24 days left for FFS, and pretty much I don't know what to tell to the surgeon during the consultation.  I keep thinking that I am no expert, that he does this on a daily basis and "surgeon knows best". So I have no clue about if I want an specific nose (because that nose may not BLEND with the rest of my face).

Half of my procedures are the kind where there aren't multiple aesthetic outcomes: Eyelids,  trach shave, lip lift... Right now the only ideas I have about telling the surgeon are:

- Forehead: Please, absolutely no Type 2. I want it as round as possible, and the x-ray clearly shows that it can't be shaven. I want a Type 3.

- Nose: I want the nasal spine and excess of collumelar tissue fixed. It's that kind of nose that pulls the lip away from the bone and it's in diagonal, giving me a "rat face"

I don't know. Do you leave it to the surgeon's experience, or you come with a magazine and say "I want a nose LIKE THIS ONE"?

I think the answer is a bit in the middle. Tell them what look you are trying to achieve, but listen when they tell you what is possible and how good the chances of success are for the  look you want.

I agree it's somewhere in the middle. Leaving it to the surgeon entirely may be bad in the sense that it may be aesthetically 'correct' (some surgeons in Korea even follow the Golden Ratio measurements - literally!) but that may not be something you like.

There is no perfect nose - but there's one that you and your surgeon can agree on. Eg. Do you want a ski-slope nose bridge or just straight? Do you want an upturned nose tip (gorgeous on some but looks like piggy nose on others)?

All the best!

You have a consultation and then FFS right after that? Geez. Why not do the consultation some weeks or months before?

I think the best is to thell the surgeon what you want to look like but go with what he thinks is best. If he says that your nose would look artificial with the changes you are desireing, most likely that is what is going to happen - with this surgeon. He can probably judge his own skills and outcomes best. If he says that something is a bad idea, either leave it to him or check another surgeon who is positive about this change - he will be the right one to do that specific change in the way that it looks good.

I dont think it is a good idea to demand something from a surgeon that he is not as experienced in or that he thinks is a bad idea - not because it really is a bad idea but because it is a bad idea to let him do it then.

Type 2 foreheads are almost enver done, right? I rarely hear anyone doing that.

Communication is key here he needs to know what you are looking for and you need to know how he plans to go about it.

I have what he proposed in the original message after sending the photos:

QuoteYour nose looks long with a mild nasal hump. I plan to reduce the
height of nasal bridge as well as the base of nasal bone for achieving of
smaller nose with slight concave profile. The tip-plasty by carving &
modification of lower cartilage structure will be also included to provide a
slight upturn & smaller nose tip. The alarplasty is recommended in
conjunction with rhinoplasty in order to adjust the size and shape of
nostril & base of nose.

TBH, I'm pretty ok with the proposed modifications. I got VFFS done, but she was not aware about nasal spine modifications (Somebody here sent me a rhinoplasty tutorial on how did they work.

Obvliously, I don want a micro nose. I have a long face and it would not fit at all. I just want it proportionate with the rest of my face instead of oversized, but not going over the top with making a "pig nose" (something like what I have seen with zukowsky several times).

I think the surgeons if they are good will be good judges on what fits your face. its their profession. Talking them into making the nose smaller or thinner or different may result in a weird look, I would not force them to do what they would not suggest. If you insist on changes you want and a surgeon says he does not suggest it - find a surgeon who thinks that it is a good idea, he may then also do other changes appropriately to fit your desires

There are a few things to consider with rhinoplasty, and you may want to look at bits of your nose individually to understand what it is you want done.

-Nasal depth. From a profile view, women tend to have much shorter nostrils than men. That is to say, the nostrils are closer to the tip.

-Nasal width. The width of a woman's nostrils (from a front view) is usually much thinner, especially as compared to the width of the bridge. Something important to remember with this is the width of the mouth, however; the width of the mouth is generally 1.6 times the width of the nose with a few millimeters of variation.

-Bridge depth. Women tend to have much more shallow nose depth. The depth for the bridge of the nose is dependent on the forehead, so a type 3 reconstruction typically allows much better results for a rhinoplasty than having the rhinoplasty done alone or with fillers/burring.

-Bridge curvature. Women more often have a bit of curvature or slope to the nose, whereas men typically have a very strong, very straight bridge. This feature is not as near-universal as some other gender dichotomies, such as brow/upper orbital rim prominence or chin length/shape (square vs. round), but it is something to consider.

-Nasal tip. This is sort of related to genetics. Some people have thinner cartilage, leading to a sharper tip, whereas others have very thick cartilage, leading to a thinner, less bulbous tip. If you have a bit of a bulbous tip, it is usually smaller in women than men, by contrast. If you have a very pointed tip, there is much less variation.

-Nasal angle. The base of the nose is slightly more upturned in women than men, leading to more nostril display. Men tend to have very perpendicular noses, the philtrum (area between upper lip and base of nose) being the other half of this angle.


When it comes to speaking with surgeons, it is very important to gauge their reactions and language much more than what they actually say. Does the surgeon seem very adamant about what limitations there are with the nose, or does s/he seem somewhat open-ended about what can be achieved? The former reaction usually indicates a surgeon who is unwilling to be aggressive, even if asked, whereas the latter indicates more willingness to be aggressive and attempt to fulfill the patient's needs. If the surgeon is all too eager to agree to your needs, however, they may be a bit brash or simply trying to get your money; make sure you look into their result history (especially third party testimonials) and be aware of how caring and nurturing they are.

If you're interested in more information about FFS, I would be happy to lend my opinion on your facial features through this thread or PM, if you like. It's a bit of a hobby of mine to both continuously learn and share about FFS, though do keep in mind that I am not a surgeon or an expert. I hope this helps, good luck!

It is important to communicate your expectations clearly. And then listen to his reaction. As it may be that he can't achieve what you expect and that us the worst type of regret. Take time to listen and contemplate on the results. Write down your feelings so that you can look back. And don't be afraid to ask for a second discussion if you are unclear on something.

My GRS consultation was smooth / I accepted Chettawuts assessment and was very happy with the results. Because I did not go with a list of expectations.

Quote from: Monkeymel on October 20, 2014, 02:54:53 PM

My GRS consultation was smooth / I accepted Chettawuts assessment and was very happy with the results. Because I did not go with a list of expectations.

Neither me, I did not ask anything like "I want's Hale Berry's Nose" (just an example, I can't even remember her nose)" or "make me pretty". I simply said in the email that I wanted to improve my appearance and passability. I have not been browsing nose galleries, or photoshopped my pictures. I don't really know the extent of how much Rhinoplasty can do. I could tell them to be aggressive or dramatic, but I'm simply ok with making it normal. Any conservative work is not going to work, since this is a seriously massive nose.

You should definitely know what you would like before going in to surgery. I would definitely suggest working with your surgeon for a plan of what he is going to do. You know what you want to look like your surgeon doesn't. This is going to be your new face you need to have input into it.

More or less I have an idea now, but I don't know if it is beyond what's physically and surgically possible. Once I see the surgeon's proposal during the consultation, I'll try to see if a balance between what he proposes and what I imagined can be achieved. I've been looking at his portfolio of examples, but there's not a "before" nose comparable to mine. And it's not BDD making it look bigger than it is. Both VFFS and two surgeons have deemed it as big and complicated. Even with VFFS she was not sure on how to approach it.



Looking at a random picture from the internet, I'd say that I want the one in the last file, second column from the left

Hehe, I think in tha tpicture I would make my cross in the center section for all three parameters

@Sybil, you sound as if you studied this - hehe. I still need to figure out what gives me a bad impression about my face at times. I guess we all have to learn a lot to make the right changes in our bodies to get it where it is supposed to be. I believe I have an idea already what may be important - having read the usual stuff like VFFS, but probably to say "hairline, frontal, nose, Jaws and Chin" is something that fits almost in all cases - buts its kind of a extensive approach. I would like to find a way to do the least invasive surgeries with the best outcome. Which is hard.

I was at a nose surgeon last year. He basically told me to not do any nose surgeries as anything i would do except maybe a small removal of a hump would look wrong on my face. So I left ther ebaffled that someone making his money with this told me to not do this.

Quote from: anjaq on October 21, 2014, 02:53:36 PM
@Sybil, you sound as if you studied this - hehe. I still need to figure out what gives me a bad impression about my face at times. I guess we all have to learn a lot to make the right changes in our bodies to get it where it is supposed to be. I believe I have an idea already what may be important - having read the usual stuff like VFFS, but probably to say "hairline, frontal, nose, Jaws and Chin" is something that fits almost in all cases - buts its kind of a extensive approach. I would like to find a way to do the least invasive surgeries with the best outcome. Which is hard.

I have learned a fair amount about facial anatomy and surgeries, yes. I find it very interesting (and useful, for my own needs). It sounds like you're looking for additional opinions? If you like, I wouldn't mind giving mine in a PM or something; I'm always open to helping anyone who'd like it.