Cynthia: Hi.

Dr. Paul Nassif: Nice to meet you.

Cynthia: Nice to meet you.

Dr. Paul Nassif: So welcome.

Dr. Paul Nassif: My name is Dr. Paul Nassif, I'm a facial plastic and reconstructive surgeon in Beverly Hills.

Dr. Paul Nassif: Now have you had any surgery since then on the nose, or just that one?

Dr. Paul Nassif: My specialty is revision rhinoplasty. A revision rhinoplasty is basically doing a nose job, but on someone who's already 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.

Dr. Paul Nassif: Hi Cynthia, Dr. Nassif.

Cynthia: Hi Dr. Nassif, nice to meet you.

Dr. Paul 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 the result of a birth defect, and I've had three operations through out my lifetime. I'm going to see Dr. Nassif for my fourth revision rhinoplasty to make my nose more symmetrical.

Dr. Paul Nassif: Okay, so you've had three surgeries.

Cynthia: Yeah. Last one was when I was 17, it was the nose and the lip. They actually put an implant into my nose.

Dr. Paul Nassif: Now are you happy with the lip right now?

Cynthia: No, I feel like a Picasso painting.

Dr. Paul Nassif: When you have a cleft lip, the right part or the side of the nose where the cleft lip is, it doesn't form properly. And that's kind of the syndrome that she has.

Dr. Paul Nassif: So that side, you feel, is collapsed.

Cynthia: Yeah, totally collapsed. It's not symmetrical. It doesn't look like the left side.

Cynthia: As a child, kids were very mean. They teased me relentlessly. They often called me scar face, and, you know, I never felt good about myself. I was definitely an outcast, because I didn't fit in. I grew up in like the '80s where everyone was a blonde, and white fair skin and blue eyes in Southern California, and, you know, perfect pearly whites and perfect symmetrical nose, and I definitely didn't fit that bill.

So, you know, just dealing with the every day type of activities, I know I'm just really self conscious when people make eye contact with me I get really self conscious and look away.

Dr. Paul 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 would want to feel beautiful walking down the aisle. So I'm hoping that I can achieve those results.

Dr. Paul Nassif: The one issue, automatically, that I can't do anything about. your nose will always be asymmetrical.

Cynthia: Okay.

Dr. Paul Nassif: We wanna make it look like a longer, more sleek, more slim, prettier, elegant nose. That's my goal.

Dr. Paul Nassif: Now, when are you getting married?

Cynthia: December 2.

Dr. Paul Nassif: Okay, so we're doing this July, okay. Well hopefully, I'll be able to give you a nice present.

Cynthia: Okay.

Dr. Paul Nassif: If you have any questions, I'm here for you.

Cynthia: Okay. Thank you.

 

[22:15 31:04]

 

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 think it's really gonna be that drastic of a change. I mean, it's gonna be slightly different, an improvement, but I don't think it's gonna be a big deal.

Lewis: Well, you'll see, at the wedding when you see family members you haven't seen in a long time, I think you're gonna get a lot of "wow".

Lewis: My name is Lewis, I am Cynthia's fiancé, and we've been dating for about four years now, and we're gonna 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: Lewis has been really a strong support. You know , I mean he really, he knows that I really wanted it, and he was really supportive in saying you gotta do it, you know, 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 confidents, increased self esteem in general, you know, not just for that big day, but throughout my whole lifetime.

Adrian Nassif: My name is Adrianne Maloof Nassif, and I'm married to Dr. Paul Nassif. I work in 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 Corporations, 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 called Thieves.

Dr. Paul Nassif: We just moved into our house a few months ago. Adrianne did all the work; I kind of just walked in with my suitcase going, "I'm here".

Adrian Nassif: We actually have nine bedrooms in the house, the house itself is about 20,000 square feet.

Dr. Paul Nassif: This is our best, most wonderful chef in the world, Jimmy Spears.

Adrianne Nassif: Our chef happens to be Britney Spears' dad.

Jimmy Spears : I'm not a chef, I'm just a cook so nothing is real fancy.

Dr. Paul Nassif: Well when we first started going out, you know, she goes, "Paul, I'm gonna make you a beautiful dinner".

Adrianne Nassif: No, I didn't say that. I didn't say it was gonna be beautiful, I said I'll make you dinner.

Dr. Paul Nassif: Let's see, let me add up all the experience Adrian's had in the kitchen that I know of. Hmm.

I broke two teeth on that piece of turkey I mean, I threw it across the room and it broke into a darn wall. And as soon as I said that, you know what she says?

Adrianne Nassif: I said I'm glad you don't like it, because that's the last time I'm cooking for you.

Cynthia: Today's the day of my surgery, and I'm excited. A little nervous, but mainly excited. I fully trust Dr. Nassif.

Lewis: Cynthia's the strongest of all of us. We're all very nervous.

Dr. Paul Nassif: Good morning.

Cynthia: Good morning.

Dr. Paul Nassif: How are you?

Cynthia: Fine.

Dr. Paul Nassif: How'd you sleep last night?

Cynthia: Okay.

Dr. Paul Nassif: So you ready for this?

Cynthia: Yeah, I'm excited.

Dr. Paul Nassif: Let me just give you a quick game plan.

Cynthia: Sure.

Dr. Paul Nassif: Today I'm performing Cynthia's revision open rhinoplasty. And there are numerous steps to this today. First thing we do is take cartilage from her ear, which we're gonna use to rebuild her nasal tip. After I do that, we're gonna go ahead and remove whatever implant she has in her nose, then we rebuild her nasal tip with the ear cartilage.

In addition I'm going to use Gore-Tex to elevate the bridge of the nose, and also to add some fullness down in the bottom part of her nose near her upper lip.

By your wedding, you'll look pretty darn good.

Cynthia: Okay.

Dr. Paul Nassif: But it's gonna take some time. I want you to know that.

Cynthia: I understand.

Dr. Paul Nassif: Okay, any questions?

Cynthia: No. None whatsoever.

Dr. Paul Nassif: Okay, you ready to rock 'n roll?

Cynthia: Yes I am.

Dr. Paul Nassif: I'm gonna take great care of you.

Cynthia: Okay.

Dr. Paul Nassif: Cynthia's revision rhinoplasty is gonna be very difficult. Any time you have a cleft lip/nose syndrome, you can improve it, but you can't make it perfect.

Okay let's start, we're just about to start now with our first incision, which will be taking the ear cartilage. Okay so I'm cutting through the cartilage. This is about as big a piece of cartilage we can get from the ear, and there we go. This is it. So we're done. Okay. So we're now gonna stitch the ear closed. Let's go to part two, the good ole' nose here. So the first thing I'm gonna 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 wanna cut into any cartilage. There it is. 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 gonna difficult. I have to deconstruct before I can reconstruct, which means I have to take apart the nose completely.

I had my work cut out for me today. It's gonna take me a lot longer than I thought.

So now what I've done is I've opened up the entire nose, it's filleted open, and now we have to start building everything from the ground up. Now ere gonna do is we're gonna fracture the nasal bones to give her a little thinner bridge. Go ahead and tap two, tap two, tap two, go, go.

Our next step now is to start building the tip of the nose, reconstructing the entire tip. Okay, where's our cartilage? There's our cartilage here, right? Let's see what side it's gonna give me another pair of pickups please. Want it like that, yeah that might look nice in there like this. Okay the last graft is called a shill graft, and what it's gonna do is sit one on top of the nose right here. Now we have to start stitching this in.

Okay we've just finished. Our next step now is to put the Gore-Tex. So what the Gore-Tex is gonna do is 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 think I'm gonna beat what I said.

Now I'm putting the last few stitches in the nose, and then we're gonna 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 gonna 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 this. I think she's gonna look great, I think her, she's gonna be happy, her fiancé's gonna be happy, and I think they're gonna make me the best man at their wedding.

Lewis: Hello Cynthia. Hey baby. How you feeling?

Cynthia: Sleepy.

Lewis: 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'll be alright.

[33:06 34:43]

Dr. Paul Nassif: Hi Cynthia, how are you?

Cynthia: Fine.

Dr. Paul Nassif: So we've been a whole week.

Cynthia: Yes.

Dr. Paul Nassif: You're breathing a little plugged up right now?

Cynthia: Yeah.

Dr. Paul Nassif: Yeah, of course. I'll look inside there. We're probably gonna have to do some mining in there.

Cynthia: Today is my post-op visit with Dr. Massif. It's been one week after surgery.

Dr. Paul Nassif: Let's see, how we doing there. As I told you, you know, everything you see with your tip, as time goes on, will get better and better. Okay you're doing great. For one week you have so much more form, especially your profile.

She's doing fantastic. I mean, she, you know, is such a pleasant person, and I am so happy right now that her nose is turning out the way that it is. You can't get a nose perfect when you're doing a cleft lip/nose, but it is about 75 percent improved already after one week. This is one week.

Cynthia: Wow...quite a difference. Oh my gosh! It's so weird to see me like this.

Dr. Paul Nassif: :Put your finger up through here.

Cynthia: Wow.

Dr. Paul Nassif: When was the last time you remember your nose being up that high?

Cynthia: (Laughter) 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 just so happy, I'm just ecstatic and I'm pleased with the results. He did explain that there's a lot of swelling still and it's just gonna get better over time. But I'm excited.

 

[38:52 40:55]

 

Cynthia: 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. I'm a couple months from my wedding, and I still need to find that perfect dress, makeup, hair, the whole shebang.

This is the veil.

Male Speaker: 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!

Female Speaker: Wow, you look beautiful!

Cynthia: Thank you.

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 gonna be a wonderful day. I finally feel like I'm ready for this wedding, you know what I mean, like I have the look the dress, makeup, the hair, the surgery, and the surgery was such an integral part of everything. I don't think I would feel as good as I do now, had it not been for me undergoing that operation.

Female Speaker: Well you look really beautiful, I'm proud of you.