Dr. Paul Nassif Has Doubts About Solving Pop Star Sammy’s “Extremely Difficult & Scary” Botched Case

What’s hiding inside Sammy‘s nose?

Dr. Paul Nassif was temporarily stumped during Monday’s new Botched episode, which saw the rhinoplasty specialist take on a particularly convoluted new case. Sammy, a Lebanese pop star with four reconstructive nose jobs already under his belt, consulted Drs. Nassif and Terry Dubrow decades after a serious accident initially kickstarted his plight for corrective surgeries.

“One night, I actually tripped down a flight of stairs,” the patient explained, recalling his first plastic surgeon’s decision to craft him a nasal implant using a material called Gore Tex (also known as Teflon or PTFE, the chemical compound responsible for nonstick frying pans and waterproof jackets).

Sammy was happy with the procedure’s early results, but complications caused by the synthetic substance led him back into the operating room. Two more surgeries and several years after that, a car crash undid much of the progress.

“The fourth [surgery] was after the accident,” he told the Botched doctors. Distressed over its shape and lack of function (all those years of trauma had impacted his airways to such an extent that Sammy had a hard time breathing properly), the singer sought additional help from one more expert in 2008, who “couldn’t do anything” for him.

After learning about Sammy’s surgical history, Dr. Nassif was eager to accomplish what his last doctor couldn’t. But doing so would require a creative approach to problem-solving, even more so than he originally anticipated.

“Right now, Sammy’s nose looks destroyed,” Nassif said, observing some very odd structural characteristics upon closer examination. “The middle vault is very narrow and this is like a rock,” he continued, pointing to the nasal tip, which shouldn’t feel like that.

Even stranger was the fact that Sammy’s skin, per Nassif’s observation, appeared to be “stuck down to whatever’s in there.”

“This now has become an extremely difficult and scary case,” noted the surgeon, who opted to move forward with Sammy’s fifth rhinoplasty despite the lingering question marks surrounding his previous procedure. Those question marks became more pronounced once the surgery was underway.

“The needle is bending,” Nassif informed his OR team before Sammy’s actual rhinoplasty had begun. Realizing he might not be able to complete the surgery’s first step—separating the nasal skin from the implant beneath via some sort of injection—Brittany Pattakos‘ husband was at a loss.

“I’ve never seen anything like this,” he told the staff, expressing concern for the rest of the procedure. “I’m nervous about starting the nose,” the doctor admitted. “If I can’t elevate the skin, I can’t do a rhinoplasty.”

Fortunately, Nassif was able to perform the surgery successfully. After discovering that Sammy’s last surgeon reconstructed his nose using an uncommon combination of “ear cartilage, calcified rib and…a lot of cranial bone graft,” he was able to remove the foreign materials and reshape it himself. 

Eight weeks later, Sammy was a whole new man.

“Before my surgery, my nose had no structure, it had no bridge. I was very self-conscious and I found it very difficult to breathe,” the performer remembered, unveiling his new look to a crowd of excited loved ones. Continuing, he thanked Dr. Nassif for giving him a nose that “fits [his] face” and finally allowed him to breathe correctly. “Watch out world! The old Sammy is back, and it’s just the beginning.”

See how everything unfolded this week—including Jessie‘s complicated implant surgery and Aimi‘s hopes for an additional butt lift—in the full recap video above!

Watch a brand new episode of Botched Monday at 10 p.m., only on E!

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