There are many reasons why a rhinoplasty may fall short of your expectations. Poor surgery, poor healing, inappropriate expectations due to inadequate preoperative counselling (to name just a few) can all lead to a less than spectacular result in the eyes of the patient. It has been estimated that 8-10% of rhinoplasty patients are so unhappy with their result that they end up having a revision rhinoplasty- so you are not alone!
The first thing to do is discuss your concerns with your surgeon. This should be done repeatedly throughout the healing process. Asymmetries and swelling should be expected, but resolve over 12 months. Twists, subtle deflections, or bony projections can be aided with massage or exercises that your surgeon can teach you. Steroid injections can help remove supratip edema- but should only be done very sparingly to prevent skin changes. Photography during the healing process is helpful to see where you started, and how your nose has changed.
If you have gotten through a year after your rhinoplasty and you are still unhappy, it may be appropriate to think about revision rhinoplasty and openly discuss this with your surgeon. Comment on the aspects of your nose you dislike and ascertain whether your surgeon feels these are correctable issues. Remember, don't seek perfection or you will always be unhappy. But improvement is something you should expect and seek in a revision rhinoplasty. If you are not confident your surgeon can aid you, see other surgeons in consultation. Good luck!
