PLASTIC SURGERY:ASIAN RHINOPLASTY (NOSE JOB) TUTORIAL DALLAS

[ndkraut1]

Oh interesting..Is there a risk of extrusion/infection with the silicone injectables, the same with silicone implants? and is this done under local anesthesia? ALong with a columella strut too?

[samlammd]

@ndkraut1 silicone injectables really cannot extrude and is very very very unlikely to have any infection risk. yes, under local. no, the columellar strut is done as part of the surgery. i would not do silicone the same time as the surgery. that would be done preferably afterward or possibly before too.

[ndkraut1]

One last question regarding implant material, please. If I wanted to augment the tip, usually what material do you suggest?

[samlammd]

@ndkraut1 if i do that, i would use silicone injectable as a permanent solution and juvederm as a temporary solution.  i do not like solid implants because they do not feel or look natural in my opinion.

[ndkraut1]

Oh thanks for the reply. Since the columella strut is made out of cartilage, does it drop in time, making a more natural columella appearance? Or does it remain propped up?

[samlammd]

@ndkraut1 it can drop a little over time. that is why i tend to overcorrect the nose just slightly at the time of surgery.

[joeyt315]

Dr. Lam, I had a rhinoplasty about 2 years ago. It was mostly tip work, augmenting the tip using rib cartilage and also raising the nose out from the lip area with anohter graft . However, the surgeon upturned my nose too much, and I am now seeking revision rhinoplasty. I know its hard to give definitive answers, but would the revision rhino be complicated and the healing be severe if I would just like to turn the tip back down slightly? I'm pretty satisfied with the top 2/3 bridge of the nose

[samlammd]

@joeyt315 in general revision rhinoplasty is always harder due to the previous scar tissue and variable healing. turning down a nose is also not an easy thing to accomplish. a consultation with a physician in person will help you determine that more precisely.

[ndkraut1]

Just a clarification, I was referred to using your own septum to make the columella strut

[ndkraut1]

For asian rhinoplasties, do you frequently use collumela strut cartilage grafts? I heard they can inhibit the smile...Typcically how long after the surgery does the normal smile return?

[samlammd]

@ndkraut1 always. they are needed to reconstitute the strength to the nose. i don't make them so long as to interfere with the smile typically. smile should return immediately typically but always there is a risk that for a few weeks things could feel somewhat off but in my experience that is rare.

[LittleDirtyBlonde23]

Whats the difference between asian rinoplasty in america and asian rinoplasty in asia? Is one more extreme than the other?

[samlammd]

@LittleDirtyBlonde23 hard to say. i personally think it more depends on the provider than the location. however, there probably would be a tendency toward more extreme here in the West as people may be using Western standards of beauty, which can be too aggressive.

[bosgo0or]

dr, i have a question iv already did it 6 months ago it was perfect at the beginning and i really liked it but now i feel that it returned back same as before so shall i do it again and is it really the rhinoiplasty rebuilds bones of its just a filler ? how do i know that this liquid thing is gone i dont feel like its hard like before its soft

[samlammd]

@bosgo0or i do not understand your question. you had a surgical rhinoplasty or a filler?

[bosgo0or]

@samlammd it called radiesse i think its a filler its been 6 months now and i feel like its back as the old shape so my question is does this radiess thing builds bones on the bridge and the tip of the nose and any other non surgical cosmetic for the nose and thank u

[samlammd]

@bosgo0or even though some effect is there it still around. it really builds up scar tissue and makes surgical rhinoplasty unsafe the more you do it. just keep that in mind if you really want a surgical procedure done in the future.

[johnklien10]

If an implant material is added to the asian nose, will this addition distort the shape of the eyes, especially if material is needed higher up on the nose inbetween the eyes?

[samlammd]

@johnklien10 no, that is a misconception. it won't.

[joelkim888]

Thank you for the response, Dr.! Just a quick followup questionn, have you noticed any damaging of the underlying tissues when using irradiated rib cartilage as the implant?

[samlammd]

@joelkim888 i don't like using it. it is simply too big. i like something very thin, pliable, soft and that would be gore-tex. rib is simply too big and hard for the nose in my opinion except in very low saddle nose deformities. but the answer is i have not seen that.

[joelkim888]

after an asian rhinoplasty and implant placement, is the strength of the nose weakened, compared to pre-op? how much force must be used to dislodge the implant?

[samlammd]

@joelkim888 although some areas are weakened, the areas are compensated by sutures and by scar tissue. that is the truth for all rhinoplasties so in other words there is no general weakening of the nose. with asian noses, if you place a non-pressure implant like a thin gore-tex there should also be no problems but with a large silicone implant it can literally destroy the underlying tissues over time. the force to dislodge an implant typically must be very very high enough to damage the nose.

[MrGian098]

doc question, for us asian, i can see that when asian people gains weight their noses got bigger and wider. do asian noses gain weight? becuase when i was not fat my nose is really great and almost perfect (as people saying) but when i gain weight my nose got bigger even my friends are reacting about this, if i lose weight will my nose returns to its original size?

[samlammd]

@MrGian098 no, that is very very odd. never heard of such a thing. sorry.

[MrRhinosapien]

You speak so well Dr Lam. Are the majority of your asian rhino patients open rhino cases? I like this video. Its very informative.

[samlammd]

@MrRhinosapien thanks so much. yes, all open. it is much more precise to manage the tip and the bridge in this manner and the incision heals seamlessly.

[LilMissSunni]

I am Vietnamese and was considering surgery in Vietnam next summer after graduating college because I could not find an ethnic rhinoplasty specialist in my area. Luckily, I have family in Dallas. Could you message your price for consultation? I understand this may change by the time I finally schedule an appointment. Thank you.

[samlammd]

@LilMissSunni $100. make sure you book ahead. i am booked in advance. contact marcy at lamfacialplastics [dot com] to do that.

best,

sml

[samlammd]

@angelrawrz because prices can change and i do not want outdated prices on here.

[tong0322]

about how much does this procedure cost?

[samlammd]

@tong0322 i have been asked by my staff not to post prices on here.

[kaykentucky]

hey i wanna noe if after the surgery, my nose wil feel pain or get shifted if i fall or if i instinctively brush across it due to an itch.

[samlammd]

no, i don't believe so. you need a few weeks to months until the implant is set from moving. obviously, a car accident or major blow could injure things but that would happen even without an implant.

[NooneL15]

Thanks for the video doctor!

I have a question that maybe you can help me out with. I'm a 15 year old guy from Canada and I just recently switched from glasses to contacts. I've noticed my face looks much more irregular and unproportional without my glasses, mainly because there seems to be a huge space between my two eyes. Is there a way, through rhinoplasty, to raise the nose bridge (yet still have it look natural) to make my face more proportional, and appealing? Thanks for the help!

[samlammd]

yes, i use a gore-tex implant, as mentioned in the video. of course, you must ask your parents since you are under age regarding this option.

[zhnf0]

I am 18 years old and my nose is large because it is wide and also sticking out too much. My nose is kinda like Asian Singer Lee hom Wang's nose. I am more worried about the width then how much it is sticking out from the face. Is it possible to change it to a thinner and less bulbous nose? Is it also possible to change it to an aquiline nose so it might "look" smaller?

[samlammd]

noses can in general be refined. however, we are always limited by the skin thickness and weakness of the cartilages. i would have to see your case in person to make that decision of what i could or could not accomplish.

[zhnf0]

Well, I would like to see you in person but New York is pretty far away from Dallas and I don't have much time until college but if you would look at Singer Lee hom Wang's nose, which is quite similar to mine in shape and size, what would you do to make it look less prominent?

[zhnf0]

When I said to look at the singer's nose, I didn't mean for you to look at it in person, but you can make a google search and look at some of his photos.

[samlammd]

i probably won't be able to see you right now anyway since i am booked almost until november for consultations. if you are interested in the future, just give me a few months in advance for consultation. looking at a singer's nose that may or may not look like yours does not give a reliable answer but i will tell you what i would do based on reviewing just a few photos. i have to start another comment since there is a space limitation on this one.

[samlammd]

i would defat the skin tip to make the central tip look less like a ball. i would use a tip graft using septal cartilage to make the bottom part of the nose have more definition and reweight the tip to the bottom of the nose so that the upper part of the tip of the nose looks less like a ball. i would most likely not reduce the sides of the nose because it will make the tip look too round and bigger. if you don't believe me, try doing that on yourself. you will most likely see it protrude.

[samlammd]

his bridge looks pretty good in height. i would not touch it most likely. the small bump actually makes him look more masculine. would probably leave that too. the other important thing is to tape an Asian nose for at least a month to 2 to 3 months at night to push the refined skin down on the new framework. it will allow one to see the result more quickly. hope that helps.

best,

sml

[58rgiz]

Dear Dr. Lam,

Thanks for the very informative video. Are there any surgeons in the Boston area that you would recommend as being experienced in Asian rhinoplasty? I'd love to make it down to Dallas to see you, but unfortunately will be very difficult for me.

Thanks again!

[samlammd]

unfortunately, i don't answer that questions as i believe what i offer is truly unique. i wish you the best in finding the right surgeon for you.

[ohlinny006]

my nose is short and kind of wide. would rhinoplasty fix that? or perhaps elongate my nose and make it more prominent?

[samlammd]

yes, it can. always within the limitations of your own anatomy.

[ohlinny006]

how are you going to lengthen it? could you give me some more info?

[samlammd]

for asian noses using cartilage grafting is the technique to improve the situation. the grafts give better structure, definition, and length.

[TaintedSoul55]

Hi, i'm 21 years old, asian, I broke my nose during the early years in high school. I can feel that it's crooked. How do you fix it? Would I need surgery?

[samlammd]

in short, yes and no. if you can only feel it, then you are not a rhinoplasty candidate. if you can see it and/or there are breathing problems, then yes rhinoplasty is the answer.

[TaintedSoul55]

Thanks! Guess I won't get it!

[tezius]

Thank you Dr. I'll check out the website.

[iranlandforever]

thank you!

[iranlandforever]

I was hit i the nose when afterwars i noticed this dent but my ENT said it sue to my deviated septum and can be fixed if i get my septum straightened , do u think this is possible without a change tot he rest of my nose?? What are the side effects of the siicon droplets?if they have any?

[samlammd]

it sounds like you need your ENT to fix your functional problem before you consider any silicone. the real risk with silicone is that it is irreversible and makes future surgery of the nose very difficult so first get a handle on your problem. some surgeons have talked negatively about silicone. having been around for 40 plus years, i think in the right injectors hands, it can be very safe but that is something you need to discuss with your potential injector.

[iranlandforever]

there is a dent on the side of my noose where the cartilage and bone meets which is much lager than the other side this causes the bone on one side of my nose to stick out a bit. Is it posible to eliminate the dent without chanding the tip of my nose because i like the rest of my nose?

[samlammd]

if there is no chance that you would have a rhinoplasty, i can perform micro silicone droplets to correct the hole permanently or restylane as a temporary fix.

[tezius]

Very Good tutorial Dr.Lam.

Do you perform rhinoplasty surgery on what society would call a "black nose"?

If so, are the end results natural looking? I mean I think we all have the picture of Michael Jackson's nosein our minds which does NOT look natural..in fact it looks quite creepy. lol His nose was quite broad when he was younger.

Do you have before and after photos of black noses that you've worked on?

Thank You

[samlammd]

good question. the african nose is very similar to the asian nose. you can go to lamfacialplastics [dot com} to see my work.

[xcutie95]

Dr. Lam, does it matter what age a person is to get rhinoplasty if they have a broken nose or can't breathe well?

[samlammd]

generally, it is more ideal to have grow most of your way. i generally like to operate on people 17 years and older.

[riceonion]

And if we keep jumping hard, will our nose get bent or displaced? will the support of the nosejob becomes weaker and slowly it will not look good as before?

[samlammd]

no, this is not a breast. it is a nose.  you should be fine.

[riceonion]

Dear Dr. Lam, after we got a nose job. Is it possible to shower with hot water, sweat in a sauna, attend to hot springs, etc? Or after we got a nosejob, we must stay away from certain activites? And are we able to play sports? What if a basketball hits the nose? Will there be any problem? And if the sun is too hot, will your nose melt?Or after you have done a nosejob, everything will still be the same in our daily lives and we will still live normally in our lives with no harms just like before?

[samlammd]

yes, you should be fine with the first sentence. as far as sports, i would really wait at least 6 months. the sun will not melt your nose. you should live a normal life (if you are normal to begin with. lol.)

[riceonion]

Dr. Lam, I'd like to ask if someone gets a nosejob done.

In the future, will there be any problem like side effects and pain, and other kinds of feeling happening on the nose?

Or after the nosejob, it is guaranteed that the nose will have no problem for the rest of your life?

[samlammd]

there is never a guarantee on anything except the best work that i can do. nose jobs are safe if done right but obviously anything can happen. that is the nature of surgery.

[ninosimone]

i had surgery with a doctor in maryland and he raised my tip too high and the cartilage on my tip is a big lumpy ball that is not even with the other side of my nose i wish i had known about you a year ago

[samlammd]

sorry to hear of your situation.

[DrCherryPie]

for how long do you suggest that the patient avoid wearing glasses?

I ask this because, without glasses it would be difficult to do tasks like reading for school.

[samlammd]

in general, 1 month. you can tape the glasses to the forehead or wear very light glasses after several weeks so long as no dents are created in the skin.

[eucodrop]

At what age does your nose fully develop? is it wise to get rhinoplasty at about 20 yrs? thx

[samlammd]

generally 16 to 17 in women, and 17 to 18 in men. 20 should be pretty safe.

[azonglee]

I'm interested in rhinoplasty and i find the information provided by Dr. Lam here to be very useful! this is a very broad tutorial!

thanks for uploading!

[samlammd]

thanks for watching!

[coNsPirAcy083]

Dr I like to know if you use gortex implant to the bridge I heard it kind of feels unnatural after it heals like when you touch the nose it is not the same feeling as when you dont have a surgery is that true?

[samlammd]

i truly think gore-tex feels natural. remember there are two types of gore-tex: sheets and blocks. i think blocks can feel like silicone, which can feel thick and unnatural. the sheets contour to the bridge, are much lower profile, and much softer so i truly doubt they would feel unnatural.  i have not had anyone complain of this. make sure you are not talking about shaved blocks of gore-tex.

[SleepyKinoko]

Will a surgeon let me bring a picture of another person's nose and ask for it like that (if it's not completely ridiculously different of course)

Also, what is the minumum age a person can get rhinoplasty?

[samlammd]

1. yes to the photo but most often you are limited by your own nose shape and facial shape.

2. minimum age is difficult. depends on how complete your growth is since the septum inside your nose is a major growth center. i think most surgeons would say somewhere between 16 and 17 years of age in general. 16 is a bit young on the scale for my taste.

[coNsPirAcy083]

Hey Dr Sam if i look like Greg Oden ugly and have a nose lift will i look handsome after the surgery. I mean for people that have kind of flat nose after nose was reshape do they have a lot of improvement in looks.

[samlammd]

obviously, improvements are in a way in the eye of the beholder. also, not everyone can look like a model, but in many cases improvements can be made. sorry to be wishy washy with this answer but i would have to see you to determine. thanks for the post.

[Sky300]

omg..hes so smart...O.o

[samlammd]

thanks!

[nomisme]

I hope there will be also lecture videos on nose tip refining procedure and rosacea extra tissue removal! I have watched all the videos from Dr. Lam even the subjects that I am not interested in.

[ApasiaMiletus]

thanks for posting this video. very informative, great job!

[theonlyone36]

Dr. could you give me a nose job and use me as a model to cut out some of the cost? Rocky

[applepk12]

i want to do the nose job...i live in nyc i want to know where i can do it and how much it cost???

[DjGurl06]

it's cheaper in the mid-west...doctors are usually just as qualified...but the demand is more in the east and west coast

[xmignonmignon]

wow he rly knows his stuff =D

[kieferslover1949]

I like how the surgery has different techniques! pretty cool. You have to know what your doing!

[dgoodson]

wow this guy knows his sh*t!

[Khepri666]

This guy is a badass!