-op result, a natural curve formed around the glabella, but before removal it was a completely Avatar-like straight nose. The nasal tip felt like it just had ear cartilage sitting on top by itself, and from the front the cartilage was so obvious it stuck out like a round dumpling. I was so insensitive that I didn’t even realize my nose had become lifted, but when I compared photos from 5 years ago, 3 years ago, and 1 year ago, the side profile was clearly different and the nose had been getting more and more lifted. Goodness.. the pinching was severe too. From the side or the front, there was no line at all... Anyone could tell it was a botched plastic surgery nose.
When I was tired I would sometimes get headaches, toothaches, and I even had a lump form inside my nose, so I had a removal surgery for that too... Compared with how it is now, functionally it was definitely inconvenient, but I wasn’t especially sensitive about that sort of thing, so whenever it hurt I’d take medicine and, being busy, just lived on thinking it couldn’t be helped. Then I finally made up my mind and decided on surgery. I lived without even knowing exactly what surgery I had had, and I didn’t know what an extension was or what the columella was, so I started consultations blindly.
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1. Revision surgery with rib cartilage First, at about four places, they recommended revision surgery to me. They spoke as if revision surgery was the only answer, as if it would be a disaster to remove it. One of them was even a place that had once become famous for removals. From the director’s blog, it looked like they had done many difficult removals too, but I remember being really taken aback when they told me I should have revision surgery with rib cartilage...
2. A well-known hospital here a. They said removal wasn’t possible.. Since the ear cartilage at the nasal tip was very visible, they said to leave that out and replace the silicone with MegaDerm; The consultation took about 5 minutes... Looking back, I don’t think there was much willingness to actually operate on me. Haha. People still get surgery there to this day, and there are people who did well as well as people who developed side effects.. Personally, the impression I got wasn’t a good one.
b. At the first consultation, they looked inside my nose and said the septum was still well preserved, so I shouldn’t worry about saddle nose, and that full removal was possible. At the second consultation, I was so anxious that it might collapse that they said they would keep it from sinking even if they had to put in a dissolvable plate. Then I did some frantic Googling... looked up what a dissolvable plate was... and decided it was a bit off, so I passed. I was taking time off work then, so I spent my days going from place to place and my nights searching online until dawn.. The more I looked into this place, the more uneasy I felt. That’s just my very personal opinion.
c. I went there for two consultations too, and they said to reuse the autologous cartilage (septal cartilage, ear cartilage). In the end, when I called to try to book surgery at the end, the coordinator told me, “There’s nothing we can help you with surgically.” After the second consultation, I had already discussed the price and everything with the coordinator... After that, I also communicated with the director a few times via online consultation. By the time I called and was about to say, “I’d like to make a reservation,” I was in a really hard state, couldn’t even eat properly, and this was a decision I made with great courage. It was the moment during surgery prep when I felt the most down. I still wonder why they refused to operate on me..
3. Other negative experiences (sharing this so you won’t get too discouraged if you hear bad things while going around for consultations..) d. This was probably the most negative hospital of all. I didn’t have high expectations, and I went there specifically to get a 3D CT scan.. They said the donated rib cartilage was so old that if I tried to remove it, the remaining septum could also come off for nothing... Don’t make a sore spot worse; just remove only the ear cartilage at the nasal tip... But after removing the ear cartilage, they couldn’t take responsibility for the nasal tip shape either. Looking at the CT, they said they couldn’t see the septum and that once the silicone and donated rib cartilage were out, I’d have literally no nose at all... <- But this hospital has been mentioned here a few times lately, right? Haha. And I heard that on CT, septal cartilage isn’t usually visible anyway. When I read forum posts sometimes, I see people asking whether a hospital that doesn’t even let you get a CT scan can be trusted, but there are more doctors saying that even if you do scan it, it doesn’t have much meaning. If you really want to get something, I heard that a lateral X-ray is actually a little more helpful. In my case, I once went to an ENT/plastic surgery hospital that had been famous for removals and got an X-ray, and I always carried it with me during consultations. When I was worried about the bridge splitting, the director who had operated on me looked at this X-ray and said decisively that I probably didn’t need to worry, and I remember finding a little peace after that.
e. Full removal was possible, but only if I truly had no desire at all for the shape and didn’t need to live a social life. (It was also the most expensive.) They said the shape would be an issue, it would 100% become lifted, and function would also get harder, and they couldn’t take responsibility for that either. They said the donated rib cartilage was so old they couldn’t guarantee it could be taken out properly, and it might already have melted away. They said they’d do it if I signed an affidavit saying I wouldn’t disclose the hospital information.
4. The rest, from memory.. f. Autologous dermis, ear cartilage reuse, donated rib cartilage reuse if needed g. Autologous dermis, ear cartilage reuse and additional harvest h. Scalp fascia, ear cartilage reuse and additional harvest, general anesthesia i. Donated rib cartilage removal, silicone replacement with a lower one, ear cartilage reuse and additional harvest j. Full removal, ear cartilage reuse and additional harvest + AlloDerm. However, they couldn’t guarantee it wouldn’t lift. If it did lift, revision surgery with rib cartilage after one year k. Full removal, ear cartilage reuse, additional harvest if needed. Later, shape refinement with autologous dermis. <- This place said they’d provide lifetime aftercare, and I remember the director leaving a good impression on me, and I went because I’d heard they were good at nasal tip work, but during the consultation something just didn’t quite click. l. Full removal, return to the original nose 100% <- They were so confident that, honestly, I was really tempted. I even had two consultations there. When I asked the coordinator what they would do if they found during surgery that the nose was lifted or saddle-shaped, they said that since this was a removal surgery, they would just remove it and close. If it was lifted, I’d have to get revision surgery 6 months later.. It felt a bit like wordplay, so I passed. m. First consultation: reuse autologous cartilage, remove non-autologous cartilage Second consultation: bridge seems to be completely worn down, the bridge is too low so I’ll probably need revision surgery anyway. Just use silicone for the revision. Ear cartilage reuse and additional harvest. <- I said I thought there was inflammation near the glabella, but they kept insisting it wasn’t inflammation.. I also said I was really worried it might become lifted, but they said if the nostrils don’t lift enough it can look stuffy, and the shape just didn’t fit what I wanted, so I passed. It was a hospital I had expected a lot from because they said they were good at shaping the nasal tip with ear cartilage, but when the shape didn’t match, I felt so disappointed. At that point I felt like there were no more hospitals left to visit, so I was even more desperate..
--------- Surgery details -------- By the time I was near the end of the consultations, I found this hospital. I didn’t have high expectations; I just went with the thought of, let’s go once and hear them out. I had two consultations, listened to detailed explanations for an hour each, and then decided to have surgery.
They removed the donated rib cartilage, silicone, and the columellar support strut (septum), and it turned out the glabella area really was inflamed. So they removed the inflammation and the capsule.
They reused the ear cartilage that had been in the nasal tip, and added more ear cartilage that they harvested, placing it in between the alar cartilages (?) and on the columellar side, they said.
In my previous surgery, they had used the right ear cartilage, and this time they said they would use the left ear cartilage, but when I looked during surgery, they were opening the right ear. I was a little sad that both ears would end up being used.. But I felt that this was care for the patient, and I was so grateful. After the surgery I asked about it, and they said they only needed a little. They told me you can’t just use someone else’s cartilage carelessly, haha.
---------- Current ---------- My post-op nose isn’t a pretty nose, but since I had imagined the worst possible outcome, I’m grateful... Well, this is the nose I was born with anyway.. I think of it as gradually returning to that old look. As my nose lowered, my forehead looks more prominent too, and especially my mom is so happy, saying I’ve returned to my old appearance haha.
As you can see from the hospital reviews, there really weren’t many positive consultations.. only a handful at most.. It wasn’t great for me, but there are definitely many people who did well at those hospitals.. That’s why I think finding the hospital that suits you is what matters.
I left out a few hospitals where the consultation reviews would be meaningless, and some places I didn’t take proper notes on.. I hope this helps even a little for people who are in the middle of preparing for surgery. There’s good information here, but if you see overly worrying posts, it’s better not to read them too closely before surgery if you can help it... When I asked the hospital where I had surgery, they said that even if it’s saddle nose, there are ways to handle it, and if the nose is well done so it doesn’t get lifted, that’s fine, and even if it does get lifted, there are still ways... They said it’s not something that happens often.. I hope you can keep your mind at ease and have a successful surgery. Sorry that I can’t reply to DMs or comments. If you’re curious about the hospitals I consulted with, please leave a comment. I’ll send the hospital information for the surgery I had by DM to each person after the swelling has completely gone down, without leaving anyone out.
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