Advice on Possible Revision Rhinoplasty. What Now? (photo)

These photos are 10 months post op. At the time, nose was supposedly straightened, bridge hump rasped. Cartilage removed from some area to shorten it or lift the tip. Closed technique. No tip work. The pictures are a final result. But as can be seen, there is noticable asymmetry from the appearance of a lump on the right side only. The nose remains slightly crooked. An assessment will be made with the original surgeon to see if revision work will resolve this. What improvements should be made?

Doctor Answers (4)

Crooked nose - revision rhinoplasty

+1

I would be curious to see your original nose. A crooked nose can be due to several different structural problems. Did you previously break your nose? Was breathing (septal) work performed during this surgery? If the interior of your nose is crooked, the outside will follow. Your nose still appears asymmetric to me so I would talk to your surgeon about the interior framework of your nose as well as the exterior aesthetics.

 


Los Angeles Plastic Surgeon
4.5 out of 5 stars 25 reviews

Possible Revision Rhinoplasty

+1

There is some asymmetry and deviation as you describe. Consult with your surgeon about a revision. I think there is room for improvement.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Revision rhinoplasty to correct a curved nose

+1

Thanks for the question, Symon. To me the primary issue is the curvature of the mid-portion of your nose, likely due to curvature of the top of your septum. This is giving your nose a C-shape. This can be corrected by straightening your septum with suture techniques and/or placement of 1 or 2 left sided spreader grafts. I would do this through an open approach, to ensure that the spreader grafts and sutures are placed precisely. 

Are you having any difficulty breathing? These maneuvers may also help your airway by lifting the left upper lateral cartilage outward, which widens the internal valve of your nose. If you do have functional issues, Insurance coverage could be a consideration. Because of the large volume of cosmetic and functional rhinoplasty in my practice, we are contracted, or "in-network", with most major insurance companies. 

Obviously I would need to see you in person to fully assess your anatomy, but based on your photo, this seems to be your main issue. In my opinion, your left profile view looks pretty well-balanced so I would leave this alone unless there is something which is really bugging you. Your primary correction would be on front and 3/4 views.

Lastly, if you were opposed to the idea of revision rhinoplasty, nonsurgical rhinoplasty involving injection of fillers such as Restylane, Perlane, or Juvederm could be an option. Widening the left side of your bridge would make the nose appear straighter. These fillers seem to last quite a while (over a year) in the nose and have the advantage of being reversed with hyaluronidase should you so desire. This is an approximately 5-10 minute procedure in the office with minimal discomfort and virtually no downtime. It sounds like you are more interested in surgery, but I thought you should know about all of your options. 

Best regards,

Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

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Possible revision

+1

well its hard to say exactly but since you have thicker skin and an element of rosacea of the skin the healing takes considerably longer.  perhaps a steroid injection if its post op swelling, massage and taping at night.

i would reconvene with the original surgeon and have him inspect for any structural abnormality aside from the skin being thicker and swollen from the operation.  In that case allow the skin to settle as much as possible to better gauge the severity of the deformity. then after another evaluation you can discuss another operation to correct it

 

 

Michael A. Carron, MD
Detroit Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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.