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                   Dr. Azizzadeh Primary

What is Rhinoplasty?

These pages will have an archive of all the rhinoplasty content and discussion we had on our site. A lot of usefull information will be in these archives. Over 100 pages of content will be added.

What we should ask the DR!!!!

Ask if any graft is going to show through the skin.If so,for how long.Will it move,will it warp,will it grow.

Ask if the graft is a lifetime fix or a temp. If it's a temp,how long before it needs to be fixed or replaced.

Or if it even CAN be done over if need be .
Can it be removed,will it discolor the skin .

Ask what his policy is on touch ups.

Ask from date of surgery to what point of time,does he guarantee his work for.

Most Dr's do NOT guarantee their work did you know that?

If the Dr.says he will touch up any problems at a waved fee then that's very promising.

If these "GREAT over priced Dr's are so great ,they should guarantee their work.

Yet many people are not happy after wards and they are stuck because the Dr. thinks there is no problem.

90% of the time there is a problem.

If he agrees you need a touch up,he should NOT take a Dr's fee again.
You may however,be responsible for the operating room & anesthesia,.
Beware of Dr's using grafts even though you need this type of procedure, you are the Genia pig for the DR !
So these questions are a must.
Most of us clam up and let them do all the talking ,not good!
You're just another pay check for the DR.
there's nothing personal between you & the Dr., so speak up.
This is why we are all here searching . we go from one mistake to another.
John Doe says "oh I'm going to the best Dr in the world & paying $20 for my nose."
OK, little does he know about that DR.
except he's high priced so he must be great.. NOT!!!!

.# 1 question to any DR is:"What is your guarantee" $$$$.



Where do you get your statistic that 90% of the time there is a problem? Are you talking about a specific doctor or all in general? How are you defining problem? Minor flaws, a difference in aesthetic opinion or botching? No doctor offers guarantees, simply because they can't. You are dealing with dynamic tissue that even in the best hands heals with it's own quirks. You reduce your risk of problems by going to someone with a tremendous degree of skill and expertise (meaning years of experience) and a proven track record.

You can go to a surgeon who doesn't charge for touch-ups and still end up with a bigger mess than you had before. But in any case all of that should be made very clear before you agree to surgery. A low fee is not a guarantee that a doctor is better than any other. I went to a surgeon who didn't charge for his "touch-up" and he made my nose worse than before my first revision because he failed to fix structural problems.

Yes, it would be nice if the most popular doctors were not expensive but that is what a competitive market place does. These guys aren't saints, just like any other business person if they can charge more because they are in demand they will. They'll just say that you don't have to go to them.

As far as grafts go, you say to beware of docs who use them. All docs who do revisions use grafts unless they use implants and there are just as many negative stories about those.

I agree that people should always speak up and be assertive with doctors in consults and throughout the process. A PS is a service provider and you are paying his salary just like any other service provider and ESPECIALLY since you are having surgery to alter the central feature on your face, it is a life changing event and requires all of your attention and diligence in choosing the right doctor. Because someone seems like a super-nice guy to think he is not going to charge you for his time is naive. It's a business transaction for him as much as it's a medical procedure. If you won't pay him for his time, he'll find someone else who will.

The bottom line is that revision rhino is very difficult and it is very hard emotionally, financially and sometimes physically for anyone who has to go through it, but unless you plan on living in misery or silence with a nose that you don't feel comfortable with, at some point we all have to choose and trust some surgeon and make the best of it. Yes, we are dependent on them and sometimes it doesn't seem like they are the most generaous or fair minded people but what's the alternative???

The only way to avoid this cycle is to avoid rhino completely or only have the most minor, conservative change done to your nose. But then hindsight is 20/20. Can't change the past, can only move forward so you don't ruin your life over a nose!!!


You are so right in every thing you said, and seem to have done lot of re-search like me, and it seems like the research has given you so much info but yet not help you make your decision. I feel the same Way I know every thing I need to know but yet can not pull the plug and make the decision but I am hoping when I do it will be a very educated decision based on what I know. I am curious the doctor that did your first revision who was it... it really seems like some of the plastic surgeons that are not ENT they try to fix problems by just camouflaging and not actually fixing the issues such as deviation or missing support and lives you with the same or even worse problem. are you ready for another revision yet or are you still contemplating? do you have any doctor in mind that you are comfortable with his grafting and skills?

best of luck


Sometimes what you need done helps you to choose your PS. For rib grafting, I think that Dr. Toriumi is probably the best out there in that he works with it consistently and seems to have minimal warping and he doesn't use the dreaded K-wire like Gunter. Since I've experienced the shortcomings of patchwork ear grafts the thought of rib doesn't scare me much. It's sturdier and straighter and comes in bigger pieces.

It is hard to make a decision but once you've had a couple of consults with your top docs and seen a bunch of photos and maybe met with some of their patients in person it comes down to weighing the risk/reward scenario for each doc and then going with your gut instincts.

It is possible to over-think something to the point where you just scare yourself away from solving your problems and moving on with your life. No doctor will have a perfect track record ever, but I feel safer with someone whose main focus is revision work, who has consistently solved challenging cases and is very skilled in working with all types of grafting material.

As far as cost goes, it is a major drag to spend tens of thousands of dollars on rhino surgery, but there are people out there who have spent the same amount going from one doc to the next ending up with partial solutions or big problems.

I guess at the end of the day you have to ask yourself how much time out of your life you are going to dedicate to the "nose project" so you don't miss out on actually living and finally what you can actually live with nose-wise. For me the limbo between surgeries is pretty unbearable so I'm eager to make a decision and get on the road to healing once and for all.


I keep hearing this from several ear patients. so Toriumi might be very right in the fact that he does not want to take the chance with ear even on less complicated patietns and goes right into the rib:( where did you feel mosst of the shortcoming when it came to your ear graft. it seems like ear is a no no to be used for spreader grafts as it will not have a good long term result since it is not strong enough...so are you considering Dr Toriumi for you revision since it seems like you might be considering the rib option? does his asthetic as far as a high radiax graft worries you at all?
wish you best of luck.


I have thin skin and with the ear grafts there were the usual issues with lumpiness and resorption. They made the shape of my nose much worse!!! Also for use in the tip they provided no shape or structure at all. But I'm just one case, so can't speak for all those with ear grafts.

I don't know why Dr. Toriumi is so keen on using rib for all patients, though based on my consults it seems like most top revisionists don't like to use ear on the dorsum due to lumpiness. His website says he uses it to lengthen add height to the radix and on all revision patients. With revision patients because the rib graft is strong enough to force a shape through scar tissue from previous surgeries.


Just wondering the previous surgeon that did the ear graft for you was he a known surgeon? do you think you will end up using Dr Toriumi?


My lumpy ear graft doc is not in the top five nationwide but he has appeared on some Best Docs lists. hmmmm....

I wouldn't rule out Dr. Toriumi as he is considered the best in the world by many of his peers in the field, I think he's done some amazing work and at this point there don't seem like too many obvious better choices for me. Attempting to manage his strong will is another issue that I would take up in a second consult.


anon can you please be kind enough to email me using above link. I like to talk to you in private.


Why won't you say the Dr's name? Or maybe you have & I didn't see that post?


it may leave you with the profile you want, but your frontal and 3/4 views will usually suffer given that the surgeon does not focus on them. several of his patients sought revisions. proceed with extreme caution.