Rhinoplasty consultation with Dr. Khadivie and Dr. Yahyavi about
A rhinoplasty consultation which was conducted by Dr. Ehsan Khadivie and “Dr. Shahriar Yahyavi” about rhinoplasty or nose job in IRAN which includes : nose cosmetic surgery, reconstructive rhinoplasty, revision , consulted sessions, Asymmetry noses and some tips in cosmetic surgery.
This article covers the following topics :
• Introduction of Dr. Yahyavi and Dr. Khadivie
• The final shape of the nose | reasonable expectations rhinoplasty
• The role of preoperative rhinoplasty
• Possibility of revision surgery after rhinoplasty
• Promises of cosmetic surgeons about rhinoplasty
• Postoperative defects and the role of a good surgeon
• How many doctors should be consulted for rhinoplasty?
• Relationship between nasal fit and face and patient expectations
• Noses suitable for rhinoplasty
• Improper noses for rhinoplasty
• Asymmetry of the nose with the lip line
• Asymmetry of the nasal fins
• Natural, fancy and semi-fancy nose
• Surgeons’ portfolio, Instagram page or site?
• Crooked nose and the possibility of complete correction
• Sanctions on Iran and rumors of a shortage of anesthetics
• Fat nose, misconceptions and facts
• Extra meat (Keloid scars) in the nose after surgery
• Age in Rhinoplasty | Limitations
• Lifting the length of the nose | Ability of surgeons
• Concluding remarks
Introduction of Dr. Yahyavi and Dr. Khadivie
Dr. Ehsan Khadivie (Host): Ear, Throat and Nose Specialist / Larynge Fellowship / Tumor Plastic Surgery / Rhinoplasty / Head and Neck Plastic Surgery
Instagram page: @drkhadivie
Free rhinoplasty consultation with Dr. Khadivie by Direct link and number +989021003747 on WhatsApp.
Dr. Shahriar Yahyavi: Born in 1960 in Tehran, is a facial plastic surgeon and ear, nose and throat specialist.
Instagram page: @shahriyar.yahyavi
Free rhinoplasty consultation with Dr. Yahyavi by Direct link and number +989127900902 on WhatsApp.
The final shape of the nose | reasonable expectations rhinoplasty
One of the reasons that the applicant seeks counseling before the operation is that he does not know whether what he wants will be achieved or not, and whether it will be 100% similar to what he wants or not. Do you agree that in these counseling sessions, the surgeon’s job is to convey the facts to the patient and explain what shape of nose is best for the patient?
Ehsan Jan, this is exactly what we are involved in. This means that the blind spot of cosmetic surgeons, especially rhinoplasty surgeons, is that even the patient lying on the operating table does not know what his nose is supposed to look like. Well, computer simulations or viewing the surgeon’s previous portfolio will help to some extent, but in the end, I think it’s a matter of the surgeon’s trust and commitment.
That is, the applicant has done his research and seen the portfolio of his favorite surgeon, talked to the surgeon’s previous clients, and finally the doctor should do his best to acquaint the patient with the facts after the operation. So that the patient is not surprised and disappointed with the result of the surgery, as this may cause the patient frustration.
But this is the problem of all cosmetic surgeons
The role of preoperative rhinoplasty & nose plastic surgery
I think that with a few detailed counseling sessions, especially for obsessive clients, these people can be helped to have a good and realistic picture of the final shape of their nose, and this process may end up in a way that the client, according to different expectations from He thought the operation would even stop him from surgery.
In my opinion, medicine is a good surgeon who, when he sees that he can not meet the client’s wishes (which of course is often irrational), tries to dissuade the patient.
Dear Dr. Khalili. There is a triangle that should always be considered. Physician ability, nasal defects and patient demand. If these three factors are compatible, I think we will have good satisfaction in a significant percentage of patients’ problems. But if the patient’s type of problem and level of expectations do not match, or maybe the doctor he has chosen is not suitable for him, then we may have a problem.
However, we must accept that not all doctors have the same experience. There is a doctor who has worked for 30 years, there is a doctor who has just started for 6 months, on the other hand, there is another doctor who is very busy and active, and another doctor does not have two or three more operations per month. However, not all surgeons have the same ability, and unfortunately, such issues now affect the outcome of surgery.
Finally, the patient must consider these three factors and see how empowered the physician of his or her choice is in this particular case.
Surgery may be more proficient for fat noses but not for restorative noses, and vice versa. It is the patient’s duty to do good research, and the physician’s reciprocal duty is to tell the facts about the patient’s commitment, and to tell the client without compromise if the surgeon is unable to do so. What’s wrong with this?!!
This is a very good thing you just said. I sometimes tell patients, whether they have a restorative nose or a fat nose, as you say, I see as much as I can, I cannot help you anymore. Therefore, I prefer not to operate on their noses. Of course, sometimes the patient gets upset and leaves the office angrily, but I myself would rather accept someone for an operation that I can help, rather than doubt myself in helping the client.
I agree with you exactly. Physicians must be morally committed and very honest, just as the patient chooses his doctor, so the doctor must be in a position to choose his patient. A patient who can get results with a high percentage of accuracy and can make a beautiful nose for him.
If we were to operate on all patients without considering these cases, we would definitely face a significant percentage of dissatisfied patients.
Possibility of revision surgery after rhinoplasty (reconstructive rhinoplasty)
True, but it can be said here that according to the statistics in the books and we also have, about 5 to 10% of surgeries usually end in revision surgery. Do you agree with this?
Ehsan Jan, something that unfortunately many patients are afraid of and consider as a negative factor of cosmetic surgery is that they say that a doctor performs a revision operation.
I think this is where we need to let listeners and viewers know that having revision rhinoplasty is not a negative score for a doctor. This is a natural case and everywhere in the world, statistics of 10% or even higher have been reported for revision surgery. We have to consider whether the cause of this operation is the negligence of the surgeon or the damaged nose or not, it is just a process of beautifying the nose or somehow meeting the patient’s expectations.
The fact that I’m sure, given the experience you have and the revision that will be made by you, will definitely not be part of the broken nose group. Most surgeons who have experience and reputation, usually if they have a revision operation, to the extent of short-term repairs or minor defects that occur frequently and unfortunately are beyond our control.
We are never a computer or a robot that can create a nose with all the subtle angles it has for the patient and promise them 100% and say that I will make exactly the picture you showed me. No, this is not the case. The surgeon, like other human beings, may make mistakes, and we always explain the possibility of revision to the patients and we will definitely tell them that your revision will be partial.
Promises of cosmetic surgeons about rhinoplasty & nose beauty surgery
Yes, you made an interesting point, Do you believe that the surgeon should explain to his patient that I am one hundred percent correct and do not need to be repaired?
Dr. Khalili, unfortunately this is a complete lie. That is, at least our elders taught us that, unfortunately, in any case, there will be a percentage of patients who complain in the office, and eventually we may have to do something for them again after a year. Because I think you agree with me that in the end our ultimate goal is to make our patients happy and we will do whatever we can and need to do for them. What is wrong with the patient’s expectations and wishes being reasonable? We do it in the natural process, but our problem is the kindness of patients whose expectations are unreasonable and beyond the ability of me and you.
This is exactly what you are talking about. You say that sometimes we are expected to do the things that are necessary. What are our revision operations or what are the colleagues’ actions that the patient says I did and I am not satisfied with and I am not happy? Is it correct for the patient to say that I am not happy or satisfied with the condition of my nose, and is it really possible to make all the noses in such a way that the owner is satisfied?
Unfortunately, the fact is that I, like all other cosmetic surgeons, like to meet all the expectations of patients, but it is not possible and I tell them explicitly in the healing process.
One fact I have to say is that the revision procedure is much more complicated than the initial surgical procedure, and we may need to spend even one or two more sessions listening to our patient and seeing if we can meet his or her expectations. Can we correct the flaws we got from the nose?
Postoperative defects and who is the best rhinoplasty surgeon?
One thing I have to say is that a lot of patients think that because they have nose cosmetic surgery, because a famous doctor performed the operation on them and they paid a lot of money, then their nose should not have a problem. This Ehsan Jan is unfortunately a mistake. Since I went to Dr. Khadivie and Dr. Khadivie is the best surgeon in Mashhad, I did a lot of research and I trust Dr. Khadivie very much, and such talk does not mean that the nose that Dr. Khadivie made has no problem.
Not normally, even the patients whose photos we put on our page as the most beautiful cases, if they become experts and take accurate close-ups, I think they will have an average of three to four problems. What celebrity do you know in Hollywood who has no problem with his nose? There are people who spend over 30,000 dollars, can I say there is nothing wrong with their nose? Jennifer Lopez, Nicole Kidman?
Yes, exactly, even our own celebrities in Iran, TV presenters often acted and often have problems.
Please do not consider the cosmetologist as a person with a special power or a person who has a certain ability and can handle anything. Like everyone else, we have our own limited skills and experience. Crooked nose, fat nose, asymmetrical nose. How can we make a top nose out of such a nose? Well, this is like a miracle, and patients’ expectations should be commensurate with our ability.
How many doctors should be consulted for rhinoplasty?
And that their nose infrastructure should allow, sometimes a client with a big nose and thick skin says they want a slim nose. This cannot be done by us or any other doctor. That is why we advise patients to always see between 3 or 4 other doctors. The more patients are aware of their own problems, the more comfortable we are.
Our main problem is those who choose us as the first doctor and are not willing to go anywhere else and have a special belief in us and have very high expectations. Why do we usually have problems with these? Because usually after two or three weeks after the operation, we see that the patient is upset. I asked what happened? The patient says what is this nose swelling? I did not expect. I wanted a much more delicate and beautiful nose.
I want them to do research. Noses that have problems should definitely consult with one or two trusted doctors to raise their level of awareness. What’s wrong with being aware of what’s wrong with their nose?
This is exactly what I am saying, especially the noses that we think the result is not perfect. I tell the patient to go to two or three other doctors. In this way, your level of understanding goes up and you can decide what your nose is going to be. Now, if we decide to operate again, I am at your service, but be sure to see one or two other doctors.
I quite agree
Relationship between nasal fit and face and patient expectations
Because people do not know what a normal nose is and they do not want to have irrational ideas before deciding to have surgery, you can talk to us about the natural angles of the nose and its relation to the face.
You see, if I want to answer your question properly, each surgeon, depending on his skill and experience, defines a series of suitable candidates for himself, who from the moment the client enters his room, tries to see them in the patient’s face. See and scan. Which ultimately leads to the conclusion that the patient is the case I want or not?
There are a number of parameters that relate to the whole face. It is true that we just want to operate on the patient’s nose, but the parameters of the face are very important to us. The main parameter is the overall beauty of the face.
Unfortunately, I have to tell you that my problem is with those whose other elements of the face are not very attractive, and unfortunately, after the operation, the faces of these people are not praised by their friends, and it causes discomfort and connects this ugliness to our work. they do.
They ask why others do not tell me my nose is beautiful? Well, a person who does not have very beautiful eyes and eyebrows, has swollen around her eyes, does not have a prominent cheek, has a retracted chin, cannot expect that after rhinoplasty, we can do something that will be noticed by those around her. It is true that we just want to have rhinoplasty on the face of these people, but other parameters are very important to us. Cheeks, eyes, eyebrows, cheeks.
Sometimes we even have to suggest to the patient that in addition to the nose, they do something else for beauty. Inject fat on the cheeks, or with the nose, perform eyelid cosmetic surgery, or with the chin prosthesis nose to correct backward chin. These are the parameters that I consider for the whole face.
Noses suitable for rhinoplasty
But the parameters that I think you agree with me, I say in the form of faces and noses that are good and perfect. Included:
- Humpy noses
- The tip of the nose is slightly larger
- The tip of the nose is slightly drooping
- The nose is relatively wide
- The nasal fins have a relative width.
These are all part of our routine, and I and both patients believe that satisfactory results will be obtained if the skin is relatively good.
Improper noses for rhinoplasty
But our problem is when the nasal defects are specific as defects that are not normal include:
• Very fat nose
• Very large nose
• Tilted noses
• Asymmetrical noses
Ugly nostrils (which has its own definition)
Unfortunately, it also puts a lot of restrictions on us.
I think you will agree with me. One of the problems and blind spots of our surgery is the ugly nostrils, which we have very limited. How to turn inappropriate holes into beautiful nostrils and many other factors that are limiting factors.
I think about all this in my first consultation, and finally I summarize and score and say whether this patient is a suitable candidate or not. Then I ask the patient to tell me his expectations, and finally, if the level of expectations and the level of objections are appropriate, I hit the target and find my own option, this will be my ideal case.
Well, this is a very specialized discussion and it is due to your high experience that after a long time of work experience, the surgeon can evaluate his patient at the first glance and see if the result of the nose operation will be good or not.
Asymmetry of the nose with the lip line
But what about the nose and its relationship to facial asymmetry? Do you have a problem with people whose lips and mouth are not in line with their eyes and eyebrows?
Unfortunately, asymmetry is very common, but fortunately it is low in most cases. But we have to admit that a significant percentage of our patients suffer from nasal to asymmetrical facial expressions.
Note that asymmetry of the nose has its own problems, but our biggest problem is the asymmetry of the nose in relation to the face, including the lips and mouth, and in relation to the eyes and eyebrows.
Unfortunately, I have my own limitations on this and I still could not handle it very well. Rarely have I suggested fat injections at the same time to some patients with asymmetrical faces, but in the case of people with significantly asymmetrical faces, I give in and tell the truth to the patients.
The fact is that the patient should not expect complete postoperative symmetry, and these are usually patients who are also dissatisfied with postoperative asymmetry. With a special difference that sometimes asymmetry intensifies. The process of narrowing and sharpening the nose is a process that sometimes leads to asymmetry of the nose to the lips and mouth, and this is part of the case that is sometimes unacceptable for patients.
Of course, there is a point that you mentioned, and when you tell the patient after the operation, I told you the facts beforehand, well, the patient also says that I paid and found a very good doctor and I expected that the result of the operation was very good. Is this true?
The doctor’s biggest task is to give initial advice and state restrictions. We must be honest and courageous in the counseling session and not be afraid that the patient may give up. There is no problem, the patient must know the truth, and finally one or two other doctors who spoke to me and confirmed you, this is where the patient understands that Dr. Khadivie was an honest doctor and told me the truth.
Asymmetry of the nasal fins in nose beauty surgery
Another point is the asymmetry of the distance between the nasal fins and the lip line. Do you believe that asymmetry will be completely corrected after the operation? That is, the distance between the nostrils and the lip line will be the same on both sides?
Unfortunately, this is one of the main drawbacks of crooked noses in the vertical dimension, and one nostril is higher than the other. I have had some relative success in correcting this with the special technique introduced in the congresses, but I do not promise any disease at all, and I only tell them that I am trying to correct it. But the fact is that the patient should not expect the doctor to be able to correct in these cases. Because one of the blind spots in rhinoplasty is the correction of asymmetries in the height of the two nasal fins, and we must admit that in some cases, after the operation, because the nose becomes more beautiful, they show their slight defects more.
Before the operation, no one told the patient that your nasal fins were asymmetrical, but surprisingly, when the nose becomes beautiful and the patient walks in front of the mirror a lot, and those around pay more attention to the patient’s nose. The patient says why everyone sees my nose blades says why it is this shape. This is an ugly truth.
There is another argument. Now, if you release the upper nostrils and want to sew lower, the connection between the nose and the lips may be correct, but when we look at the nose itself, the nose itself collapses and becomes one side lower than the other.
That is why I say that surgeons should remind the patient of this before the operation and it is better not to touch it at all.
Incidentally, I had the same things. The fact is that the policy of many of our colleagues is very clear. Now, maybe I do not observe this frankly in my office, maybe I do not have the courage. But I admire some of my colleagues who tell the client very honestly and frankly, and as soon as the patient points out the asymmetry of the nasal fins, they explicitly tell the patient that there is no correction.
I think this is an instructive case and I have to practice doing it. I have to have the courage to tell patients. Unfortunately, this compromise and lack of courage has sometimes caused me trouble, and sometimes my patient complains to me and says why you did not tell me before the operation, and she is right.
Natural, fancy and semi-fancy nose
Regarding the model of the nose and the fact that the clients say that they want a natural, fancy or semi-fancy nose, did you really accept the patient’s request and do exactly what the client wants?
Dr. Khalili, expectations are very high today. The fact is that the skill of many of our colleagues is becoming more and more, and this is a process that is happening all over the world, and on the other hand, it is true that cyberspace has many benefits, but clients also see different photos in this Space and their expectations become very high.
In cyberspace, not everyone is honest and sometimes you see that they put certain photos on their pages under the title of rhinoplasty and face surgeries, which one really feels that seeing these photos only raises the level of patients’ expectations more and more. And it did not help the doctor’s work and only makes the patient see the image and say if this doctor could do it, you and Dr. Yahyavi would do it for me.
I tell them very honestly that creating fancy, semi-fancy or very stylish noses is not applicable for all patients. A limited number of our patients fall into this group and none of them are the clients we promised them in the office. There is no such thing as a promise to the patient that “I will give you a fancy nose or a first-class doll nose.”
In the first place, you have to see if it fits the patient’s face or not. Yes, this can be agreed with the patient. I try my best to have the nose in the most beautiful shape after the operation, but whether the nose looks like this photo or this photo or like this lady that I showed you in the waiting room, or like Nose that you operated on last year, no, we do not have these cases.
Unfortunately, these are demands that we hear over and over again. But in the end, we surgeons have to deal with the patient’s nose problems with only these two hands in the operating room. Computer simulations and various photos of Instagram pages are all in-office conversations, none of which ultimately play a role.
Yes, of course we have to listen to the patient’s opinions completely, patiently pay attention to the patient’s opinions to see if the level of the patient’s expectations and desires is the same as the extent of his nasal defects.
I honestly say I can’t make a stylish nose out of a fat , crooked, big or flawed nose. This is a fact.
Surgeons’ portfolio, Instagram page or site?
Sometimes clients come to me and show the nose of one of their relatives who had a nose operation and say that I want to be like this. I say, did his nose look like yours before the operation? And when we look, we see that this is not the case and the original noses are different. And I’m saying you should not expect the final shape of your noses to be the same when the original shape is not the same.
I advise these people not to trust the photos even before the action that their people take, because there is a possibility of manipulation. Just use the photos as a basis for the analogy that we take in the office before and after the operation. And if you find someone who looked like your nose before the operation, you can also expect your nose to look like it after the operation.
But it does not make sense to simply select fake and beautiful photos and then expect the result to be like them. Because you do not know before the operation of those noses.
Dr. Khalili, like other markets, we try to put the best examples of our work on our pages or site. My request to all the audience is that they consider this fact and, if necessary, make the correction in their minds that Dr. Yahyavi or Dr. Khalili show the best examples of their work. Do they also show noses that have some flaws?
No, at least I did not do that. I do not know about you.
In any case, I suggest that clients who choose only cyberspace for research, not just refer to an Instagram page, and be sure to take a look at the sites, because the information on the sites is more complete. Incidentally, those who only refer to the pages are those who also experience dissatisfaction after the operation. Please consider all these facts and factors that not all the noses we operate on, including fat or asymmetrical noses, may have the same beautiful result.
I do not know if you visited my page or not. I think I’m the only doctor who even took pictures of my revision noses. And when I did it very honestly, a lot of people commented on why this nose was revision? Well, we say that we have already said that there is a 10% chance of revision and it may need to be corrected. We put these pictures to say that you are comfortable and if there is a problem, we can improve it, and I am not one of the surgeons to say that the result of the operation is 100% good.
Crooked nose and the possibility of complete correction
There is another discussion about these crooked noses, when the client comes to us, we never promised him 100% to correct the crooked nose, and we say that there is a 80% chance that it will be corrected, and incidentally, this is the result of the operation. When we post this photo after the operation, many people ask questions and comment on why the complete crooked nose has not been removed, why you failed. Have you encountered such problems? Is it possible to correct a crooked nose 100%?
We have to admit that almost all crooked noses are accompanied by asymmetries of the face and I can safely say that I do not think I have more than 80% success in crooked noses and 20% either needed revision or I really could not get their noses Clear. That’s why I’m so honest about the first counseling session. If they are looking for this nose to be 100% flat, unfortunately this did not happen and this problem may be solved in the second stage. Rarely, the nose may not be completely straightened with revision surgery neither. It is a matter of the day that despite all these modern techniques, crooked noses are still a problem for the cosmetic surgeon community.
This is exactly what you are saying and my question to the audience is whether when Dr. Yahyavi says I cannot correct this 100%, it is because of his weakness or the reason is his humility and whether there is a surgeon in the world at all that can solve this case 100%? Because I have to tell the truth to the patient, sometimes there are cases that do not solve the problem even with one or two or even three reconstructive operations. Because it is not just a matter of the nose, but of the whole pyramid.
Sanctions on Iran and rumors of a shortage of anesthetics
Is there a question that you have asked in your page, Dr. Yahyawi?
Yes, one of the most frequently asked questions is the issue of sanctions against Iran and anesthetics. Well, fortunately we do not have any sanctions on anesthetics and we do not have any drug dealings with China to worry about. Like everywhere else in the world, we use the German remifentanil and propofol, and I urge the audience not to worry in the slightest. Because if this case wants to happen, it is not only related to cosmetic surgery, and it also includes all major surgeries such as brain, heart and internal surgeries. This has never been a problem and God willing; it will not be in the future and do not worry, dear ones
Fat nose, misconceptions and facts
One of the most frequently asked questions by our audience is about fat noses. Some of our clients, when they find out that their nose is fat, think that something very bad has happened and that their nose is going to break down and bring extra meat. Note that I have repeatedly stated that the fat noses themselves include the spectrum and not all of these nose models are the same shape.
Some fat noses are mild and some fat noses are very severe, which is a problem for all surgeons, and is currently out of our discussion. But in between, there are fat noses that are among the suitable noses.
In other words, the nose that:
- It has cartilage
- Or a fat nose where the tip of the nose is low and easily forms under the nose when we lay the foundation
- A fat nose that has a relative hump
- A fat nose with a broad bony part.
We can make these clear changes. I can boldly say that there are some fat noses that get much better results in the long run than normal noses. There should not be a negative mentality in our patients that when we say: Your skin on your nose is thick, it immediately implies that my nose adds meat, so I do not get results, my nose remains bloated. No, there are many fat noses that give very good results.
What is your opinion, Dr. Khalili?
True, the worst cases are those that have very thick skin and so-called orange peel, and at the same time have very weak cartilage. These are not good cases for surgery. But these noses can also be formed by strengthening the cartilage, and you should talk to the patient that your surgery is meant to shape the nose, not to turn your nose into a very thin and small nose. The next topic about meaty noses is the waiting. I have to tell the patient that your nose is not a nose that takes 2 to 4 months to form and may even take up to a year to reach its final shape.
Extra meat (Keloid scars) in the nose after nose reshaping
What do you think about “extra meat”? Did you encounter these cases?
Dr. Khadivi, scientifically, when we say “extra meat”, we mean the same “Keloid scars”. That is, incisions are made in the shoulder or at the angle of the jaw or in chest surgery. But in nose or eyelid surgery, we do not have Keloid scars. The fact that our patients sometimes refer to “extra meat” stems from their own popular perception.
They refer to the tip of the nose as fat or plump or wide. Unfortunately, this also happens more often by our inexperienced colleagues.
Audiences should note that fat noses are not turned into beautiful noses by all surgeons. The fat nose wants a special package of its own, including:
– Preoperative consultation
– The surgeon’s previous experience in these cases
-Familiarity with fat nose surgery techniques
– Postoperative care
– Postoperative recommendations
– Postoperative injections
– Postoperative taping
All this is completely different for this group of clients.
We try to use cartilage techniques in these patients, which do not apply to thin skin.
I think this extra meat mentality stems from the not-so-satisfactory results of some of our patients’ relatives that frighten patients.
It is the surgeons’ job to tell the patient not to listen to this nonsense and to fully explain the facts and risks after the operation.
I think you mean inexperienced surgeons, our younger colleagues, and the misconception that people think a surgeon can make a nose as small as he wants. And after the operation, they insist, why didn’t you make your nose smaller? And we have to keep explaining that the smaller the nose, the worse the result. This is exactly what you are saying and the nose should be strengthened as it gets smaller with cartilage so that the nose takes the right shape.
Unfortunately, these inexperienced surgeons completely listen to the client who has a fat nose and make the nose smaller by lowering the back of the nose. And it so happens that in these cases, after the operation, the patient says, “Why has my nose become more fat?”
It is hard to believe that the nose was operated on but found more fat after the nose operation. This is because the nasal skeleton shrinks and the nasal skin becomes looser and thicker.
Age in Rhinoplasty(nose cosmetic surgery) | Limitations
Dr. Khadivie One of the questions that people ask us is the issue of age in cosmetic surgery. At what age do you accept to operate?
At a scientific congress I attended in Australia, the argument was that the appropriate age is 17 for men and 16 for women. But in the same congress, it was pointed out that we must also consider the mental maturity of the client. Can any 16-year-old client be operated on? We must first pay attention to the character of the client. Sometimes a person still has childish thoughts and does not have the right mindset for surgery. Sometimes a 17-year-old client tells us that I want a very puppet and fancy nose, so I tell them, are you sure you want the same nose model at 30? So, I tell him that I think if you have a natural nose, it is suitable for your whole life, rather than just having a fancy nose when you are 18 years old.
I almost agree with you. However, despite the new techniques, surgeons’ hands have become much more open in surgery. Both at younger ages and at older ages. In the recent scientific research has suggested that pediatric rhinoplasty may be applicable to certain accidents or abnormalities.
Of course, the patient’s physical development must be reasonable and sufficient, and the patient’s nasal defects must have reached her parents’ nasal defects so that we know that the patient has had sufficient growth.
And most importantly, what you mentioned is mental growth and maturity. Maturity is a factor that must be taken into account along with physical maturity. If you feel that personality stability has not yet formed in the client, you should encourage him to postpone her surgery. This is a statement that I think is very reasonable, and for those who have very hasty and emotional demands and are in the critical period of adolescence, surgery can be troublesome.
But Dr. Khadivi, on the other hand, at an older age, I want to know what is your opinion in those cases? which Of course, these days, people come to us at older ages for rhinoplasty, even those over 60 years old.
Although I have experience of operating on a 63-year-old patient, most of my clients are under 60 years old. I think we should first see why a person in her 50s or 60s go for nose cosmetic surgery? Does she feel there is a problem for her in the community? Is there a problem with her face? Is there a problem with her body? Is it emotionally problematic? One may think to oneself that by operating the nose, one can return to her former place in society.
These cases are much more dangerous. There are mistakes that people make, for example, a woman with a large body with many facial wrinkles and many facial imperfections comes to me and says that my nose needs to be operated on. Well, at that age she may think wrongly that by operating her nose, everything will return to the previous state and return to the age of 25 to 30.
In these cases, I must inform this person that you must first solve other apparent problems. This nose, which has been on your face for about 60 years and has not changed anything, if you feel that you do not have that previous position in society because of your appearance, it is probably not because of your nose because your nose is the same as your old nose.
What do you think, doctor?
My record was a 73-year-old patient. Of course, we have to be careful that patients who come in over the age of 60 have to accept that in many cases, the skin is no longer fresh.
You must have noticed that many patients at this age have very fragile, vulnerable and thin nasal mucosa
These are limiting factors. In addition, people who go for rhinoplasty in middle age are a bit more emotionally fragile. We must listen to their words carefully. understand what their level of expectations is? And what do they want to achieve after 50 or 60 years of life? Tell them the limits
Unfortunately, most of these patients also experienced age-related changes in other parts of the body. The eyes and forehead are wrinkled, the cheeks are drooping, there is a chin under the throat, there is a drooping face. If we can have a combination of offers with nose lift surgery(rhinoplasty), I think we can bring our dear clients closer to their expectations.
Of course, I have to admit that in this age group, rhinoplasty is also associated with problems. Many of these clients do not live up to their expectations. However, I try to remind them of this in the first consultation session.
Incidentally, I also point out that in these cases we have to think about whether the problem is only the nose or other parts of the body need to be corrected.
Lifting the length of the nose | Ability of surgeons
And as a final question, I want to ask whether the length of the nose can be increased or not? This is a question that I am often asked. What is your opinion on this?
Dr. Khadivi, because I operate on most noses with a closed method, I have some limitations in this regard and I must admit that I cannot operate on their noses naturally. Maybe by putting cartilage in the lower part of the nose Either use special grafts on the back of the columella to make the nose slightly longer, or in other words, prevent the nose from getting shorter. I will run this second case more. I mean, the nose is short and is one of our most difficult cases, and the tip of the nose is already high and the nostrils are visible. I try not to make the nose any higher because then the nose becomes a pig’s nose.
Or maybe I can do a small amount of correction by using special cartilage in the area under the nose. But in general, I cannot create a thin nose with my own method.
Thank you very much for taking the time, Dr. Yahyawi, given that in critical situations of the Corona virus, esteemed clients cannot take the time to go to the office, maybe this way we can answer their questions and help them decide on cosmetic surgery.
Dr. Khadivi, thank you very much for your suggestion about this live session and we were able to use this opportunity to help our clients make better decisions.