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Reasons Why People seek Revision Rhinoplasty

September 19th, 2013

Nose surgery offers results that can significantly improve your overall appearance. Helping you understanding what the surgery can and cannot do is part of the consultation with the plastic surgeon. Before the patient and surgeon commit to the procedure, predictions of results will settle patient’s expectations. Rhinoplasty is a complex, custom-fit operation that offers substantial aesthetic improvements, but there are occasions where patients are left with imperfections. When deformities and flaws are dissatisfying, revision rhinoplasty may be appropriate and necessary.

Revision rhinoplasty can be done to correct functional or aesthetic issues not addressed or brought about by a previous rhinoplasty procedure. Surgeons advise a revision surgery for patients who developed breathing issues and cartilage loss. Patients also seek revision after initial nose surgery to correct aesthetic flaws that their first surgeon failed to correct. Dr. Vladimir Grigoryants is visited often to treat patients for revision rhinoplasty in Los Angeles. Many of his patients will seek his attention to correct flaws from previous surgeries and he achieves success from the closed rhinoplasty technique.

Closed rhinoplasty allows the nose to be reshaped from the inside. Incisions are not made across the columella and lift the skin as it is in open rhinoplasty, instead the dorsal hump and tip is reshaped from incisions inside the nose. In rare instances where patients received open rhinoplasty, Dr. Grigoryants would resort to the open technique to correct scarred tips.

How Long Should I Wait Before Undergoing Revision Rhinoplasty?

After the initial rhinoplasty procedure the patient may see results within the first few days, but the face needs to adjust to the enhancement for a few months and allow the swelling to subside. Most surgeons advise to wait a minimum of six months to a year before considering revision rhinoplasty.

It is necessary to wait to allow the face to heal and allow scar tissue to mature. This permits the surgeon to perform revision rhinoplasty with healthy scar tissue and achieve better results.

Reasons for Revision Rhinoplasty

Patients undergo revision rhinoplasty for a number of reasons. The most common reason Dr. Grigoryants comes across is the disappointment from the outcome of their initial rhinoplasty procedure. The patient’s nose is now too small or still too large, the shape looks crooked, or the patient is suffering from nasal obstructions. Naturally, aesthetic flaws leads to cosmetic dissatisfaction. Such flaws may include:

  • Displaced implants or cartilage grafts that look round and bulbous
  • Too large, small or wide in appearance
  • Inadequate tip projection, droopy tip
  • Asymmetrical appearance

Functional problems that develop as a result of a primary rhinoplasty procedure that led to nasal obstructions making it difficult to breathe or constantly feeling stuffed up can lead a patient to seek revision rhinoplasty.

According to a study from the American Society of Plastic Surgeons, most secondary rhinoplasty cases are considered appropriate to correct new developments or unresolved conditions from initial procedures. There were 150 participants seeking revision and 90 percent of those patients were determined as acceptable candidates. After revision, 97 percent of the patients treated were satisfied with the outcome.

Candidates for Revision Rhinoplasty

Secondary rhinoplasty may be appropriate to fulfill patient expectations that primary procedures could not reach. Candidates for revision should be in good health and present valid reasons of dissatisfaction of results. They must possess realistic expectations for results of treatment.

Patients must wait a minimum of six months for the site to fully heal before secondary surgery. Depending on the body’s healing abilities, patients may need to wait longer than six months to obtain revision. Scar tissue must be healed and healthy before the surgeon can treat the site properly.

Schedule a Consultation

Dr. Grigoryants plans a custom revision rhinoplasty to treat the needs of his patients. He considers the details changed from previous surgeries and applies precise techniques to correct new developments or untreated aesthetic flaws. Book your appointment in Los Angeles for revision rhinoplasty, you can still achieve the results you deserve. If you are dissatisfied with your initial rhinoplasty discover the quality results of revision rhinoplasty with Dr. Grigoryants.

Breath Better with Rhinoplasty

September 10th, 2013

Many people are unsatisfied with the shape of their nose and turn to rhinoplasty to promote balance and improve attractiveness. However, there are many people suffering because they have a defect in their nose that prevents them from breathing normally. After clearing your nose with nasal saline spray do you still experience problems breathing? Even after treating congestion problems does it feel like there is something still blocking your airways. There could be structural issues that have developed and are responsible for blocked airways. Fortunately rhinoplasty can restore normal function of the nose as well as enhance the appearance while balancing out your facial proportions.

Rhinoplasty, more commonly known as nose surgery, is a cosmetic surgery designed to reshape, restructure, and treat any nasal airway obstructions. Board certified plastic surgeon, Dr. Vladimir Grigoryants has mastered an effective rhinoplasty technique which offers his patients maximal results with minimal downtime. This technique allows him to reshape the nose without leaving behind visible scars or damage.

What Causes Nasal Obstruction?

There are many reasons why the nasal airways can be blocked, affecting a person’s breathing. A plastic surgeon is able to evaluate the underlying problems and create a plan of treatment to improve breathing and aesthetic appeal. Some common issues that can result in nasal obstruction are:

  • Deviated septum

  • Internal valve collapse

  • Enlarged turbinates

  • Nasal polyps

What are Signs of Airway Obstruction?

Nasal obstruction can affect a patient’s quality of life as it causes fatigue, poor sleep quality, loss of energy and snoring. Symptoms of airway obstruction include:

  • Nasal congestion

  • Mouth breathing

  • Dry mouth

  • Reduced sense of smell

  • Recurring sinus infections

  • Sleep disturbance

Treating Nasal Obstruction:

Patients can improve nasal airways with treatment from Dr. Grigoryants. He will correct a patient’s deviated septum through septoplasty. A hidden incision is made in the nose to straighten the crooked septum.

Enlarged turbinates can cause frequent nasal airway obstruction. They swell and shrink throughout the course of the day negatively affecting nasal breathing. It is initially treated with nasal sprays to reduce tissue growth, but for patients who are unresponsive to treatment, surgical intervention can definitively treat the enlarged turbinates. During surgery the turbinates are reduced to normal size, thus restore breathing function.

The internal valve area is located a little less than halfway up the nose, in the middle of the nasal bridge. This is a very sensitive area and the height or width of the bridge can affect the valve. Invisible spreader grafts and sutures reconstruct cartilage attachments and maintain good flow of air through this region.

Why Should you Correct Nasal Airway Obstruction?

The nasal airway plays a key role in bringing oxygen into the body. A damaged nasal passage will not perform its functional duties of filtering air pollutants and bringing in adequate amounts of oxygen. In Southern California quantities of pollutants continue to increase daily and is likely to affect those with nasal problems.

According to the American Society of Plastic Surgeons, nose surgery improves appearance and proportion of the nose as well as correct impaired breathing that was caused by structural abnormalities. Only the most experienced plastic surgeons are capable of achieving cosmetic improvements and enhance breathing function.

What to Expect After Rhinoplasty:

Patients may experience a few effects immediately after treatment, including swelling, discomfort, and pain. These side effects of the surgery will subside over time and airflow will gradually improve.

A well-planned rhinoplasty will alter the shape of the nose and improve the nasal passage for smooth and easy breathing. Dr. Grigoryants offers treatment options to correct airways for patients suffering from nasal airway blockage.

Discover how you can reduce signs of nasal airway blockage with the help of Dr. Grigoryants. His precision and accuracy will remove obstructions in nasal structures and patients can enjoy breathing freely. Open the airways to a healthy life with rhinoplasty in Los Angeles.

What are spreader grafts?

August 30th, 2013

Spreader grafts are frequently used in rhinoplasty.  Spreader grafts are strips 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. Dr. Grigoryants prefers to use patient’s own septal cartilage to make spreader grafts.

Spreader Grafts Drawing

Spreader grafts are very important to prevent midnasal  collapse (also known as an internal valve collapse or inverted V deformity).  In fact, in nearly all cases when dorsal hump reduction is performed, spreader grafts should be used.  Many patients with nasal airway obstruction may already have a pre-existing narrow internal nasal valve and spreader grafts are used to reconstruct the internal nasal valve.   The diagram on the left shows that following dorsal hump reduction the septum and nasal bones become open (open roof).  When the nasal bones are narrowed, the sidewalls fall in (collapse) if there are no spreader grafts. This results in nasal airway obstruction and inverted V deformity.   This collapse narrows the internal nasal valve which causes nasal airway obstruction.

Spreader grafts support the sidewalls, preventing them from collapsing and maintaining the  internal nasal valve.   Aesthetically, spreader grafts also allow to produce smoother nasal contour line 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.

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

Dr. Grigoryants reviews safety of plastic surgery

August 21st, 2013

This post will describes what steps we take to ensure safety for our patients. When these guidelines are followed, plastic surgery can be performed with a very high degree of safety.

1. Patient selection:   Prior to surgery, patients are screened for any medical conditions and their ability to withstand surgery and anesthesia. For young and healthy patients, surgery is very safe. Older patients and patients with medical problems will need to undergo medical clearance by their primary care doctors or cardiologists. In certain cases, even stress tests will be ordered to evaluate the patients cardiac function. From time to time, we will turn down patients based on their age and/or medical condition.

2. Type of surgery performed: Certain procedures like (rhinoplasty, facelift, breast augmentation etc.) are associated with relatively little bleeding and little stress on the body. On the other hand large volume liposuction (over 5 liters) or tummy tuck with a large volume liposuction is more stressful for the body. When patients undergo combined surgeries or large volume liposuction, we recommend the patients stay in the hospital for at least 1 day for observation and intravenous hydration. During surgery surgery the patients vitals signs and fluid maintenance is very important. Dr. Grigoryants’ training and experience in Critical Care Medicine in addition to plastic surgery, allows him to take extra steps in ensuring intraoperative safety for his patients.

3. Duration of surgery: Most procedures in plastic surgery when performed by an experienced surgeon are relatively short. For example, Dr. Grigoryants’ rhinoplasty takes about 2-2.5 hours, breast augmentation 1.5 hours, and tummy tuck with liposuction 3-3.5 hours. Certain procedures can be combined safely. Although the relationship between the risk of complications and duration of surgery is not very clear, Dr. Grigoryants limits the duration of surgery to less than 6-7 hours when procedures are combined. When more extensive procedures are required, it is best to do them separately at different times.

4. Surgical Enviroment: Surgical procedures with anesthesia have to be performed in the hospital or an accredited surgical center. These facilities will have the necessary equipment and medications to allow for safer surgery. For example, patients vital signs are carefully monitored before, during, and after surgery; warming blanket are used to keep patients warm; and sequential compression devices (SCD’s) are placed on all patients to minimize the risk of deep vein thrombosis.

To learn more visit our website http://www.vgplasticsurgery.com

Combining rhinoplasty with other surgeries

August 17th, 2013

Rhinoplasty is frequently combines with other procedures in our practice.  Patients undergoing rhinoplasty will undergo another procedure such as breast augmentation, liposuction, breast reduction, lip augmentation, ear reshaping or labioplasty.  The advantage of combining surgeries is one anesthesia, one recovery period, and lower cost as compared to doing these procedures separately.  As long as the total duration of surgery is not excessive, the procedures can be safely combined.  The duration of surgery depends on the surgeon’s skill and complexity of surgical problem.   For example,  rhinoplasty and breast augmentation with Dr. Grigoryants takes about 3- 3.5 hours. Patients will return to work in one week and can resume exercises in 4 weeks afte surgery.  It important to have the procedures performed in a certified surgical facility (surgery center or  hospital).   Visit http://www.vgplasticsurgery.com/los%20angeles%20nose%20reshaping(rhinoplasty).htm to get more information about rhinoplasty with Dr. Grigoryants

Nasal taping after rhinoplasty

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

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.

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How Nose Reshaping Redefines your look

August 6th, 2013

Nose reshaping is one of the most personalized surgeries that people want to pursue. Some people have a large hump on their nose, and some people have a bulbous nasal tip that makes their whole face look out of proportion.  Then there are some that suffer from chronic breathing complications, because their nose is disrupting airflow. For whatever the reason that applies to you, you chose to have your nose reshaped. Now all that needs to be done is to prepare for it. There are a number of chores to be done up until the day of the surgery. Here are some tips to help you relieve some of that stress and help you plan for the road ahead.

Nose reshaping, known as rhinoplasty, is a surgery to make the nose larger or smaller, changes the angle of the nose, reduces the tip of the nose and can correct bumps or defects. Dr. Grigoryants is a board certified plastic surgeon who has the ability to improve the shape of a patient’s nose, as well as treat any existing nasal airway obstructions. In the initial consultation, he plans together with his patient to decide on what the nose reshaping changes will be. Reviewing the patient’s goals and evaluation of the nose will allow him to produce the best results possible. With his improved techniques of closed rhinoplasty, Dr. Grigoryants leaves no visible scarring and prevents any future airway blockage.

According to the American Society of Plastic Surgeons, nearly 243,000 nose reshaping surgeries were conducted in 2012, ranking second to breast augmentation in cosmetic procedures. Cosmetic or functional problems with the nasal structure can occur at any age, and it is the facial feature that causes the most dissatisfaction in people unhappy with their appearance. Depending on the desired results, some bone and cartilage may be removed, or tissue may be added through the inside of the nose. A splint will be placed outside the nose to support the new shape and nasal packing may be placed inside the nose for additional support.

How to prepare for nose reshaping

Dr. Grigoryants will give his patients guidelines to follow two to three weeks before the surgery, but here is what needs to be done for the patient to prepare in the months or weeks before surgery date:


  1. Get lab testing or medical evaluation to determine if the body is healthy for surgery

  2. Take medications or stop certain medications to avoid surgery complications

  3. Avoid taking aspirin, anti-inflammatory drugs or herbal supplements to avoid increase of bleeding

  4. Stop smoking in advance of surgery

There are also chores that need to be done at home to ensure a successful recovery in the weeks post-operation, which include:

  1. Stock up on medication or painkillers

  2. Stock up on ice packs or ice bags to apply for soreness

  3. Have ready made meals for after the operation (Soup, juice, soft foods, snacks)

  4. Wash your face thoroughly with antibacterial soap to eliminate germs

  5. Avoid use of makeup and hair products on surgery date

  6. Dress in loose, comfortable clothing the day of surgery

  7. Do not eat until after the procedure

  8. Have a driver available to take you home after the operation

  9. Arrange for a caretaker for two days, post-surgery

  10. Plan to take off work or school for at least a week to recover

If the patient becomes sick or catches a minor illness in the week or on the day of the surgery, call your surgeon to reschedule for a later date. Being sick can increase the risk of complications during surgery.

The nose takes time to settle into its new shape, so allow the body to rest as much as possible. Avoid strenuous activities for two to six weeks and try to avoid sun exposure for at least eight weeks.

The final results will achieve the shape and feel that the patient was determined to get. Now that you are ready for the surgery, you will no longer experience defects or breathing issues and you will be able to enjoy an improved quality of life. Dr. Grigoryants performs every nose reshaping case to transcend his patients’ goals. Ask him how he can improve the shape of your nose today.

Why Rhinoplasty Might be Right for You

July 31st, 2013

Nose surgery serves more than just a cosmetic purpose. People today are having work done to improve more than just their looks. With advanced technology and experienced surgeons, society is able to get their nose worked on to repair trauma from accidents, improve self-esteem and relieve medical issues. These reasons make it easier for people to understand that getting plastic surgery is not always about looking good, but about feeling better emotionally and physically.

Nose surgery, known as rhinoplasty, produces a natural shaped nose and achieves balance with respect to the face. Dr. Grigoryants is a board certified plastic surgeon who has the ability to improve the shape of a patient’s nose, as well as treating any existing nasal airway obstruction. His specialty in closed rhinoplasty procedures leaves no visible signs of scarring and prevents any future airway blockage. Dr. Grigoryants will consult with his patients to determine what needs to be done in order to improve their nasal structure.

According to WebMD, rhinoplasty improves the shape, size, and angle of the patient’s nose. Not only that but the surgery is known to correct the nasal structure that cause chronic congestion and breathing issues.

What corrections can be made with nose surgery?

Your nose is repaired for medical issues. Patients who struggle breathing daily can have serious health complications later in life. A lower oxygen count makes the heart pump harder and adding that strain to the heart can cause it to weaken over time. Lower oxygen will also affect a person’s concentration and brain function. Rhinoplasty will relieve these health problems and achieve proper breathing for people with these issues.

A deviated septum is a condition where the cartilage of the nose is off center and also creates difficulty breathing. This can sometimes result in sinusitis or sinus infections. It is estimated that more than 80 percent of all nasal septums are off center. For these cases the nose can be repositioned in conjunction with rhinoplasty.

After an accident to the head, sometimes the nose is broken and deforms its original shape. If the patient undergoes rhinoplasty within the first few weeks of the accident, the surgery will show the most beneficial results. After the nose is broken the first two weeks is the window of repair before the bones start to heal, which makes it more difficult to straighten. Some patients are even happier with the new shape of their nose before the occurrence of the incident.

Then there are patients that were just born with prominent noses, bumpy nose shapes and crookedness. Their nose makes them very self-conscious and reduces self-esteem. There are even the rare few that have experienced faulty previous nose jobs and they want to correct those results. Dr. Grigoryants wants his patients to feel good about their nose and give them that confidence back. He provides his patients with results that achieve their goals.

As long as the patient has realistic expectations Dr. Grigoryants performs every case to transcend those goals. A good nose job will relieve pain, breathing complications and improve self-esteem. A nose surgery will do more than just make a better shaped nose, it will impact and improve the quality of life.

Look your best with a tummy tuck

July 18th, 2013

Flat, well-toned abs is something everyone wants to make their body look better. When the body does not respond to dieting and exercise there still lies that excess layer of flab in front of the abdomen. Depriving the body of food will not help to diminish the saggy skin either. Pregnancy and massive weight loss can leave the abdominal area with excess loose skin that is unresponsive to even the strictest diet and exercise routine. So what options are Beverly Hills and Los Angeles women and men left with? The solution is a tummy tuck.

A tummy tuck, technically known as abdominoplasty, is a procedure that will remove excess fat and skin from the abdomen. The abdominal skin is elevated and then pulled down, and then the excess skin is removed. Loose skin is caused by severe weight loss and post-pregnancy, and sometimes trimming the fat can leave all of that skin and remaining fat in the abdomen. In some instances, the abdominal muscles become separated and weaken when the stomach walls enlarge. With a tummy tuck the body will regain its defined shape and smoother and firmer skin.

A new and improved version of the tummy tuck can do even more for a refined body shape. Lipoabdominoplasty is a procedure that combines liposuction and a tummy tuck to enhance results from the tummy tuck. Plastic and reconstructive surgeon Dr. Vladimir Grigoryants frequently uses this method  to give his patients the best results possible. The procedure sucks out the fat from the flanks of the stomach, arms, back and thighs as the tummy tuck is performed. Most people do not know who is considered good candidates for such a procedure, but it is simple to determine .

The most common causes of a flabby and sagging stomach include:

·         Pregnancy

·         Aging

·         Significant fluctuations in weight

·         Heredity

·         Prior surgery

According to a report from the American Society of Plastic Surgeons, tummy tuck surgeries have increased 70 percent since 2000. This indicates that more and more people are trying to maintain the slim body size that they had as they were growing up. Diet and exercise is something that does not always get the job done, but the benefits of a tummy tuck can be life changing.

People who are unhappy with their bodies often experience embarrassment and a drop in confidence. A tummy tuck can help improve the self-confidence of the individual and give them a greater outlook on life. After healing from the procedure, patients no longer feel unattractive or upset with themselves. Their clothes no longer reveal pudgy bellies and love handles. They can put on that bathing suit and reveal their bodies at the beach in the summer. Their confidence increases and they feel better capable of taking on whatever life throws at them.

After the tummy tuck patients no longer feel shy about their bodies and now feel comfortable socializing. Their bodies have given them the ability to be more outgoing and meet other people at public outings with friends and family. They take more time to go out to more intimate events and feel more comfortable leaving their comfort zone.

The results of the procedure even give patients the urge to try new things. Upon seeing the new body that they have been striving for they have the energy to get out and learn how to snowboard, go surfing or enjoying a three-mile nature hike. It can turn them into the life of the party whenever they are out with their friends dancing at a nightclub.

There are a lot of things holding people back from gaining that confidence back. They often wonder if they are even considered a good candidate for a tummy tuck. People never know until they get the information that they need. It is normal to feel shy about a saggy stomach but having a surgery is beneficial to improve life.

Abdominoplasty is a good option for patients if they:

·         Are physically healthy and at a stable weight

·         Have realistic expectations about their body shape

·         Are finished having children

·         Do not smoke


Everyone has the right to have a slim and trim waistline. People do not need to feel ashamed about getting work done. These days it is as common as going to the bank. Stop dreaming about having a good life. Get the look that makes the best come out to play. Continue that healthy diet and trim the fat that makes that slim body shine bright in the sun.

 

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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