Look Your Best

Im Vs BM - consultation outcome

Rhinoplasty (more commonly referred to as a nose job)
Functional Septoplasty

Postby NG571 » Wed Jun 10, 2009 8:49 pm

Different surgeons use/prefer different techniques...lots of surgeons used open because they can view everything clearly....i think a lot depends on how they were trained...people like IM were probaly trianed using the closed procedure hence why he prefers it and i think it also limits risks and minimises swelling...If i did my research before my primary i would probably go for closed becuase i didnt really need much doing but now i have lots of asymetry etc i would like an open so someone can view the alas etc and try to improve things from seeing where things have moved etc...

You should always consider how the surgeon was trained...i.e dont insist on closed if the surgeon you want to use has not got much experience with closed...find a surgeon that is experienced with closed ...hope that helps :hug:
NG571
Old Timer
 
Posts: 2608
Joined: Tue Dec 30, 2008 3:09 am

Postby Elizabeth 64 » Wed Jun 10, 2009 8:45 pm

thank you guys!
I know i haven't even had a primary yet but I was just wondering whether it was better to try to have a closed primary incase one needed to have a revision later??? :Rhino:
User avatar
Elizabeth 64
 
Posts: 491
Joined: Sat Apr 18, 2009 7:14 am
Location: London

Postby NG571 » Wed Jun 10, 2009 8:01 pm

As Podsy said you can have an open rhino twice, there are slightly higher risks of some complications and some surgeons will not do this if you have thick skin becuase of the swelling and the risks....you need to wait 12/18months before you can consider an open operation :-F
NG571
Old Timer
 
Posts: 2608
Joined: Tue Dec 30, 2008 3:09 am

Postby podsy » Wed Jun 10, 2009 7:44 pm

Elizabeth 64 wrote:I'm interested in the answer to this one.....


Hi Elizabeth, do you mean you are interested in Obsession's question, above?
If so, yes you can have an open op twice, the surgeon will usually cut along your previous incision line to prevent additional places of scarring :-F
podsy
Moderator
 
Posts: 2014
Joined: Sun Aug 05, 2007 7:10 pm

Postby Elizabeth 64 » Wed Jun 10, 2009 7:32 pm

I'm interested in the answer to this one.....
User avatar
Elizabeth 64
 
Posts: 491
Joined: Sat Apr 18, 2009 7:14 am
Location: London

Postby obsession » Wed Sep 10, 2008 7:41 pm

can you have an open onto top of a previous open. does this lead to worse scarring?
User avatar
obsession
 
Posts: 258
Joined: Sat Aug 23, 2008 2:46 pm
Location: North

Postby *harri* » Wed Sep 10, 2008 2:10 pm

The top rhino surgeons in the world use open. It's not a fashion fad. I've seen no signs that's it's falling out of favour on the US boards. If anything it's becoming more popular but that's perhaps because less experienced surgeons do open because it's easier and that's the way they were trained. That's why I've always said go with a surgeon who is happy to do both. :dontknow:

There is also a US surgeon called Clark who won't do opens and some surgeons refer patients to him who refuse the open because they think he can get a better result closed than they could.

However, the question I really can't answer is can IM do as good a job closed as Matti can do open. IM wasn't going to touch one tip that Matti improved drammatically with an open.

JRJ used to be against the open too - he told me 'the court is out' but i've seen a few cases recently where he's opted for open.

Matti does a lot of closed surgeries too - he only uses open if he can't get the result closed and sometimes he decides this half way thru the op.

I don't think anybody has asked Matti for his open v closed %. It might be worth asking the question :dontknow:
User avatar
*harri*
Old Timer
 
Posts: 21915
Joined: Mon Apr 25, 2005 11:49 pm

Postby freezer » Wed Sep 10, 2008 11:40 am

*harri* wrote:http://www.lookyourbestuk.com/info.php?pgId=46

I'm surprised IM said closed.

Does he do opens :?:


I had a consult with IM this very morning and he said he does 99% closed - he only does open if there is no other option - e.g. rugby players with multiple old breaks that require complete remodelling. At the end of the consult, you get to talk to his secretary about the mundane stuff (where the hospital is, post-op consults etc) and she also talked about the fact he does closed (i'd wanted to check that would mean I had no external stictches, which I'd forgotten to ask IM myself). quote "yes... open was very fashionable a few years ago in the US and people just seemed to jump on the bandwaggon" in a tone which suggested those people should know better!

I'm not trying to provoke a debate about the relative merits of open vs closed, but thought it might help shed some light - IM is def a closed man (but a very lovely one).
freezer
 
Posts: 18
Joined: Tue Aug 19, 2008 5:02 pm

Postby *harri* » Wed Sep 10, 2008 11:15 am

Then I asked for my letter outlining what he would do and boy was that a whole other story


I'm not sure he routinely sends letters so you may need to ask for one.

I never got one but maybe he does now. :dontknow:
User avatar
*harri*
Old Timer
 
Posts: 21915
Joined: Mon Apr 25, 2005 11:49 pm

Postby miki97 » Wed Sep 10, 2008 10:52 am

“The good news is that Matti didn't mention rib which is the worst case scenario”

Harri, he actually did mention the rib.... he said ear or rib…but I chose to ignore the rib part, because the whole idea would be way too much for me to deal with.

Irishgal, I felt the same after my consult yesterday….with me he didn’t even attempt to provide any images of what my nose may end up looking like, I know these things are hardly ever realistic but it would be good to have even the vaguest of ideas.
I hope you’re right about the letter, though nobody in his surgery mentioned anything about it.

Thanks for all your replies, it sure is comforting to know there are people who can understand my concerns
x
miki97
 
Posts: 72
Joined: Sun Aug 31, 2008 4:34 pm
Location: Midlands

consults

Postby irishgal » Wed Sep 10, 2008 10:26 am

Hi,

I just wanted to add that I was devasted after my consult with Matti. I burst out crying in the street outside his office because I felt he was so indifferent to my nose. The image he did of my nose wasnt any different to my existing nose even his admin couldnt tell which was before and after.

Then I asked for my letter outlining what he would do and boy was that a whole other story. Matti is taking everything in. He suggested stuff, repeated stuff that I thought he wasnt even listening to and he got me down to a tee.

Get the letter first before you write Matti off. I cant offer advice on IM as I didnt see him at all.

Dont worry..... I'm sure matti's letter will certainly shed some light.

Irishgal
irishgal
 
Posts: 174
Joined: Sun Apr 20, 2008 1:51 pm
Location: Ireland

Postby *harri* » Wed Sep 10, 2008 10:17 am

Miki is your surgeon the one in the BAAPS register :?:
User avatar
*harri*
Old Timer
 
Posts: 21915
Joined: Mon Apr 25, 2005 11:49 pm

Postby *harri* » Wed Sep 10, 2008 9:44 am

The good news is that Matti didn't mention rib which is the worst case scenario (IM doesn't use it and Matti doesn't use it very often) and both surgeons seem to be willing to tackle your nose. :Rhino:

I would think you have a good chance of improvement but improvement is the name of the game.
User avatar
*harri*
Old Timer
 
Posts: 21915
Joined: Mon Apr 25, 2005 11:49 pm

Postby *harri* » Wed Sep 10, 2008 9:37 am

miki97 wrote:"I'm surprised IM said closed."

he didn't say closed, or open for that matter. He said he'd need to think about what the best procedure would be. I'll be seeing him again in october


Sorry I must have been thinking of someone else. :dontknow:

He discussed possibilities of tip refinement, but said he would have to wait until he has a look inside during the surgery before he decides on the best technique.


This is another key point. It's very hard to compare op plans because really it does depend on what they find on the day.

It's also textbook advice to tell a revision patient they may need another revision.

I'll say this although maybe I don't want to - if you were asking about JRJ and Matti for a complicated revision I would say IMHO Matti would be a better choice. That's not because I don't rate JRJ very highly because I do, as do the majority of his happy patients.

However, this forum just doesn't have IM stories for me to form a judgement. He's highly regarded in the rhinoplasty world so he's a very safe bet for a consult and as you know i don't say that about many surgeons. :LOL:

If you read Sally A's story Matti was prepared to do a lot more to her tip than IM was (and Matti delivered). This is why I asked about open v closed because my guess is that complicated tip work would require an open.
User avatar
*harri*
Old Timer
 
Posts: 21915
Joined: Mon Apr 25, 2005 11:49 pm

Postby miki97 » Wed Sep 10, 2008 9:09 am

"I'm surprised IM said closed."

he didn't say closed, or open for that matter. He said he'd need to think about what the best procedure would be. I'll be seeing him again in october
miki97
 
Posts: 72
Joined: Sun Aug 31, 2008 4:34 pm
Location: Midlands

Next

Expand view

Return to Nose Surgery (Primary & Revision Rhinoplasty)




Users browsing this forum: Google [Bot] and 1 guest