Revision rhinoplasty

Stella Desyatnikova, M.D. answers: Revision rhinoplasty - have I had too many nose jobs?

I had 2 previous nose jobs when I was 18 and again at 20 I am now 37 and would like to shorten the tip of my nose but it seems the previous doctors left a hole between the nostrils inside. In other words, from what drs. have told me, there is no cartilage to hold up the tip to get it shorter.
Can you help me? Is there a way of correcting this and so there is no longer a hold from one nostril to the other.
Many thanks for anything you can suggest.

Stella Desyatnikova, MD
20 months ago

We do many revision rhinoplasties, and they are sometimes indeed extremely complex. Sounds like you have a septal perforation, perhaps, and a droopy tip. The first thing you need to do is to see an experienced facial plastic surgeon and discuss your problems and expectations. Usually we can get cartilage from the ear, sometimes from the rib, to rebuild the structure that has been lost. It might be helpful for you to see several surgeons for their opinions, and decide whether the revision procedure is right for you.

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A: Rhinoplasty revision can be very safe

Sam Naficy, MD
18 months ago

There are a number of reasons why patients seek a secondary (revision) rhinoplasty procedure. In certain situations, the initial procedure may have not fully corrected the undesirable features of the nose. In other situations, the initial rhinoplasty may have actually resulted in certain undesirable features. As long as the skin of the nose is healthy, and enough time (typically one year) has passed since the previous surgery, there is no problem with having one or multiple revisions. The most important point is to do your homework and go to the best surgeon that you can so that you minimize the chance of needing a revision in the first place.

Presence of a hole (perforation) between the nostrils (this is called a septal perforation) does not prevent anyone from having a revision rhinoplasty but it does make it more likely that you will need cartilage grafting from the ear.

Revision rhinoplasty can correct a number of problems witht he tip and the bridge such as shown here:

http://www.seattleface.com/html/before_n_after_set.php?procedure=revision_rhinoplasty&id=02

Revision rhinoplasty can also correct the common polybeak defomrity, caused by too much removal of structure (bone and cartilage) from the bridge of the nose, such as shown here:

http://www.seattleface.com/html/before_n_after_set.php?procedure=revision_rhinoplasty&id=03

Revision rhinoplasty can be performed to shorten the tip as depicted here:

http://www.seattleface.com/html/before_n_after_set.php?procedure=revision_rhinoplasty&id=12

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A: Revision rhinoplasty is a discipline all and of itself...

William Portuese, MD
19 months ago

Revision rhinoplasty is a discipline all and of itself and is an extremely difficult operation to execute.

After each surgery the nose goes through a healing process. Unfortunately, with each subsequent surgery the healing becomes less and less predictable.

It is best to keep the number of nose jobs at a minimum to prevent scar tissue, untoward healing, and an over-resected and operated look.

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