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Anonymous asks:
Hi there, I am considering rhinoplasty. I have been to several consultations in London, however I have quite a specific issue and haven’t yet found a surgeon that I feel confident with. I want to change the dorsal hump, I also want to refine the tip of my nose, however the issue is that on the tip of my nose - off center I have a growth – one that I have had since my early teens, and I am now 28 years old now. I have had the growth looked at by 3 different dermatologist and they are all very confident that it’s a benign cyst/ skin lesion. Please see photos attached. When discussing the removal of the growth I was told that I would require open rhinoplastly and that the options for removing the growth where : 1) cutting out the growth with an elliptical cut that would then require sticking to close the wound, however I was told that due to the location of the growth, in order to close the wound the skin would be pulled and this would result in nostril deformity – which of course I do not want
2) The other option suggested was skin graft, removing the growth with a margin and grafting skin from behind my ear over the space created by the removal – with this I am worried that the skin grafted will be to obvious and perhaps leave too much scaring.

I would really appreciate your opinion on the matter, perhaps you a have another approach to delivering the best possible result.
Thank you, best Regards Val.

On: 05/21/2014 08:42 am

To doctors from: New York

Category: Face

Answers

DrNealGoldberg on 05/21/2014 01:00 pm wrote:
As the previous doctor explained, photos or an exam are absolutely required to give you good advice. If there is a significant lesion on you nose right now, however, it might be wise to consider treating it first before going ahead with a more complicated rhinoplasty. This was we are not trying to adjust too many variables at once.
DrWilliamRosenblatt on 05/21/2014 12:13 pm wrote:
I don't see any photos. I am an expert at Rhinoplasty as both ENT and Plastic Surgery based. I do almost all of my noses closed. I have removed lesions at the same time. I have not seen what your problem is, so I would need to see you in person before knowing what to do. Personally skin grafting seems like overkill and often we can remove a lesion with an inconspicuous scar. Feel free to email me a photos, That might help.
William B. Rosenblatt, M.D.
Lenox Hill Plastic Surgery Center
308 East 79th Street
Suite 1D
New York, NY 10075
212-570-6100
212-570-6155fax

wbrosenblattmd@verizon.net
www.WRMD.com
Follow my blog http://williambrosenblattmd.com/
DrDouglasMonasebian on 05/21/2014 11:49 am wrote:
Thank you for your questions and concerns Val. The aesthetic components of your rhinoplasty are straight forward. The medical concerns are more involved. I have often performed functional and aesthetic rhinoplasty together and would like to assist you. I would need to examine you to discuss all treatment options. I trust we can come up with a mutually rewarding plan that will meet all objectives. Please call our office to schedule this appointment. We look forward to meeting you soon.
Regards, Dr. Monasebian.
DrElliotJacobs on 05/21/2014 11:10 am wrote:
Dear Val

Removing a dorsal hump and refining the tip are routine parts of a cosmetic rhinoplasty. I am equally comfortable doing rhinoplasty "closed" (ie through the nostrils) or "open."

I cannot offer an opinion on removing the skin growth because I haven't seen it and do not know it's size. If it is a cyst, then it might be possible to remove it through a small incision, which should heal well. If it is a solid structure, then some alternative methods may have to be used. The pros and cons of each method would be discussed at the time of your consultation. Please call 212 570 6080 for an appmt.

Elliot W. Jacobs, MD, FACS
New York City