[MERGED] Rhinoplasty ( Nose Lift )

[Doctor J]

ang alam ko after 5 days tatanggalin na yung stiches...
after 3-4 weeks medyo acceptable na pero medyo paga pa yung face.

Stitches are supposed to be removed after 4-5 days for the scar to be less noticeable. Depending on the surgeon, there is usually medical tape and or plaster cast over your nose to keep the implant in place. It is also removed along with the stitches in 4-5 days. Swelling will be considerably lessened in a week and you may go back to work. But the final result of the surgery will be fully appreciated in at least 2 months up to 6 months.

[Doctor J]

anyone here done this procedure?especially in rhinoplasty. i heard na maganda ang goretext kesa sa silicone implant,kasi i read na ginagamet din ito sa heart surgey etc... so this must be safe and best. may kamahalan lang ang price nya pero mas maganda at di ganun kadelikado. 2 doctors na ang nahihingan ko ng opinion about sa goretex.
please share your opinions here....
thanks

Goretext was originally used as artificial blood vessels in replacement or to connect other blood vessels when and where needed. It has just started recently and gaining attention for augmentation rhinoplasty. However, the cost is at least almost double compared to the silicone implant. I think however that its more of a preference. Silicone implants have been tested by time and is the standard in augmentation rhinoplasty. I think the chances of getting a reaction from silicone and goretext is the same because they are both considered as foreign body. They are both however inert, meaning non reactive to tissues. Any choice you make between the two is fine. Just do not have a "collagen injection" done. Its not really collagen but silicone admixed in OIL.

Final word: use implants, not injection.

p.s.
there is a type of injection though that is safe - dermal fillers.

[flower02]

bakit sa kakilala ko 2weeks na paga ang ilong nya tsaka malapad pa din ang ilong para lang nilagyan sa gitna ng bridge pero lapad pa din,tsaka ang kay kris bakit tabinge ang ilong nya?

[Doctor J]

First of all, let me correct myself. It should be "goretex" and not "goretext". I was trying not to do text speak, instead i wrote a different "text". Hehe. My apologies.

Anyway, ang pamamaga ay depende sa ilang mga factors and it depends on each patient. May di gaanong namamaga, meron namang matagal mamaga. 2 weeks is still possible although that is not the common occurrence. Rhinoplasty really depends on the surgeon doing the procedure. Kung ano ang perception niya ng beauty, yun ang kakalabasan ng procedure niya. Besides, rhinoplasty also involves not only one procedure, but a combination. In Filipino (or Malay, not Oriental) nose, a combination of procedures are involved.

And as they say in cosmetic surgery regarding rhinoplasty, "He who masters the tip, is the master of rhinoplasty". I cant recall who exactly said that pero ang ibig lang sabihin, pag maganda gawa ng tip ng ilong, magaling ang gumawa.

[joeller_33]

First of all, let me correct myself. It should be "goretex" and not "goretext". I was trying not to do text speak, instead i wrote a different "text". Hehe. My apologies.

Anyway, ang pamamaga ay depende sa ilang mga factors and it depends on each patient. May di gaanong namamaga, meron namang matagal mamaga. 2 weeks is still possible although that is not the common occurrence. Rhinoplasty really depends on the surgeon doing the procedure. Kung ano ang perception niya ng beauty, yun ang kakalabasan ng procedure niya. Besides, rhinoplasty also involves not only one procedure, but a combination. In Filipino (or Malay, not Oriental) nose, a combination of procedures are involved.

And as they say in cosmetic surgery regarding rhinoplasty, "He who masters the tip, is the master of rhinoplasty". I cant recall who exactly said that pero ang ibig lang sabihin, pag maganda gawa ng tip ng ilong, magaling ang gumawa.

HI Doctor J...i agree with your saying about the perfection of the tip...I'm planning to have my nose done next month (combination alar trimming, bridge augmentation, and tip plasty). I looked online and found dr. lorenzo peregrino vi...has anyone heard of him? magaling ba sya? nakita ko lang sya online and he's charging 40,000 for all three procedures. does anyone know someone better or has really mastered yung "tip" nga?

[smilewarrior]

^Good morning. Please click this: TextSpeak is NOT allowed in this forum

[joy_conanan]

Silicone implant for nasal augmentation leads to a lot of complications such as material rejection, implant deviation, contracture formation and infection to name a few. That is based on the British Journal of Plastic Surgery 24:405-411, 1971. Due to these many complications, First World countries ban the use of silicone implant in surgical procedures.

GORE-TEX was discovered in 1958 and approved by FDA in 1975 for expanded medical use. True that it was originally and effectively use for pulmonary and heart valve operations because of its strength and biocompatibility. It is a good implant material for nasal augmentation because its soft and porous - properties which allow the growth of human tissue within and through the implant - something that a hard silicone implant is not capable of.

Because silicone is made of hard plastic, the nose suffers from daily trauma. It's actually like placing a nail on our nose. Imagine putting a hard object on our nose which has varied articulations? Then walk, jump, run, kick, dive everyday. What do you think will happen? That hard object puts pressure to the normal movement of our nose. Too much of that eventually lead to the complications earlier said. None of these happens with goretex. In fact, goretex is judged to be the best implant by nasal surgery masters.

Based on studies, there's a very nil case of rejection with goretex. Please note that these isolated cases only happen to immuno-compromised patients (those with diabetes, HIV, etc.).

Further, unlike silicone, with goretex the patient can still engage to active sports like volleyball, badminton, scuba diving and the likes - withOUT the worry. They don't have to alter their lifestyles simply because they have to take care of their silicone noses. That's why I chose gore-tex when I had my noselift.

Yes, it's almost double the price of silicone but it's worth it. It's safe, worry-free and rejection-free. I don't have to worry about replacing it and undergoing another surgery after a couple of years because I'm sure that what's inside my nose can last a lifetime. And what I love the most about my nose is how it looks. My nose is so beautiful! SO natural that even my parents didn't recognize I had it done. It has a bit of a curve and bears a very soft and natural appearance as if I'm born with it. No one believes me when I tell them I had a noselift. You don't have to believe me - just see me in person to find out how beautiful and natural-looking my new nose is.

My cousin will actually have her silicone nose replaced with gore-tex implant. Coz her nose looks so stiff and too artificial - not to mention that it's a bit like a parrot's nose. The problem with silicone is no matter how nice it looks at the start, eventually it changes its appearance as contraction or deviation gradually develops through time. It is simply not capable of providing permanent aesthetic result unlike goretex.

There are other implant alternatives like autologous rib cartilage harvest or irradiated donor cartilage. But WOW! The price for implant alone is too expensive - too expensive that it could already afford me to pay in full a slightly used second hand car. So I settled with goretex implant which is as safe as cartilage implants despite beign a foreign body. Truth is, as our tissues grow within and through goretex implant, our body no longer treats it as foreign - eventually it really becomes a part of us.

[joy_conanan]

This is for lulugirl. If you're seriously considering to have a noselift, I can refer you to the doctor who did me. He was trained in Korea, a place known for its advanced technology in the fields of rhinoplasty and facial plastic surgery. Siya and nag-introduce dito ng gore-tex noselift sa Pilipinas. He trains a lot of surgeons here in the country para gumawa ng gore-tex. Pati surgeons sa mga sikat na clinics siya rin ang nagtitrain dito. I was surprised to see nga in his clinic the surgeon who did me other procedure two years ago. Kasi that surgeon came from the most popular cosmetic center here tapos nakita ko siya dun for his hands-on training.

[eegelsI]

I'm considering rhinoplasty... hindi naman ako pango... but just like the others, kailangan ng hindi masyadong matangos and malapad. But i'm concerned about the procedure because i'm a keloid former. Baka matangos nga ang ilong ko... puro naman keloid. That would be frustrating!

[Doctor J]

Silicone implant for nasal augmentation leads to a lot of complications such as material rejection, implant deviation, contracture formation and infection to name a few. That is based on the British Journal of Plastic Surgery 24:405-411, 1971. Due to these many complications, First World countries ban the use of silicone implant in surgical procedures.

GORE-TEX was discovered in 1958 and approved by FDA in 1975 for expanded medical use. True that it was originally and effectively use for pulmonary and heart valve operations because of its strength and biocompatibility. It is a good implant material for nasal augmentation because its soft and porous - properties which allow the growth of human tissue within and through the implant - something that a hard silicone implant is not capable of.

Because silicone is made of hard plastic, the nose suffers from daily trauma. It's actually like placing a nail on our nose. Imagine putting a hard object on our nose which has varied articulations? Then walk, jump, run, kick, dive everyday. What do you think will happen? That hard object puts pressure to the normal movement of our nose. Too much of that eventually lead to the complications earlier said. None of these happens with goretex. In fact, goretex is judged to be the best implant by nasal surgery masters.

Based on studies, there's a very nil case of rejection with goretex. Please note that these isolated cases only happen to immuno-compromised patients (those with diabetes, HIV, etc.).

Further, unlike silicone, with goretex the patient can still engage to active sports like volleyball, badminton, scuba diving and the likes - withOUT the worry. They don't have to alter their lifestyles simply because they have to take care of their silicone noses. That's why I chose gore-tex when I had my noselift.

Yes, it's almost double the price of silicone but it's worth it. It's safe, worry-free and rejection-free. I don't have to worry about replacing it and undergoing another surgery after a couple of years because I'm sure that what's inside my nose can last a lifetime. And what I love the most about my nose is how it looks. My nose is so beautiful! SO natural that even my parents didn't recognize I had it done. It has a bit of a curve and bears a very soft and natural appearance as if I'm born with it. No one believes me when I tell them I had a noselift. You don't have to believe me - just see me in person to find out how beautiful and natural-looking my new nose is.

My cousin will actually have her silicone nose replaced with gore-tex implant. Coz her nose looks so stiff and too artificial - not to mention that it's a bit like a parrot's nose. The problem with silicone is no matter how nice it looks at the start, eventually it changes its appearance as contraction or deviation gradually develops through time. It is simply not capable of providing permanent aesthetic result unlike goretex.

There are other implant alternatives like autologous rib cartilage harvest or irradiated donor cartilage. But WOW! The price for implant alone is too expensive - too expensive that it could already afford me to pay in full a slightly used second hand car. So I settled with goretex implant which is as safe as cartilage implants despite beign a foreign body. Truth is, as our tissues grow within and through goretex implant, our body no longer treats it as foreign - eventually it really becomes a part of us.

Hello Joy,

Congratulations to you on your new nose! I am sure that with a goretex implant chances of complications will also be low. With your knowledge, it seems that you have researched a lot, although a little bit on the one side I should say. Your surgeon should be happy to have a patient endorser such as you. You should get paid for that (hehehe - joke only).

Anyway, it seems unfair for you to judge the silicone implant as such. We also do goretex graft in our center but silicone implants as well. Also, the reference you gave was made in 1971. Silicone implants were a lot different 36 years ago. Besides, the British would not need goretex nor silicone implants in most of their rhinoplasties. Most of their rhinoplasties are of reduction rather than augmentation. I should say that the Asian surgeons, Koreans as well as Filipino surgeons, would be in a better position to say so because we would definitely have more experience on that. Just google on the safety of silicone implants and you will see that it is safe to use. Silicone is an inert material meaning it does not cause raction to tissues. Rejection also is almost nil.

Also, no surgery is totally worry-free and goretex is not totally rejection-free. I am glad that your cousin is having her nose redone. The reason probably why her nose looks stiff is because the silicone implant used was a regular type. Silicone implants also come with the soft type that I also use. it may look artificial because of the trimming that was done on the silicone implant. Silicone implants can actually be trimmed and shaped according to the nose of the patient and its desired shape. Moreover, even with silicone implants, you can engage in sports with regular care as you would do without an implant. Silicone implants are flexible. One thing more, if there will be a problem with the silicone implant, it can be easily be removed. Have you asked your doctor how he can take out the goretex if there comes a problem? Tissues do grow within the goretex and with that may be difficult to remove once ther comes a problem. The chances of rejection or infection may be lower but as I've said, it is not totally worry-free nor rejection-free.

I don't have anything against goretex implants, in fact I think it is a good material. It's just that I would not want to take away the option of other patients who would want a more affordable procedure/implant that is just as safe to do as well.

Just my two cents worth on this.

[Doctor J]

I'm considering rhinoplasty... hindi naman ako pango... but just like the others, kailangan ng hindi masyadong matangos and malapad. But i'm concerned about the procedure because i'm a keloid former. Baka matangos nga ang ilong ko... puro naman keloid. That would be frustrating!

Hello Eegels,

Healing on the face is usually very good, even in keloid formers. In your case, a rhinoplasty with incisions that are done inside the nostril would be best. However, the type of procedure you will need would depend upon the anatomy of your nose. It would be best to consult first, express what you want as well as your concerns, have the doctor look at you afterwhich he/she will give an opinion on what you will need.

Bottomline, consult first. It doesnt hurt to ask right?

Good luck!

[yssamer_lyn]

Silicon!silicon!silicon!!!!!!!!!
I think silicon implant is still a good implant for rhinoplasty- provided it is correctly use by a well trained surgeon. There are several ways naman para di mareject ang silicon;
1. your surgeon can suture the silicon implant into the cartilages to secure it and keep it from moving
2. your surgeon can also put a cartilage graft at the tip of the implant para protected ang skin from tissue errosion;
3. you can also ask your doctor to choose a nice implant for you- thru experience by other md, the biege colored implants are the one easily rejected. Meron na rin na two toned silicon implant(soft tip with firm dorsum)
4. the implant should be not too large for your nose - some patients kasi mataas ang gusto na ilong kahit di naman bagay.
5. always ask your doctors their credentials - some doctors are just self-proclaimed cosmetic surgeon. Cosmetic surgeons are usually graduates of Gen. Surgery, ENT-Head and Neck Surgery and others finished Dermatology before pursuing into cosmetic surgery.

Goretex!Goretex!Goretex!!!!!!!!!!!!!!
This is a very good option for those who do not want to have a complications from silicon implant.
1.This implant gives natural looking result( vs silicon-"operated look").
2. This implant is also good for those people who are very physically active. You can play the sports activity you like without worrying about your nose
3. good also for those patients na may allergic rhinitis- you can sneeze and blow your nose without deforming it- silicon? forget it if you have allergic rhinitis
4. Goretex is very good specially if handle by good hands. Only few doctors are very familiar in goretex handling- so choose your doctor pa rin, ask if he trained in handling the goretex.

In the end, it's a matter of choice. Either silicon or goretex are good. But if you will ask me, i like Goretex better for my patients. But it's the patient who will choose; and it is the responsibility of cosmetic surgeon to explain. ...Most of the time patient will choose what is best for them.

[eegelsI]

Hello Eegels,

Healing on the face is usually very good, even in keloid formers. In your case, a rhinoplasty with incisions that are done inside the nostril would be best. However, the type of procedure you will need would depend upon the anatomy of your nose. It would be best to consult first, express what you want as well as your concerns, have the doctor look at you afterwhich he/she will give an opinion on what you will need.

Bottomline, consult first. It doesnt hurt to ask right?

Good luck!

Thanks for the information Doctor J. I really appreciate it. But of course, the best way is to consult trusted doctors. And I'm sure they are costly. No pain, no gain!

[Doctor J]

Thanks for the information Doctor J. I really appreciate it. But of course, the best way is to consult trusted doctors. And I'm sure they are costly. No pain, no gain!

I do think that consultation would not be costly since there are still a good number of cosmetic surgeons who do consultation for free. You can even shop for doctors since you dont have to pay them. That way, not only can you get a fair price for your procedure, you also get to choose the best doctor for you. And it doesnt mean that if the surgeon charges for a consultation fee, he is automatically a good surgeon you can trust. Of course that is not the basis.

[yssamer_lyn]

Thanks for the information Doctor J. I really appreciate it. But of course, the best way is to consult trusted doctors. And I'm sure they are costly. No pain, no gain!

Trusted doctors for rhinoplasty.

In the Philippine Medicine, the specialty the requires the knowledge in rhinoplasty in their diplomate board exam are the Ears, Nose and Throat-Head and Neck Surgeons. Meaning, before they finished their training they should be able to know and perform rhinoplasty. ENT surgeons trained with the pathology, function, anatomy and aesthetic details of nose. So I guess they know the nose best. Of course not most of them go into cosmetic surgery training. Some self-proclaimed cosmetic surgeons dont even have residency training such as General Surgery or ENT-Head and Neck Surgery. These specialties are usually the minimum requirement for one surgeon to be accepted in plastic and cosmetic training in the philippines. The advantage on an ENT is that he already knows the nose even before he further trained in rhinoplasty. He can even do and get paid doing rhinoplasty even if he will not trained further as cosmetic surgeon. Well, I'm just talking about rhinoplasty. Fact is the pioneers of rhinoplasty in the Philippines are the ENTs. Many members of the Philippine College of Cosmetic Surgery are ENT (I even heard that their founding president is also an ENT).
ENT surgeons even have their own subspecialty in Rhinoplasty and Facial Plastic Surgery (Just like in the USA). If you want to choose a cosmetic surgeon make sure he finished at least General Surgery or ENT (sometimes Dermatology) before he became a cosmetic surgeon. If they did not finish any of these they are just GENERAL PHYSICIANS. ...FOR YOUR INFORMATION ONLY.

dR. H

[flimmmmeryrose]

any newly graduated surgeon here?
I volunteer to be experimented for rhinoplasty!

[yssamer_lyn]

any newly graduated surgeon here?
I volunteer to be experimented for rhinoplasty!

I'm not a new graduate. Pero tigasaan ka ba? I''ve been doing rhinoplasty for five years now. I have clinic in Gen. Santos City and Tacurong City. I also do surgery in Davao City.

Dr. H

[Doctor J]

I'm not a new graduate. Pero tigasaan ka ba? I''ve been doing rhinoplasty for five years now. I have clinic in Gen. Santos City and Tacurong City. I also do surgery in Davao City.

Dr. H

Hi Dr. H.

Glad to meet a colleague here in PEX. My background is general surgery. Your practice is in the south mainly? I have a partner who is a member of FACES, are you part of that too? Ok ang samahan ng ENT cosmetic group.

More power to you.

[yssamer_lyn]

Hi Dr. H.

Glad to meet a colleague here in PEX. My background is general surgery. Your practice is in the south mainly? I have a partner who is a member of FACES, are you part of that too? Ok ang samahan ng ENT cosmetic group.

More power to you.

Dr. J,

Good morning po! Yes, I'm a member of FACES (Facial Aesthetic Core of ENT Surgeons). Actually, I finished my training with them. Maganda talaga samahan sa FACES. All the faculty members are very eager to teach. No secrets, turo nila lahat. I'm glad to belong to this group. We have a post-grad in Rhino in OSMAK on June 9-10. You can come if you are interested.

I'm from Macabebe, Paampanga. Pero dito na ako ngayon sa Gen. Santos City kaya dito na rin ako practice.

Dr. H

[Doctor J]

Dr. J,

Good morning po! Yes, I'm a member of FACES (Facial Aesthetic Core of ENT Surgeons). Actually, I finished my training with them. Maganda talaga samahan sa FACES. All the faculty members are very eager to teach. No secrets, turo nila lahat. I'm glad to belong to this group. We have a post-grad in Rhino in OSMAK on June 9-10. You can come if you are interested.

I'm from Macabebe, Paampanga. Pero dito na ako ngayon sa Gen. Santos City kaya dito na rin ako practice.

Dr. H

I am actually going to attend the OSMAK post-grad. Kita na lang tayo dun.