Plastic Surgeon Los Angeles call  
Home About Us Before & After Testimonial Our practice Locations In the News Contact Us
 

Posts Tagged ‘rhinoplasty los angeles’

What are spreader grafts? Dr Grigoryants Reviews Spreader graft use in rhinoplasty

Tuesday, May 30th, 2017

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 Reviews Post-rhinoplasty Instructions

Tuesday, May 30th, 2017

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

 

Will All Rhinoplasty Patients Experience A Voice Change?

Friday, February 7th, 2014

We have not observed any voice changes in our patients or received reports from patients that their voice changed  after rhinoplasty

Rhinoplasty: Choosing the Right Shape for the New You

Friday, January 3rd, 2014

Your nose is one of the most definitive parts of your face, and its size is one of the first things people notice. Now that the new year is here you have considered taking the next step in altering your appearance, because the shape of your nose continues to make you feel self-conscious. There are plenty of options to consider during rhinoplasty, and Los Angeles rhinoplasty surgeon Dr. Grigoryants is available to show you the best shape for your nose.

Rhinoplasty is mostly an elective procedure that reshapes the nose for aesthetic purposes, but it is sometimes necessary to resolve functional issues that have been caused by injury of deformity. Being unhappy with the nose shape you were born with is a common feeling among many candidates considering rhinoplasty, so a consultation with your plastic surgeon will help you determine a shape that refines facial harmony.

The alterations made to a patient’s nasal structure considers all the components that make up the person’s nose. This includes:

  • Nostrils
  • Bridge
  • Septum
  • Nasal Bone
  • Cartilage
  • Tip

Depending on the patient’s goals and agreement with their surgeon all of these areas can be addressed during procedure. Results of nasal surgery are never hurried or drastic, which is why a skilled plastic surgeon attempts to bring out near perfect harmony and balance with their patient’s facial features.

Determining Shape

During consultation is the best time to discuss the desired shape of the nose. Cosmetic surgeons agree that people should always strive for a look that is natural, so a female may consider more feminine results that include straight nasal bridge, slight lift and a nose that is not too long or pointed.

Many nose surgery candidates also consider the results of friends or celebrities who had a nose job. A plastic surgeon will remind their patients that a copycat or imitation nose surgery is not the best decision. Attempting to capture someone else’s look may appear artificial or out of balance with genetic makeup. However, this gives the surgeon an idea about how to achieve the shape for you, and the doctor can communicate the features that are achievable.

According to the American Society of Plastic Surgeons, a nose surgery candidate can expect to discuss their expectations and desired results from rhinoplasty during consultation. With respect to their patients’ desires, the plastic surgeon will determine the procedure’s reshaping of the nose as well as likely outcomes of nose surgery.

The goal of nose reshaping surgery is to make the nose as natural as possible. Dr. Grigoryants can show you the steps he takes to define your nose shape to restore facial balance and harmony. Then you can decide how beneficial rhinoplasty can reflect your appearance for the better.

Common Reasons Patients Seek Revision Rhinoplasty

Wednesday, November 13th, 2013

Just as any other surgery, there are certain misfortunes that cannot be avoided. Rhinoplasty is probably one of the most difficult cosmetic surgeries and most plastic surgeons will admit to this. No one can claim to provide their patients with the perfect nose. However, years of experience, practicing up to date techniques and utilizing the latest technology will attempt to meet and surpass patient expectations. Revision rhinoplasty is called upon rare instances in which patients feel unsatisfied with their initial results and seek advanced aesthetic improvements. There are many reasons patients seek a secondary nose surgery, today we will discuss the common reasons why patients request secondary rhinoplasty.

Results of Initial Procedure were Undesirable

It is a rarity when the patient and the surgeon are not on the same page to meet expected results. This is when the need for thorough consultation with the surgeon is advised to avoid such outcomes. Careful planning and execution the second time will to ensure that aesthetic results match the patients’ preference.

Patients Experienced Unfavorable Healing

Following recovery many patients observe excessive scarring as a result of poor healing. The initial surgery was smooth and recovery may have gone well, but the nasal structure did not conform to its natural state. In this case revision may restore nasal shape and remove excess scar tissue.

Breathing Complications Arose

The patient’s ability to breathe comfortably following rhinoplasty is an important part of the procedure. In some instances, breathing issues develop. Revision for this complication restores the patient’s breathing while improving appearance to excess cartilage or bone previously removed.

Post Surgical Injury Affected Nasal Structure

The nose is the most vulnerable part on our face, and it is more likely to receive injury when objects strike the head. The sensitivity levels increase when the patient sneezes following rhinoplasty. Plastic surgeons always instruct their patients to practice safe habits to avoid injury, but we all know that accidents are bound to happen when least expected. Hold in sneezes and avoid blowing the nose until your surgeon allows full use after recovery.

Patients often worry that they may be going back under the knife too soon, so the ideal time to consider revision is after a full year following the initial procedure. This allows time for incisions to heal and allow the shape to conform with the face.

Plastic surgeons never admit to performing the perfect treatment. They provide their patients with accurate expectations and will make corrections that achieve balance with facial features. Every rhinoplasty procedure is different for every patient and it is not a failed surgery if expectations are not met or complications follow, it is a part of the cosmetic process. If you feel that your nasal appearance is unrealistic or unsatisfactory, schedule an appointment to discuss revision rhinoplasty with board certified plastic surgeon Vladimir Grigoryants in Los Angeles.

Friends Starlet Shares How Nose Surgery Changed Her Life

Wednesday, November 6th, 2013

Beauty, brains and friends are some of the most important things every young girl struggles with, even Hollywood actress Lisa Kudrow found herself as an outcast among peers. The former Friends star, known as Phoebe on the hit NBC show, revealed that she had undergone rhinoplasty, and celebrates her experience as a one that altered her life for the better.

Kudrow, 50, expressed no regrets for her decision in an interview with the Saturday Evening Post about her decision to have nose surgery at the age of 16. In her mind, she went from “hideous to not so hideous,” which made her feel the experience as “life-changing” as she transitioned through high school.

From Outcast Teen to Emmy Winner

A few of her childhood friends felt they needed to spare their friendship with Kudrow entering junior high school, leaving her friendless and disappointed. Being depressed going into high school with the same group of peers was no picnic either.

“For your own good, you need to see what would happen if we weren’t here,” said Kudrow about the experience of her friends evicting her. A difficult pill for her to swallow.

She took the initiative to gain a spark of confidence and had nose reshaping surgery during one summer and transferred to a new school. Only then was she able to feel the excitement about attending school and feel comfortable with her appearance. It turned her life around for the better, Kudrow said.

She dove deeper within academics and attended Vassar College in New York. She flirted with ideas of medical school, but it was then where she decided to get into acting. After her breakthrough role on Friends, she has become a highly requested actress, performing in about 30 films as well as many appearances on other television series, including her latest role on ABC drama Scandal.

Advantages of Rhinoplasty

In Kudrow’s high school days, teens were not frowned upon as they are now for undergoing plastic surgery. Surgeons express that maturity is a big concern for making the decision to get nose surgery, and in Kudrow’s case she understood the role rhinoplasty played. Photos of Kudrow before the surgery depicted a nasal tip that protruded and was bulbous in shape. Now the actress’s nose is shorter and smaller, which continues to prevent the hideous feeling that she once felt about her appearance. According to the American Society of Plastic Surgeons the changes of rhinoplasty include:

  • Corrections to nasal asymmetry and deviation
  • Reduction of wide, large or upturned nostrils
  • Adjustments to visible humps or depressions
  • Reshaping nasal tip that is bulbous, drooping or upturned
  • Promotes balance of facial features

Kudrow fans continue to show their praise for her performance on Friends. Her Twitter feed and Facebook display young girls who look up to her character. Kudrow expressed that it is a good feeling to be a role model for her fans beyond the end of the series. Her nasal appearance may have made an impact to her roles as an actress, but she feels that her procedure played an important role in her life. She was able to display her character with confidence, without having to worry about the overbearing and unbalanced features from her youth. Learn more about what rhinoplasty has to offer to help inspire a change in your life.

Even Iconic Beauties Can Benefit from a Little Nip/Tuck

Thursday, October 31st, 2013

Today when you look at Maxim magazine how many of the cover girls do you think had plastic surgery? It is not too shocking to learn that they had work done, but Marilyn Monroe on the other hand, was perceived as a natural beauty. A Southern California plastic surgeon claims to hold evidence proving that the legendary model and actress had cosmetic surgery. Monroe’s au natural presence continues to thrive well beyond her death in 1962, and now X-rays and doctors notes report that the icon had enhancements including chin implants and rhinoplasty.

Marilyn was constantly in front of the camera, so the fact that she had work done shouldn’t change her legacy. She wanted to maintain her appearance and be her best on the silver screen and in public. In the 1950s, the rise of Monroe’s career, there was not a presence of paparazzi that hounded their lives as they do today. Her surgical visits went unnoticed by the press. In that era plastic surgery was fairly new and kept under wraps if you were a public figure. Photos of her early days in modeling compared to work later in her career show differences in her chin and nose, which indicate surgical enhancements.

Did She or Didn’t She?

Monroe will forever remain a woman of beauty and her legacy will continue to thrive as a legend in the modeling and film industry, and evidence of surgery would only indicate that she was interested in keeping up with her appearance in Hollywood stardom. She may have been made over by Michael Gurdin in two procedures as early as 1946, coinciding with her name change and signing with Twentieth Century-Fox Studios. A chin augmentation, using bovine (cow) cartilage, would have filled her jawline out to give her a more distinct shape and improve facial proportion. Her nose was said to be fractured in the year of her death and the X-rays indicate that she may have had a nasal tip refinement.

Justifying Her Unveiled Medical Records

Much of society and public authorities are up in arms to the news that her medical records are going up for public auction. According to the Department of Health and Human Services, Health Insurance Portability and Accountability privacy act rules prohibit disclosure of medical records until 50 years after a person’s death. Many are unaware, but Marilyn passed away 51 years ago. The unveiling of her records is legal and her records are to go up for auction in November. The proceeds are to be donated to U.S. veterans in need of medical work.

Cosmetics and Beauty Today

Plastic surgeons of today strive to achieve natural beauty for every patient that improves their facial form and body contour as they see fit. Chin augmentation is no longer with the use of cow cartilage, but with FDA approved silicone implants. Aesthetic improvements for the nose are to improve shape and restore balance for a bulbous tip, improve breathing or reduce nasal humps.

Model or not, everyone has a fair share of aesthetic improvements they wish to achieve for their appearance. Plastic surgery only proves to show that if Monroe did in fact have the procedures done, without advanced technology of today, made her appear natural. Those interested in exploring options with plastic and reconstructive surgery can visit Dr. Vladimir Grigoryants in Los Angeles. He is a board certified plastic surgeon offering comprehensive treatment with amazing, natural appearing results.

Improve Facial Harmony with Rhinoplasty

Saturday, October 19th, 2013

Nose surgery (nose job) can produce a very pleasing  aesthetic  balance of the face especially in  patients with large noses preoperatively. Common changes performed in rhinoplasty in such patients  are reducing the dorsal hump, refining and possibly raising the tip, and shortening the projection of the nose.   In some patients, the size of the nostrils is also reduced.

Aesthetic benefits achieve with rhinoplasty are the following:

-Reducing the dorsal hump allows to accentuate the eyes and cheek bones.

-Decreasing the projection of the nose improves the balance between the nose and the chin ( and lips)

The angle between the columella and upper lip is considered aesthetically desirable  to be 95-100 degrees in women and 90 -95 degrees in men.   This results in a more youthful appearance of  the nose in patients with droopy noses preoperatively

 

 

These are general guidelines. Patients’ preferences need to be considered when formulating a rhinoplasty plan.  For example, some patients prefer to preserve ethnic or family features and may not wish to reduce the size of the nose much. A combination of surgeon’s recommendations and patients goals typically results in a better nose reshaping balanced plan.

 

Dr. Vladimir Grigoryants Plastic 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

Rhinoplasty: Your Nose, Not Clones

Friday, October 18th, 2013

A controversial epidemic swept through Korea earlier this year when a group of aspiring Miss Korea 2013 contestants had faced claims that cosmetic procedures left all of them looking the same. Currently, South Korea boasts a booming plastic surgery industry with more young people turning to plastic surgery than any other country. Much of South Korea’s booming plastic surgery industry is fueled by an obsession to look more “westernized.” In the United States most surgeons feel that patients can turn to plastic surgery to achieve aesthetic results to make improved versions of themselves, NOT to look like someone else.

Rhinoplasty, offers men and women the ability to reshape their nose for a more balanced and natural appearance. Surgeons do their best to achieve the desired results for their patients, but they do not recommend nasal surgery to look like someone else. That person’s nose is suitable for their facial contours, it does not mean that a flattering nose will look good on everyone else. There is no one size fits all procedure, a patient’s goals will be established during consultation and the surgeon will predetermine results.

Why Men and Women Seek Rhinoplasty in Los Angeles:

Most patients that seek out Rhinoplasty in Los Angeles want a nose that matches the rest of their facial proportions. They want to correct a large dorsal hump on the bridge of the nose or shrink down a bulbous nasal tip. State of the art technology aims to give the surgeon assistance needed to achieve the best results possible, while maintaining the natural look of the patients facial features.

Other patients go through surgery to restore breathing function when they are limited to certain breathing levels because of a deviated septum. Patients turn to nose surgery for reasons including the following:

  • Unhappy with size and shape
  • Feeling of a crooked or disproportionate nose
  • Correct upturned nose or drooping tip
  • Repair unusually large or small nostrils
  • Injured nasal structure did not heal properly
  • Appearance of the nose reduces confidence
  • Wish to combine rhinoplasty with other facial enhancements

According to the American Society for Aesthetic Plastic Surgery, rhinoplasty is one of the most frequently performed procedures that has a greater impact on a patient’s appearance. The nose is the most defining characteristic of the face and even a simple alteration can achieve great improvements for a person’s appearance.

Striving for a Natural Look

Even the greatest plastic surgeons tell their patients that perfection cannot be achieved and their goal is not to make the nose appear like someone else. The goal is to achieve the patients desired results while maintaining the natural contours of the face, this creating facial harmony that makes the patient proud to show off THEIR features.

Surgical skills alone will not guarantee a successful outcome, patients with good tissue and complimentary healing responses will promote a successful procedure. With today’s advanced technology and Dr. Grigoryants vast training and experience a natural and beautiful nose that will compliment the facial proportion for a lifetime can be achieved through Rhinoplasty in Los Angeles.

 

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.

Plastic Surgery Website Design and Search Engine Optimization by www.intactinfo.com