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Cosmetic / Plastic Surgery Message Board

Cosmetic / Plastic Surgery Board Index

To Summer 33 and Kewell:

I'm glad my post re: Dr. Constantian was helpful to you both. Unfortunately, I don't have any new information to report because I cancelled my consultation with him. I am actually having my revision surgery this Wednesday with a doctor in NYC by the name of Constantinides at NYU Medical center. I met with Dr. Constantinides before I was scheduled to meet with Dr. Constantian and was very impressed with his knowledge, level of professionalism and genuine caring so decided to save myself a trip and some cash by staying local. Also, realized that the back and forth for follow-up visits to New Hampshire would quickly turn into a logistical problem.

FYI: Dr. Minas Constantinides is the Director of Facial and Reconstructive Surgery at NYU. 85% of his practice is rhinoplasty. He has studied at Brown, Harvard, Columbia and NYU and did his plastic surgery residency with Dr. Adamson in Canada who is considered one of the best in the world. You've probably seen him mentioned on these boards but his name is often confused with Constantian.

I don't know how complex your cases are, but I will require a fair amount of tip grafting to correct a primary rhinoplasty that I had many years ago. I now have a severly deviated septum (almost no air flow through the left side) and a fair amount of tip and nostril asymmetry. :( My bridge is pretty much okay (thank goodness). I will be having an open procedure.
That doesn't thrill me, but it allows for the greatest amount of control and best outcome for tip work.

To provide you with a bit of perspective, I was extremely reluctant to even have another surgery, because I'm used to how my nose looks though it is far from perfect and--quite frankly who really wants to have surgery of any kind :). However, after meeting with Dr. C I was convinced that it was the right thing to do and that my nose will look better and function better. I've spoken to three of his former patients all of whom have had complex revisions and they are all extremely happy with his work. His results are very natural and he is very conservative so you won't wake up with any surprises as is so often reported on these rhino boards. He is so confident that he actually PROMISED me that I would be happy with my outcome. Believe me that is rare. When I met with a couple of other surgeons here in NYC whose names are always being bandied about as "the best" and "the top" ,I just wasn't impressed. Poor attitudes, poor communication and quite frankly unimpressive results.
One doctor actually told me that who couldn't predict my outcome--that it would depend on whether or not he was lucky that day. WHAT-EV-ER!! Talk to the hand!!

I've really looked around and I could not find one negative post about him anywhere. Nothing but good things!!

Also, another important factor, Dr. Constantinides will work with your insurance company to get as much
of your surgery as possible covered--hospital, anaesthesia etc and his portion if it can be shown to be a medical necessity. His office billed the consultation fee directly through to my insurance and took whatever they covered as payment.

Well, hope that helps. Wish me luck with nose Version 2.1!

Hi Summer 33NY:

Itís a funny coincidence that you wrote today asking about my surgery because I was just thinking how I should post a follow-up to my pre-op message to you and Kewell and AK47 an whomever else may benefit from my account.

Okay hereís the scoop:

Two weeks post-op I am both very happy and relieved (knock wood) Happy because the procedure is over and I seem to be healing nicely and relieved that I chose Dr. Minas Constantinides to tackle my revision rhinoplasty.

As it turns out my surgery was more complex than originally anticipated. When Dr. C got inside he found that my previous surgeon had completely removed the cartilage from the side of the right nostril and part of the cartilage from the left. He also, in his infinite wisdom removed cartilage from above the tip. I basically had a septum and nasal bone left--oh and some skin :). Dr. C. said it was a small miracle that my nose hadnít completely collapsed!

The surgery itself lasted 4.5 hours. He had originally estimated 2.5 to 3. He gave me 150% and it shows. He performed the following:

1. Straightened the septum (separated it from nasal bone and repositioned so it was aligned properly with vertical and horizontal planes on my face and so that oxygen could flow freely.

2. Took three grafts from my septum. Rebuilt sidewalls of both nostrils and inserted a columellar strut in the tip to reinforce the structure.

3. Did an alar base resection on left nostril to improve symmetry.

4. Removed scar tissue and brought tip down slightly

5. Used suture techniques to reduce tip size and improve symmetry.

6. Note that he did not remove tissue. He doesnít believe in weakening the nose or doing things that canít be undone. Like my previous surgeon for instance, hacking away at my nose as if it was an outgrown shrub!

Following the surgery Dr. C spent even more time giving my fiancť a detailed explanation of his work and told him that even though he found some unexpected challenges he was still able to achieve our aesthetic and functional goals and that all went well.

I had minor discomfort for about three days which I easily managed with Tylenol. My nose did swell quite a bit but considering I had open rhino, was a revision patient and am only two weeks post-op I am thrilled with the progress thus far. The swelling has really gone done significantly in two weeks and I have absolutely no idea where he made the external incisions (and Iíve had three). Iím sure youíve seen columellar incisions that look just plain nasty, but mine never even got pink. For three days I was afraid to look in the mirror because I couldnít bear looking like a patchwork quilt but voila! Nothing! I admit Iíve been very strict with myselfósleeping sitting up, lots of fluids, no sodium and a regime of arnica gel, anti-inflammatory and anti-oxidant supplements, minimal exertion, no alcohol and no smoking. That said, I really owe the results to Dr. C. Heís a brilliant surgeon, highly skilled technically, aesthetically gifted AND a kind and compassionate man. Heís also a perfectionist who takes great pride in his work. He doesnít take unnecessary risks and heís got the experience to find creative, smart solutions to difficult problems (like mine). But then, I really am not impressed by the self-promoting types who appear in all the mags and do all the day-time talk shows but canít find the working end of a scalpel with both hands. When it comes to surgery one really should not be swayed by the American proclivity to be drawn toward celebrity. A good publicist does not equal a good surgeon. Get back in your office and practice your sutures--that's what I say to the lot of them.

I know it is early days and the cynics of the rhino revision world will scoff at my enthusiasm but I am very optimistic and believe me going into this my knees were knocking.

I had a check-up today and Dr. C said Iím doing great and will continue to improve over the next few weeks up until three months when I should be in good shape with nostril and tip symmetry to the point where he and I will both be satisfied (heís his own harshest critic) He also said that I will continue to refine over the next year. I do have internal swelling that is causing external asymmetry, but it already looks better than before the surgery! If for some inexplicable reason I am not entirely happy (I don't exactly hit the photoimaging goal) he said he can easily make small tweaks in his office under local but he doesn't forsee that happening.

No Dr. C is not perfect (he does charge for his time J ) but heís darn close. I would not hesitate to recommend him to An-y-body! When it comes to doctors and people in general I am very discriminating. I got a good vibe from Dr. C from day one and Iím glad I trusted my instincts. He oozes integrity if one can ooze such a thing. You can trust that he will do what he says he will do. After reading all of the horror stories on the message boards, I agonized over this decision and my choice of surgeon and I walk around all day now smiling to myself breathing huge sighs of relief!

A final note, the Anesthesiologist and nurses at NYU were also terrificóprofessional and caring. I was very impressed with the whole process.

I hope all this helps. If you have any specific questions feel free to ask. But donít hesitate to schedule a consultation with Dr. C. Heís truly exceptional, a prince among surgeons!

Feel free to check back for progress reports. I donít visit the boards much these days as Iím on the sunny side of surgery now. :)

Cheers and good luck to you all!

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