I don't know specific medical details but I had open rhinoplasty to alter the tip & bridge of my nose. Most work was done on the tip. It has been over 1 year and I have noticed nostril assymetry. On the side with the nostril I dislike, I have noticed the cartilage in the tip slowly becoming more prominent (as it was before) looking at my face as a whole, my nose, I feel, looks slightly shifted/crooked. I am not sure if I am a candidate for revision. Can provide additional photos
Am I a Candidate for Revision Rhinoplasty? (photo)
Doctor Answers (6)
Revision Rhinoplasty for poor rhinoplasty results
I think if you are unhappy, you need to visit some surgeons who do revision rhinoplasty on a frequent basis. These operation are a bit more difficult and require novel techniques. For issues with thin skin, dermal fat grafts and fascia grafts are helpful. For crooked noses, spreader grafts and septal rest are helpful.
Revision rhinoplasty to treat tip asymmetry
Revision rhinoplasty could be considered to improve the nasal asymmetry you're concerned with.
I can get a sense of the tip cartilage prominence you're seeing as well. I can also see (on your base photo) that your left nostril wall has some signs of collapse. This is something that can be improved with cartilage grafting during surgery.
Your current frontal photo shows some signs of narrowing of the left middle third of the nose. This can be improved with a spreader graft.
You can read more about revision rhinoplasty at my web reference link below.
Candidate for Revision Rhinoplasty?
You certainly have some tip asymmetry and some boxiness to your tip. It is difficult to fully assess without a proper set of photographs, but I see no reason why you couldn't undergo a revision rhinoplasty. I wqould encourage you to seek a couple of different opinions from surgeons with expertise in revision surgery. You will then be able to see what your options may be and who you feel comfortable with. Best of luck.
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Revision rhinoplasty is always more difficult than the primary rhinoplasty. Nostril asymmetry can be improved but do not expect perfection. The crookedness appears to be an upper lateral cartilage there is become concave and creating a shadow effect. The treatment for this would be a spreader graft on that side. Additional full face photographs are needed. Please see the link below for examples similar to your own
Am I a Candidate for Revision Rhinoplasty?
I think the result can be improved, but I am not sure that I would offer a revision in your case. Even if a nose looks perfect on the table, there are alterations that can occur in healing. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA
Web reference: http://www.hughesplasticsurgery.com/Rhinoplasty.php
Who is a Rhinoplasty Revision "Candidate"
The tip and profile of the nose can ALWAYS be made to look better either during a primary rhinoplasty or with a revision. On the other hand, there are ALWAYS "vagaries of healing" that occur with any surgery. Surgeons who do a lot of rhinoplasties and get consistently good results will tend to see the potential good that they can do and will tend to ignore the uncertainties that occur with individual healing. Even in the best of hands, "shit happens", especially when the surgeon is not just trying for improvement, but trying for a "home run". All cosmetic surgeons and cosmetic patients alike, especially when considering the wisdom in having revision surgery need to remember the saying "The Enemy of Good is Perfection" -- meaning that when you have something that looks "good", you could end up with a worse problem if you accept nothing but perfection. Any surgeon will, of course, only publish their best results and air the videos of only their best patients with the best results. You never get to see the results that the surgeon, him/herself, would rather do (and often offers to do) a revision on.
So the message is this: When you have a result that you are OK with, and especially if it is better than where you started, think hard about revising it. Although I, for instance, am fully capable of improving the appearance of any tip or profile, and know what it takes to make a nose "perfect" through a revision, and like to believe I can do that consistently, I have seen many patients seeking perfection who I have turned down. Hopefully other surgeons have done the same.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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