Cynthia's Rhinoplasty Experience by Dr. Nassif on Dr. 90210
Doctor Nassif’s Office
Dr. Nassif: Hi, nice to meet you.
Patient: Nice to meet you.
Dr. Nassif: So welcome.
My name is Dr. Paul Nassif. I’m a facial plastic and reconstructive surgeon in Beverly Hills.
Have you had any other surgeries since then on the nose or just that one?
My specialty is revision rhinoplasty. A revision rhinoplasty is basically doing a nose job but on somebody who’s had it done before and they have a problem with it whether it’s the second time or the sixth time.
I’m the last stop.
Hi Cynthia Dr. Nassif.
Cynthia: Hi Dr. Nassif, nice to meet you.
Dr. Nassif: Nice to meet you too.
Cynthia: My name is Cynthia, I’m 31 years old and I was born with a cleft lip. My cleft lip is a result of a birth defect and I’ve had three operations throughout my lifetime. I’m going to see Dr. Nassif for my fourth revision rhinoplasty to make my nose more symmetrical.
Dr. Nassif: Ok so you’ve had three surgeries.
Cynthia: Yeah, last one when I was seventeen it was the nose and the lip. They actually put an implant in my nose.
Dr. Nassif: Are you happy with the lip right now?
Cynthia: No, I feel like a Picasso painting.
Dr. Nassif: When you have a cleft lip, the right part or the side of the nose where the cleft lip is doesn’t form properly. And that’s kind of the syndrome that she has.
So that side you feel is collapsed?
Cynthia: Yeah it’s collapsed it’s not symmetrical it doesn’t look like the left side.
As a child kids were very mean. They teased me relentlessly; they often called me scar face. You know I never felt good about myself. I was definitely an outcast because I didn’t fit in. I grew up in the 80s where everyone was a blonde, white fair skin and blue eyes in Southern California and you know perfect pearly whites. Perfect symmetrical nose and I definitely didn’t fit that bill. So you know just dealing with the everyday type of activities I’m know I’m just really self-conscious. When people make eye contact with me I get really self-conscious and look away.
Dr. Nassif: Why don’t you put your head back for me.
Cynthia: I want the surgery basically to improve my self-esteem. I am getting married this winter and I want to feel beautiful walking down the aisle. So I’m hoping that I can achieve those results.
Dr. Nassif: The one issue automatically that I can’t do anything about; your nose will always be asymmetrical. What I want to make it look like a longer more sleek more slim, prettier elegant nose. That’s my goal.
Now when are you getting married?
Cynthia: December 3rd.
Dr. Nassif: Ok, so we’re doing this July, ok. Hopefully I’ll be able to give you a nice present. If you have any questions I’m here for you.
Cynthia: Ok, thank you.
Cynthia’s fiancée’s parent’s house
Family chatting: Pass the potatoes please, how come I got the smallest one?
Cynthia: We’re here in Long Beach, California at the home of my future in-laws and we’re here for a barbeque.
I don’t know if it’s going to be that drastic of a change. It’s going to be a slight improvement but I don’t think it’s going to be a big deal.
Louis: When you see family members that you haven’t seen in a long time I think you’re going to get a lot of wow.
My name is Louis, I’m Cynthia’s fiancé and we’ve been dating for about four years now, and we’re going to be getting married in a couple months. When we first met she was pretty candid with me that she had a cleft lip since she was born and all that and it didn’t affect me that much and it really never even entered our relationship at all. I knew it was something that she wanted to correct later down the road if she could.
Cynthia: Louis has been really a strong support I mean he really… he knows that I really wanted it and he was really supportive in saying you have to do it for yourself. And really that’s what it’s about.
The surgery will definitely give me the confidence to walk down the aisle and feel beautiful and I’m hoping to just get a better sense of self-confidence and increased self-esteem. You know in general, not just for that big day but just throughout my whole lifetime.
Dr. Nassif’s House
Dr. Nassif: Do you want another bite?
Adrienne: My name is Adrienne Maloof-Nassif and I’m married to Dr. Paul Nassif. I work at a family business, it’s Maloof Corporation. My grandparents started by opening up a general store. We started off with a Coors distributorship and from there we started a chain of hotels. We actually went to creating a multi-billion dollar business. We own a casino in Las Vegas called the Palms Maloof Coroprations. We currently own the Sacramento Kings which is part of the National Basketball Association. We’re also involved in the television and film production business. We’ve got a new movie we co-produced with Ben Affleck and Matt Damon.
Dr. Nassif: We just moved into our house a few months ago. Adrienne did all the work; I kind of just walked in with my suitcase and go ‘I’m here’!
Adrienne: We actually have nine bedrooms in the house. The house itself is about 20,000 square feet.
Dr. Nassif: This is our best, most wonderful chef in the world, Jamie Spears.
Adrienne: Our chef happens to be Britney Spears’ dad.
Jamie: I’m not a chef, I’m just a cook so nothing is real fancy.
Dr. Nassif: When we first started going out she goes ‘Paul I’m going to make you a beautiful dinner’.
Adrienne: No I didn’t say that, I didn’t say it was going to be beautiful I said I’ll make you dinner.
Dr. Nassif: Let’s see, let me add up all the experience Adrienne has had in the kitchen that I know of.
Let’s see, I broke two teeth on that piece of chicken, I threw it across the room and it broke into a darn wall. As soon as I said that you know what she says.
Adrienne: I said I’m glad you don’t like it because that’s the last time I’m cooking for you.
Dr. Nassif’s Surgery Center
(Family praying before Cynthia’s surgery)
Cynthia: Today is the day of my surgery and I’m excited, a little nervous but mainly excited. I fully trust doctor Nassif.
Louis: Cynthia’s the strongest of all of us. We’re all very nervous.
Dr. Nassif: Good morning.
Cynthia: Good morning.
Dr. Nassif: How are you?
Cynthia: I’m fine.
Dr. Nassif: How’d you sleep last night?
Dr. Nassif: So are you ready for this?
Cynthia: Yeah. I’m excited.
Dr. Nassif: So let me just give you a quick game plan.
Today I’m performing Cynthia’s revision open rhinoplasty. Now there are numerous steps to this today.
First thing I’m going to do is take cartilage from her ear which we’re going to use to rebuild her nasal tip.
After I do that we’re going to go ahead and remove whatever implant she has in her nose. Then I’m going to rebuild her nasal tip with her ear cartilage.
By your wedding you’ll look pretty darn good, but it’s going to take some time, I want you to know that. Any questions?
Dr. Nassif: You ready to rock and roll?
Cynthia: Yes I am.
Dr. Nassif: I’m going to take great care of you.
Cynthia’s revision rhinoplasty is going to be very difficult. Any time you have a cleft lip nose syndrome you can improve it, but you can’t make it perfect.
Nurse: Take a nice deep breath. Nice sweet dreams.
Dr. Nassif: Ok, we’re just about to start now with our first incision which will be taking the ear cartilage.
Ok so I’m cutting through the cartilage, this is about as big as a piece of cartilage that we can get from the ear. There we go this is it so we’re done. Ok, so now we’re just going to stitch the ear closed. Let’s go to part two the good old nose here. So the first thing I’m going to do is make the incisions in the nose and that’s for the open rhinoplasty. We don’t want to cut into the implant, or more importantly we don’t want to cut any cartilage. There is it, so that’s the little silicone implant. Right now the nose does not have any shape to it; it’s just like one big blob. As I’m looking at Cynthia’s nose it’s going to be very difficult. I have to deconstruct before I can reconstruct which means I have to take apart the nose completely. I have my work cut out for me today; it’s going to take me a lot longer than I thought. So now what I’ve done is I’ve opened up the entire nose, it’s flayed open and now we have to start building everything from the ground up. Now what we’re going to do is we’re going to fracture the nasal bones to give her a little thinner bridge. Go ahead tap tap. Our next step now is to start building the tip of the nose, reconstructing the entire tip. Ok, where’s our cartilage? Here’s our cartilage here right. Ok let’s see which side, give me another pair of pick-ups please. Yeah that might look nice in there like this. Ok the last graft if called a shield graft and what it’s going to do is it’s going to sit right on top of the nose right here. We have to start stitching this end. Ok we’ve just finished, our next step now is to put the Gore-tex, so what the Gore-tex is going to do is it’s going to build up the bridge of the nose and that’s in place of that silicone implant. I’m very happy with this so far. I’m putting the last few stitches in the nose and then we’re going to put a cast on the nose and then we’re all done. I’m really happy with the result, and I’m sure she will be too. Yeah, she’s going to love this nose. We are done!
Cynthia’s surgery took about four and a half hours. It went great so I’m really happy with it. I think she’s going to look great. She’s going to be happy, her fiancé’s going to be happy, and I think they’re going to make me the best man at their wedding.
Nurse: There she is.
Louis: Hello, Cynthia-hey baby. How are you feeling?
Louis: Cynthia looks pretty bad to be honest with you. She looks pretty swollen, pretty beat up but she seems to be in pretty good spirits she’s pretty tough. It’ll be a rough night but I think after that it will be alright.
Dr. Nassif’s Office:
Dr. Nassif: Hi Cynthia, how are you?
Dr. Nassif: How are you feeling?
Dr. Nassif: So it’s been a whole week, your breathing a little plugged up right now?
Dr. Nassif: Yeah of course. I’ll look inside, we might have to do some mining in there.
Cynthia: Today is my post-op visit with Dr. Nassif, it’s been one week after surgery.
Dr. Nassif: Let’s see, how we doing there? As I told you everything you see with your tip as time goes on will get better and better. Ok, you’re doing great. One week and you have so much more form, especially your profile.
She’s doing fantastic. She is such a pleasant person and I am so happy right now that her nose is turning out the way it is. You can’t get a nose perfect when you’re doing a cleft lip nose, but it is about 75% improved already after one week.
This is one week.
Cynthia: Wow! It’s quite a difference, oh my gosh. It’s so weird to see me like that.
Dr. Nassif: Put your finger up through here. When is that last time you ever remember your nose being up that high?
Cynthia: I don’t.
It was really weird to explain how I felt when I saw my nose for the first time. It looks much better, you know obviously it’s still swollen and stuff but I’m just so happy. I’m ecstatic and pleased with the results. He did explain that there’s a lot of swelling still and it’s just going to get better over time but I’m excited.
Wedding dress shopping
Cynthia: Well help me find a dress, I need one ASAP.
I’m three months post-op and the healing has gone remarkably well, I know I’m not going to need any additional operations.
Cynthia’s friend: This one looks kind of nice. It’s fitted so it will compliment your figure.
Cynthia: I’m a couple months from my wedding and I still need to find that perfect dress. Makeup, hair, the whole shebang.
This is nice, what do you think?
Cynthia’s friend: I love it; do you think this is it?
Cynthia: I think it’s beautiful, I think it’s awesome.
At the salon.
Cynthia: This is the veil.
Hairstylist: Are there any kinds of looks that you have in mind?
Cynthia: Just very free flowing hair. My hair is naturally curly; I have a lot of hair.
Prior to the operation I just did not like people looking at me. I was even contemplating not having a photographer at my wedding just because I didn’t want to take pictures. So now I’m actually looking forward to taking pictures and I feel totally comfortable with people staring at me.
Wow, this is wow.
You know I feel great, I feel attractive for once in my life. I’m looking forward to my wedding day. It’s kind of a new me, a new better me so it’s going to be a wonderful day.
You know I finally feel like I’m ready for this wedding you know what I mean? Like I have the look the dress, the makeup the hair. The surgery was such an intrical part of everything. You know I don’t think I would feel as good as I do now had it not been for that operation.
Vanessa: Well you look really beautiful.