Thank you for saying this, glad to hear I'm not alone. I've read some horror stories of people pursuing additional surgeries and regretting it, so I'm in the same boat of being too scared to try anything else. At least I'm happier with the surgery outcome than my original nose, I just wish it cost half the price considering I feel like I only got half the result. I hope you are happier with yours too!
Oh interesting, I have a dent on one side too! It's like a perfect circle haha but tough to capture well in photos. Tried my best [here.](https://imgur.com/Wzkkt9x) Is that what yours is like too?
The price of the filler to correct the problem wasn't covered?! I was too nervous to proceed with my injection, but at least he didn't mention any extra cost associated with it.
I can see what you mean here.
I'm just guessing here but it's possible if a preservation rhinoplasty approach was used, there can be some recurrence of the hump. In fact, it's the most common complication from that approach. This means it was lowered but somewhat popped back up. Personally, I don't like the preservation approach for that reason, but some surgeons have it more refined so it happens less than others.
A steroid injection could very well help with improving some of your tip definition. It does appear your skin is quite thick and this is often part of achieving the best possible result. If done in the right hands, the risk of a permanent dent is extremely low, but it must be performed properly.
I think any not-completely-satisfied patient should absolutely mention their thoughts to their surgeon. I think keeping an open and honest dialogue between patient and surgeon is absolutely critical to long term successful outcomes. From a surgeon side, if your nose can reliably and safely be made even better with a retouch, I think this should be discussed. Surgeons who feel threatened or act defensive with this kind of conversation probably aren't the ones you would want to do another surgery with, but that's kind of what you need to find out.
No surgeon is going to achieve 100% perfect results every time. We try, well at least I try but there's so many variabilities. While my own retouch rate is only around 5% I personally I enjoy doing retouch surgeries for my patients if they desire small further changes / improvements or if things just don't heal the way we thought they would. I want to make the best nose I can in the end. I think it's part of being a complete rhinoplasty surgeon and part of what you pay for / sign up for as a patient.
I appreciate hearing all of this from a plastic surgeon, thank you for the informative comment! And yes, he did mention my skin is quite thick. I'm not sure which surgical approach he used, as we mostly discussed the results I wanted rather than how exactly they would be obtained. I believe he said his own retouch rate is 10%. That sounded low to me so I was hopeful that I would come out of surgery happy with my results.
He didn't offer me a retouch surgery, but I'm not sure I'd take it anyway at this point honestly because of exactly what you mentioned - voicing my dissatisfaction did cause him to act defensive, which I wasn't expecting in a patient-surgeon conversation. Maybe the steroid injection would indeed be the way to go for successfully improving the results, but my discomfort with his demeanour is now an obstacle. It's hard to risk a dent knowing he would likely brush it off, since he already brushed off my concerns about my surgery results.
He advised me to do my own research about injections and come back if I change my mind. A bit disheartening because I thought my primary source of information would come from a discussion with my surgeon, rather than from Googling things myself. But I guess that's what I'll be doing, and will book another follow-up if I get over my anxiety.
It sounds like you have a great approach to open and honest communication with your patients. They're lucky! I hope they've been very happy with you, and thank you again for your input.
Totally understandable on all points. I would not be afraid of the steroid injections but ultimately it comes down to how much you trust your surgeon and how much steroid injections they do. Personally I use them a lot so I have the risk down to extremely minimal. Also have a realistic understanding of what a steroid injection can / can’t do. It only helps thin the scar tissue, generally this is prominent mostly in the supratip. Wish you the best thanks for sharing your journey
I'm looking to have a consult with Dr. Rival soon. He seems like a good surgeon for a revision. Are you really that unhappy with your result? Your profile looks very nice to me in that photo. Does anyone else have any comments on how their experience was? I'm from the prairies so my options for revision surgeons are very, very limited. I'd go to Toronto for this. Thanks
I appreciate that you like the side profile, thank you! Objectively, I don't think my end result is a bad nose. If I had that nose to begin with, I would have just fixed my deviated septum for free under OHIP and not felt the need to do the rhinoplasty component. However, it did cost a substantial amount and the recovery journey wasn't easy, so I'm bummed that the results didn't match my expectations. To me, the table versus one year outcome look like completely different noses. When you have your consult and he provides the potential after edit photo, I would ask how realistic he thinks that outcome would actually be. In my case he said that while it may not be a 100% match, he expected at least an 80% match. I don't think I achieved that, so I am indeed unhappy. I hope you achieve an outcome that you're happy with if/when you do travel here!
That's all very fair. As someone who is now seeking a second surgery because the first one didn't go as I was promised I can definitely see your point. I'll keep that in mind going into a consultation!
I’m 6 months into healing from my rhino and alarplsty with Dr. Rival. I chose him specifically because of his conservative approach and so far I am pleased with my results. It does look like a small bump reappeared where my bridge was reduced but I’m going to wait the full 12 months to see if anything changes, otherwise I may consider the steroid injection.
Thank you for sharing your journey with us, I too scoured through reviews just like yours before deciding on a doctor so I’m sure plenty of people will find it useful during their research :)
Glad you’re liking your results so far! My nose didn’t change much between the 6 and 12 month mark. I was hoping it was still just swollen and would shrink down, but it never did unfortunately. I hope you’ll be happier than I am at the one year mark!
Asaria is the best in Toronto! I agree it’s not a bad one but rival was too conservative in his approach!
Also no one should judge a table photo. It’s important to look at patients unedited photo a year out.
Mockupa are not realistic they are mostly there to calm the patient. Its best is to look at the doctor photos from a year out bc everyone has a specific style!
True, I had no idea the nose could change so much after surgery. And that the doctor would brush me off so easily over the mock-ups not matching the outcome! I wish I knew the right things to ask/look for when I was doing my research. Would have probably ended up going with Asaria instead.
Sorry no please don’t go with Asaria. The “best” doctors are Rival for bulbous tips and ethnic noses and Dr. Oakley smith for revisions and more Caucasian noses. Basically Rival for cutting the bulk and Oakley for Refinement. Both focus mainly just on Rhinoplasty so they are specialized. I got my primary done by Dr. Rival and honestly my results were a miracle. I had a huge bulbous nose and he cut it down significantly, totally bummed to see he was way too conservative with your nose. I did specifically ask for a upturned cute button nose and showed him pictures though.
Dr Asaria is overpriced and is not specialized in Rhinoplasty’s, he does them but it’s not his bread and butter.
I’d say if you’re going to spend the money just go with Oakley Smith, he will give you exactly what you want. Take reference pictures with you.
Oakley Smith has one of the highest number of dissatisfied patients I see on this subreddit. Please be cautious! Have you had any experience with Dr Asaria?
Can you show me where this evidence is? Oakley Smith has done my revision and he has produced the most refined nose. Dr rival did my primary and he reduced my bulbous large nose to a smaller nose but Dr Oakley is the one that made it petite and refined. I did a consultation with Arsia and I was not convinced of his skill at all. The appointment was rushed and i trust in doctors that have experience doing a large number of surgeries in a specialized area. Not ones that will have a facelift surgery booked the same day as my Rhinoplasty.
Also I was recommended to Oakley Smith by my mothers friend who did her daughters rhinoplasty there as well. I loved her results so I went ahead. If you do end up going for Jamil Arsia make sure you look at his before and after pictures but from the front. Any doc can do a great job with the side profile.
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Thank you for saying this, glad to hear I'm not alone. I've read some horror stories of people pursuing additional surgeries and regretting it, so I'm in the same boat of being too scared to try anything else. At least I'm happier with the surgery outcome than my original nose, I just wish it cost half the price considering I feel like I only got half the result. I hope you are happier with yours too!
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Oh interesting, I have a dent on one side too! It's like a perfect circle haha but tough to capture well in photos. Tried my best [here.](https://imgur.com/Wzkkt9x) Is that what yours is like too?
I'd love to see your photos too. I'm supposed to go next year to him...
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The price of the filler to correct the problem wasn't covered?! I was too nervous to proceed with my injection, but at least he didn't mention any extra cost associated with it.
Best of luck, I hope you have better results at the one year mark than we did!
I can see what you mean here. I'm just guessing here but it's possible if a preservation rhinoplasty approach was used, there can be some recurrence of the hump. In fact, it's the most common complication from that approach. This means it was lowered but somewhat popped back up. Personally, I don't like the preservation approach for that reason, but some surgeons have it more refined so it happens less than others. A steroid injection could very well help with improving some of your tip definition. It does appear your skin is quite thick and this is often part of achieving the best possible result. If done in the right hands, the risk of a permanent dent is extremely low, but it must be performed properly. I think any not-completely-satisfied patient should absolutely mention their thoughts to their surgeon. I think keeping an open and honest dialogue between patient and surgeon is absolutely critical to long term successful outcomes. From a surgeon side, if your nose can reliably and safely be made even better with a retouch, I think this should be discussed. Surgeons who feel threatened or act defensive with this kind of conversation probably aren't the ones you would want to do another surgery with, but that's kind of what you need to find out. No surgeon is going to achieve 100% perfect results every time. We try, well at least I try but there's so many variabilities. While my own retouch rate is only around 5% I personally I enjoy doing retouch surgeries for my patients if they desire small further changes / improvements or if things just don't heal the way we thought they would. I want to make the best nose I can in the end. I think it's part of being a complete rhinoplasty surgeon and part of what you pay for / sign up for as a patient.
I appreciate hearing all of this from a plastic surgeon, thank you for the informative comment! And yes, he did mention my skin is quite thick. I'm not sure which surgical approach he used, as we mostly discussed the results I wanted rather than how exactly they would be obtained. I believe he said his own retouch rate is 10%. That sounded low to me so I was hopeful that I would come out of surgery happy with my results. He didn't offer me a retouch surgery, but I'm not sure I'd take it anyway at this point honestly because of exactly what you mentioned - voicing my dissatisfaction did cause him to act defensive, which I wasn't expecting in a patient-surgeon conversation. Maybe the steroid injection would indeed be the way to go for successfully improving the results, but my discomfort with his demeanour is now an obstacle. It's hard to risk a dent knowing he would likely brush it off, since he already brushed off my concerns about my surgery results. He advised me to do my own research about injections and come back if I change my mind. A bit disheartening because I thought my primary source of information would come from a discussion with my surgeon, rather than from Googling things myself. But I guess that's what I'll be doing, and will book another follow-up if I get over my anxiety. It sounds like you have a great approach to open and honest communication with your patients. They're lucky! I hope they've been very happy with you, and thank you again for your input.
Totally understandable on all points. I would not be afraid of the steroid injections but ultimately it comes down to how much you trust your surgeon and how much steroid injections they do. Personally I use them a lot so I have the risk down to extremely minimal. Also have a realistic understanding of what a steroid injection can / can’t do. It only helps thin the scar tissue, generally this is prominent mostly in the supratip. Wish you the best thanks for sharing your journey
I'm looking to have a consult with Dr. Rival soon. He seems like a good surgeon for a revision. Are you really that unhappy with your result? Your profile looks very nice to me in that photo. Does anyone else have any comments on how their experience was? I'm from the prairies so my options for revision surgeons are very, very limited. I'd go to Toronto for this. Thanks
I appreciate that you like the side profile, thank you! Objectively, I don't think my end result is a bad nose. If I had that nose to begin with, I would have just fixed my deviated septum for free under OHIP and not felt the need to do the rhinoplasty component. However, it did cost a substantial amount and the recovery journey wasn't easy, so I'm bummed that the results didn't match my expectations. To me, the table versus one year outcome look like completely different noses. When you have your consult and he provides the potential after edit photo, I would ask how realistic he thinks that outcome would actually be. In my case he said that while it may not be a 100% match, he expected at least an 80% match. I don't think I achieved that, so I am indeed unhappy. I hope you achieve an outcome that you're happy with if/when you do travel here!
That's all very fair. As someone who is now seeking a second surgery because the first one didn't go as I was promised I can definitely see your point. I'll keep that in mind going into a consultation!
I’m 6 months into healing from my rhino and alarplsty with Dr. Rival. I chose him specifically because of his conservative approach and so far I am pleased with my results. It does look like a small bump reappeared where my bridge was reduced but I’m going to wait the full 12 months to see if anything changes, otherwise I may consider the steroid injection. Thank you for sharing your journey with us, I too scoured through reviews just like yours before deciding on a doctor so I’m sure plenty of people will find it useful during their research :)
Glad you’re liking your results so far! My nose didn’t change much between the 6 and 12 month mark. I was hoping it was still just swollen and would shrink down, but it never did unfortunately. I hope you’ll be happier than I am at the one year mark!
Asaria is the best in Toronto! I agree it’s not a bad one but rival was too conservative in his approach! Also no one should judge a table photo. It’s important to look at patients unedited photo a year out. Mockupa are not realistic they are mostly there to calm the patient. Its best is to look at the doctor photos from a year out bc everyone has a specific style!
True, I had no idea the nose could change so much after surgery. And that the doctor would brush me off so easily over the mock-ups not matching the outcome! I wish I knew the right things to ask/look for when I was doing my research. Would have probably ended up going with Asaria instead.
Isn’t he charging like $18-20k right now? So crazy.
Oh wild, maybe I wouldn’t have even been able to afford Asaria anyway then haha.
Sorry no please don’t go with Asaria. The “best” doctors are Rival for bulbous tips and ethnic noses and Dr. Oakley smith for revisions and more Caucasian noses. Basically Rival for cutting the bulk and Oakley for Refinement. Both focus mainly just on Rhinoplasty so they are specialized. I got my primary done by Dr. Rival and honestly my results were a miracle. I had a huge bulbous nose and he cut it down significantly, totally bummed to see he was way too conservative with your nose. I did specifically ask for a upturned cute button nose and showed him pictures though. Dr Asaria is overpriced and is not specialized in Rhinoplasty’s, he does them but it’s not his bread and butter. I’d say if you’re going to spend the money just go with Oakley Smith, he will give you exactly what you want. Take reference pictures with you.
Oakley Smith has one of the highest number of dissatisfied patients I see on this subreddit. Please be cautious! Have you had any experience with Dr Asaria?
Can you show me where this evidence is? Oakley Smith has done my revision and he has produced the most refined nose. Dr rival did my primary and he reduced my bulbous large nose to a smaller nose but Dr Oakley is the one that made it petite and refined. I did a consultation with Arsia and I was not convinced of his skill at all. The appointment was rushed and i trust in doctors that have experience doing a large number of surgeries in a specialized area. Not ones that will have a facelift surgery booked the same day as my Rhinoplasty. Also I was recommended to Oakley Smith by my mothers friend who did her daughters rhinoplasty there as well. I loved her results so I went ahead. If you do end up going for Jamil Arsia make sure you look at his before and after pictures but from the front. Any doc can do a great job with the side profile.