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Dr Grigoryants Reviews | Dr Vladimir Grigoryants Reviews

Saturday, May 13th, 2017

When selecting a plastic surgeon, patient frequently turn to online reviews.  We would like to warn our prospective patients that recently   someone  started writing negative reviews about our practice on various websites.  This poster under different user names creates  posts  with with false and misleading stories accusing us of causing different rhinoplasty complications.

        I have been performing rhinoplasty for over 10 years. Rhinoplasty is the most commonly performed procedure in my practice and I do this surgery every day. Over 90% of my patients are happy with their results. My practice is busy and based on numerous referral from my patients and colleagues, including their family members and friends. I have performed rhinoplasty on many of my own family members, employees, colleagues, and celebrities. Having performed numerous rhinoplasty procedures, we have been able to improve closed rhinoplasty techniques over the years  to produce better cosmetic and functional results.
Despite our high satisfaction rate,  occasionally we have patients who are not  happy with their results. Every busy rhinoplasty surgeon has patients who are unhappy with their rhinoplasty results. By now, I have re-operated or consulted on patients from most busy plastic surgeons in the country and many patients from abroad. Many unhappy patients actually have good noses and not every patient can be made happy.
       I do my best to understand what kind of result the patient is looking for and discuss surgery on the day of our consultation, on the day of our preoperative visit, and again on the day of surgery. I show patients in the mirror what to anticipate based on our discussion. Some patients want an upturned nose, some want a straight profile, some prefer to raise the tip of the nose and some do not. I do what we agree on before surgery. Despite my efforts, not every patient can be made happy. Patients who are sure about what they want and do not want, communicate to me their goals well, and have realistic expectations are typically happy with their results.
  Perception of a good or bad result after rhinoplasty is very subjective. Therefore, anyone considering rhinoplasty should look at the before and after photos and decide for themselves if they like the results.
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You can view real patient  rhinoplasty results here:
– Rhinoplasty videos on our instagram page   –   drvladimirgrigoryants
–  Realself review –  Rhinoplasty with Dr. Grigoryants , happy!  by Flowii
– RealSelf review –   Rhinoplasty with Dr. Grigoryants by LifeofPi– Hello all, I ‘ve been a member here on Realself…
– Realself review –  Very Happy After Rhinoplasty with Dr. Grigoryants !- Glendale CA by Juno1
– Realself review –  Grigoryant’s Gal-Posop 1 Year! by RoxZDr. Grigoryants review
– Realself review – Dr Grigoryants . Yes. He’s the BEST. Glendale, CA by TLC_14
– Realself reviw  –  Waiting list for Revision Rhinoplasty Dr Vladimir Grigoryants -Glendale, CA by Joegal
– Realself review – 20 year old, Rhinoplaty with Dr. Grigoryants by audreyy99
– Realsefl  review – Nose Master, Glendale CA  BelleChanel
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This post discusses dr grigoryants,  dr vladimir grigoryants, dr grigoryants reviews

What are spreader grafts?http://www.vgplasticsurgery.com/blogs/what-are-spreader-grafts/

Friday, February 26th, 2016

Review of Spreader Grafts  by Dr. Vladimir Grigoryants

Spreader grafts are frequently used in rhinoplasty.  Spreader grafts are strips cartilage made of patients own cartilage that are placed on each side of the septum ( between the septum and the side wall).   Typically, the mid or lower portion of the septum is harvested to make spreader grafts.  Other synthetic materials or other sources of cartilage (e.g ear cartilage) can also be used for spreader grafts. I prefers to use patient’s own septal cartilage to make the spreader grafts.

1. Why are spreader grafts needed? 

Spreader Grafts Drawing

Spreader grafts are very important to prevent midnasal  collapse (also known as an internal nasal valve collapse or inverted V deformity).

The dorsal aspect of the septum (the top or the bridge)  is naturally wider than the portion below it,  looking like a letter  T.  The wider part of the T  holds the side walls apart.  This is the internal nasal valve.   When the dorsal hump is removed that wide portion of the septum  (horizontal part of the T)  is removed in most cases leaving the narrow portion of the septum, looking like an  letter I.  Without reconstructing that  wide portion of the dorsal septum, the side walls will invariably  collapse causing nasal valve obstruction (breathing obstruction) and cosmetically collapsed nose, called an  inverted V deformity.   Therefore,  in nearly all cases, when  dorsal hump reduction is performed, spreader grafts should be used to prevent the sidewalls from collapsing.    In some patients, with or without the dorsal hump, the wider portion of the T is naturally narrow causing nasal valve collapse on inspiration. Spreader grafts are used to reconstruct the internal nasal valve and improve nasal airway patency in these patients.

Furthermore, the spreader grafts also used close the open roof following dorsal hump reduction. Click on the diagram above to enlarge it. 

So, spreader grafts support the sidewalls, preventing them from collapsing and maintaining or improving  the  internal nasal valve.   Aesthetically, spreader grafts allow to produce smoother nasal contour line from the forehead to the tip on the front view, knows as dorsal aesthetic lines.  The spreader grafts are not visible as they are placed between the septum and the lateral walls.

Please google Inverted V deformity in Google images to see what an Inverted V deformity looks like when spreader grafts are not used.

 

2. Will spreader grafts make the nose wider following dorsal hump reduction?

Patients with a wide dorsum (bridge) will have narrower noses following dorsal hump reduction, spreader graft placement and nasal bone narrowing via osteotomies.

Those patients with a narrow midportion of the bridge preoperatively will have a slightly wider midportion of the nose after spreader graft placement, which would be aesthetically more appropriate and better functionally.

Patients with an average dorsal width of about 7 -12mm will usually have about the same width after surgery as before surgery.  It is possible for the width of the midnasal area to be slightly wider after surgery  if the nose is significantly deviated and additional spreader grafts are needed to keep the nose straight.

It is very important to note  that even 12 months after rhinoplasty there is  still a small amount of swelling that takes years to go away. So, the nose may initially appear wider and continue to narrow during the first several years.

 

Case Example

This patient underwent rhinoplasty almost three years ago. Her dorsal hump was removed and the  tip and nasal bones were narrowed.  Spreader grafts, septoplasty and turbinate reduction were performed to treat nasal airway obstruction.  The bridge/midnasal area and tip  appeared wide preoperatively. Spreader grafts allowed to produce smooth dorsal aesthetic lines (lines from the forehead to the tip on each side of the dorsum) and prevent nasal wall collapse. The midnasal area is narrower postoperatively.

Dr. Grigoryants rhinoplasty

 

 

To learn more visit  http://www.vgplasticsurgery.com/los%20angeles%20nose%20reshaping(rhinoplasty).htm

 

 

 

Dr. Grigoryants’ Post-rhinoplasty Instructions

Sunday, December 27th, 2015

The following instructions are given to Dr. Grigoryants’ patients after rhinoplasty. These instructions may be modified for each patient depending on what was performed during surgery.

First day after surgery:  Keep you upper back elevated 30-40 degrees.  Apply cold compress (cloth soaked in cold water or crushed ice  in a glove placed over a cloth) during the first 24 hours. Avoid applying anything frozen directly on the skin.  Start taking antibiotics (prescribed by Dr. Grigoryants) the same evening and prescribed pain and nausea medications as needed (read instruction labels on the medications).

Facial swelling tends to get worse during the first 3 days after surgery and improves by the fifth day after surgery.  Call Dr. Grigoryants’ office to schedule your postoperative appointment 5-7 after surgery.

Starting day 3 : Start cleaning the bottom of the nose gently using cotton balls or facial tissue soaked in warm water.  Apply Vaseline on the  rims of the nostrils once a day. Do not put Q-tips inside the nose.

Day 5-7:  Dr. Grigoryants will remove your splints and sutures if nostrils were narrowed.  Having the nostrils lubricated with vaseline prior to the appointment makes suture removal less uncomfortable.  Dr. Grigoryants does not use nasal packing.

– Irrigate the nose with saline spray (also known as Ocean spray).  Apply Vaseline inside the nose at night for two weeks using a corner of an open paper napkin rolled into a cylindrical shape (Q-tips are too stiff and my cause injury ).  Sutures and dry secretions/dry blood will come out. Breathing will improve.

– Tape your nose only at night.  Although taping will not affect the final result, it will help minimize  swelling that develops overnight during the early postoperative period.

– Avoid alcohol and  blood thinners (aspirin, motrin, advil, excedrin, naproxen, ibuprofen, vitamin E, fish oil, omega 3 fatty acids, herbal  supplements ) for 2 weeks after surgery.

– Showers, make up, facial creams can be restarted.

Nose blowing: Can be started gently 2 weeks after surgery.

Driving:  You may drive when facial swelling is not impairing vision and you are no longer taking pain medications.

Exercises:  Avoid bending for 2 weeks after surgery.  Exercises can be resumed 1 month after surgery.

Swimming:  Swimming with submerging head in the water can be started 2 months after surgery.

Sun exposure: You may be in the sun but avoid prolonged exposure. Use a hat to protect your nose.

Pore strips:  May be resumed 3 months after surgery.

Unpleasant smell in the nose: May occur in some patients after rhinoplasty and will go away over time.

Stiff upper lip and smile:  Usually resolves by 2-3 months after surgery.

Flying on airplanes:  You may fly 7 days after surgery. Dr. Grigoryants will review special in-flight care instructions with you.

If you have additional questions, please contact Dr. Vladimir Grigoryants at 818 952-7070 or via email at  vladgrigor@gmail.com

 

Physical Activity After Rhinoplasty

Thursday, March 6th, 2014

Instructions given to Dr. Grigoryants Patients

Walking –   The next day after rhinoplasty

No bending for 2 weeks

Light running – 3 weeks after surgery

Weight Lifting-   start gradually 1 month after surgery.

Swimming – 2 months after surgery .

Rhinoplasty to Improve a Facial Balance – Front View Analysis

Saturday, October 19th, 2013

 

Rhinoplasty requires  not just surgical skills but also understanding of facial proportions.  Preoperatively, patients frequently ask how narrow should my bones or tip be or how much will my tip be lifted.

The following are general observations of facial-nasal relationship found in models.

1.  The width of the nostrils is about the width of the vertical lines drawn from the inner corners of the eyes

2. Nasal bony base width is narrower than the alar (nostril) base width

3. Tip width slightly wider than the width of the filtrum (cental portion of the upper lip)

4. Position of the tip slightly higher than base of the nostrils

 

The front view of the patient below shows how nose surgery can improve facial-nasal harmony.  This patient underwent closed rhinoplasty.

Many patients, however, may have specific preferences as to how they would like their noses reshaped.  A detailed discussion between the patient and  nose surgeon  considering the  patient’s goals and reshaping suggestions from the  surgeon typically results a well thought out plan and best chances for a successful outcome.

To view more before and after photos of Dr. Vladimir Grigoryants patients, visit  our photo gallery

Nasal taping after rhinoplasty

Thursday, August 15th, 2013

Dr. Vladimir Grigoryants removes the nasal splint 5-7 days after rhinoplasty. His  patients are instructed to tape the nose for at least  3-4 weeks every night. Although taping affect the final result, it will reduce swelling in the morning.  The nose, especially the tip of the nose tends to swell overnight. Having the tape minimize that swelling.  Our patients frequently report that when they do not tape the nose, they wake up with a thicker appearing nose.   A special light brown paper tape will be given to our patients when the splint comes off. We will also show how to tape the nose.  Some patients may develop irritation from the tape in which cases they will be instructed to stop taping.  Foods rich in salt, alcohol, and strenuous physical activity may increase swelling.

Visit our rhinoplasty page to learn more about rhinoplasty with Dr Vladimir Grigoryants.

Dr. Vladimir Grigoryants reviews swelling after rhinoplasty

Wednesday, August 14th, 2013

Patient undergoing rhinoplasty need to be prepared to experience different staging of swelling.
Unfortunately, there is no way to have rhinoplasty without swelling and take more time for swelling to resolve after rhinoplasty than after other plastic surgical procedures. Swelling after closed rhinoplasty tends to resolve faster than after open rhinoplasty.

1. Onset of swelling. Swelling develops around the nose and upper face day 1-3 after surgery and tends to look more pronounced during these first 3 days. This usually happens in patients who had work on the nasal bones.

2. Splint Removal . In our practice, the splint comes off on day 5-7 after surgery. At this stage, most of pronounced swelling around the eyes has improved. There may be swelling in the bridge of the nose, face, and upper lip. Noticeable facial swelling improves fast over the next 7-10 days. The upper lip may appear longer and the smile may feel stiff. This resolves gradually within 30-60 days. The tip may look more upturned and it will come down over the next 7-14 days.

3. Upper part of the nose. Although the entire nose will be gradually shrinking and softening, swelling in the upper part of the nose will be resolving faster. By 30-60 days after surgery most upper nasal swelling will subside and the skin will feel soft in the upper part of the nose.

4. The tip. Although one may read online that it takes one year for all nasal swelling to go away, the reality is that it takes several years for all swelling to go away before you can see the final shape. At the end of the first year after surgery, the patients are likely to see 85-90% of swelling resolution and by the end of the second year almost all of swelling will resolve. Patients with think nasal skin may take longer to heal. Once nasal tip swelling resolves, the tip feels softer and tip cartilages become more visible and easier to feel.

To learn more about rhinoplasty with Dr. Vladimir Grigoryants, visit our rhinoplasty page.

 

Dr. Grigoryants Los Angeles cosmetic surgeon provides plastic surgery services throughout Southern California including Glendale, Burbank, Pasadena, Los Angeles, Encino, Huntington Park, Studio City, Arcadia, Montrose, Hollywood, La Crescenta, La Canada Flintridge, Valencia, Monrovia, Eagle Rock, Altadena, San Marino, Sherman Oaks, Thousand Oaks, North Hollywood, Long Beach, Beverly Hills, Van Nuys, Santa Monica, Calabasas, Palmdale, Fresno, Northridge, and Westlake Village, and Simi Valley.

Our Plastic Surgery center in Glendale, Los Angeles, California specializes primarily in Cosmetic Plastic Surgery inclding breast enlargement, breast augmentation, breast implants, liposuction, tummy tuck, abdominoplasty, cosmetic facelifts, rhinoplasty (nose surgery, nose job), Forehead Lift, Eyelid Surgery and other body contouring procedures. The center led by an expert Los Angeles Plastic and Cosmetic Surgeon. As a board certified Los Angeles plastic surgeon, Dr. Grigoryants is dedicated to providing high quality yet affordable cosmetic plastic surgery options to Los Angeles patients and being the best plastic surgeon in Los Angeles, Glendale, Pasadena, Beverly Hills.

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