Last week I performed perhaps the most difficult Revision Rhinoplasty of my career. This nice man had a history of nasal collapse secondary to a huge perforation of his septum from previous history of medications and chronic trauma to his nose. Septal perforations can be fixed if they are very small but the larger they are, the harder they are to fix. Septal perforations are irreparable if they become too large. To put this in perspective, a perforation the size of q-tip head is fairly easy to fix. A perforation the size of a dime has a very high rate of failure when correction is attempted and a perforation the size of a quarter is uncorrectable. This man had a perforation the size of a silver dollar. The reason that this is important is that the septum provides the support for the nose the same way the studs and beams inside the wall support the wall support the wall. Any trauma or insult to the septum puts the nose at risk of collapse which is why you see professional boxers with saddle nose deformities (because their septums become destroyed from repeated trauma). It is taught that someone has a septal perforation is not a candidate for rhinoplasty because the lining of the nose and perforation will weaken the support as I described above. I always have subscribed to that teaching until this particular person entered my office. This man has changed his life around and no longer does things that are detrimental to his nose or body. The appearance of his nose has severely affected his self esteem and is a daily reminder of the life and person he once was that he is trying to forget. He had been rejected for years by surgeons who he consulted with to fix his nose. I felt compelled to step outside the box if possible to help him move on with his life. He fully understood the risks associated with rhinoplasty and he desperately decided to proceed. I told him that I may be able to achieve a 5% improvement in his appearance and he thought that even that small amount would make him happy.

I performed a rhinoplasty using his own rib cartilage to rebuild his nose. During surgery, I proceeded very carefully step by step making sure not to violate the tiny amount of support that he had to his nose. At any step I was prepared to abort the mission if things looked too tenuous. As I proceeded I could not believe how much improvement I was able to get. I expected 5% improvement and I was looking at more like 95% improvement. Furthermore, I was able to increase his support by using rib cartilage so his nose is actually stronger following the rhinoplasty. He is now 1 week out from his revision rhinoplasty and I am astounded at the results! Never in my wildest dreams did I think I would be able to achieve this result. This is one of the most rewarding procedures that I have ever done and needless to say he is absolutely thrilled and amazed with his results.

The aesthetic goals of the patient need to be discussed thoroughly on a case by case basis because some people may want to maintain their ethnic (or family) look while others will want to eliminate it all together. I see about 60% of people who want to maintain their ethnic appearance to some degree and 40% of people who want to eliminate it. There is no right or wrong answer, it all depends on the patient’s desires.  I really enjoy working with people of all ethnic backgrounds and now with my offices in NYC, Dubai, as well as LA, I have the privilege of doing a very high number of ethnic rhinoplasty procedures.

This procedure requires a very specializes set of skills that I have aquired over many years doing ethnic rhinoplasty in Beverly Hills. I have had many middle eastern patients fly to Beverly Hills and New York City to see me for ethnic rhinoplasty but now I am happy to be able to save them the travel expenses and deliver them the same Diamond quality rhinoplasty that people have become familiar with.

Dr. Diamond,

It’s been two weeks since my procedures: face lift, neck lift, C02 laser resurfacing, fat injections, cheek implants, and a rhinoplasty. My husband asked me if I would do it all over again and I said, “Yes, in a heartbeat!” and I sincerely mean it. Before our consultation I had many concerns and doubts which is only natural when dealing with surgery of the face. However, you set my mind at ease by truly listening to my concerns and answering all my questions in a way that I could fully understand. You spent a significant amount of time and were never in a rush to answer my questions and explain the procedures. I came away feeling very confident in your abilities and I knew I could trust you. This allowed me to focus on your instructions for after surgery so that my recovery would be quick and the results positive. Despite being only two weeks post-op, I already am so happy with my results! I’m especially thrilled with how you repaired my deviated septum! After so many years, I can finally breath normally and my nose looks terrific.

What an amazing work family you have in Janet, Lynsay, and Ashley! These ladies were always respectful, caring, and knowledgeable. They took great care of me and were always there with a smile. I am truly happy with the outcome of all the procedures and so glad I took your suggestion to add cheek implants and the rhinoplasty. Thank you so much!

Sincerely,
A.S.

 I have at least one Middle Eastern patient fly to Beverly Hills to have surgery with me every few weeks including many royal family members from different countries in that region.  There has already been a lot of press coverage of my trip that has already hit the internet, but we are setting up several large press conferences to take place as soon as I arrive there.  I look forward to spending time with my new friends and patients from the Middle East and I am really excited about this endeavor.