Hello, I had a nose job about a year ago and I'm unhappy with my results. Should I seek revision? Also, what exactly is wrong with my nose? Why is there a depression at the junction between the tip and the bridge? What did my surgeon do wrong?
Bad Nose Job- Seeking Revision.
Doctor Answers (11)
Promoted Local Answer
Difficult to say with pictures you sent, It appears that you have a bulbous tip and there is a tip-dorsum unevenness. You should get a second opinion if you are not happy with your results.
Super-tip after rhinoplasty
I feel your pain and sympathize with you. Rhinoplasties are tricky when the skin is Mediterranean and oily. It sounds counter-intuitive i know but an augmentation, not just a reduction, is needed in most cases. I'm Syrian/Lebanese and I know my peoples' noses like few Westerners know them. You need a revision, and a bridge graft (possibly a silicone implant). I've tried cartilage and it doesn't do the job in our noses. Sorry to be so personal but few Europeans have the type of nose you and I did, and it is important to seek the advice of a board certified plastic surgeon this time. I would see a surgeon who has done a ton of ethnic noses. My nose job was performed by Bahman Teimourian MD in 1985, and it still is hard to see that I have had anything done. Anyone can do a rhinoplasty on thin skinned white people, few can make you (and I) look great...but it can be done.
Bad nose job seeking revision rhinoplasty
Usually, the deformity that you've encountered stems from overresection of the nasal dorsum, especially in the middle third of the nose. If I were to see a profile photo I'm betting that I would see a deficient amount of height on the bridge of the nose and too much fullness of the supratip region with a droop. This is due to overresection of bone and cartilage and a pollybeak deformity. The inverted V you see on the photos is due to the shadowing of too low a middle third of the nose. The best manner to correct this problem is a fairly aggressive augmentation of the nose at this point to rebuild, heighten and create a longer more elegant dorsum with either implant material or rib cartilage, followed by projection of the nasal tip with supporting suturing and perhaps fine refinement of tissue. Unfortunately, this would require a revisional surgery but it would get the job done for you. Hope that helps!
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Difficult to say from these photos alone. You may have what is called poly beak deformity as the reason for your "step off" in frontal view or it may be scarred soft tissue. You should have an exam with a surgeon with revision experience for a better evaluation.
Yes, if you are unhappy I would find a revision rhinoplasty specialist and go in for a consult
Yes, if you are still unhappy with your results i would find the best revision rhinoplasty specialist in your area and schedule a consultation. It is hard to tell from the photos what is 'wrong' but about 20% of people need revisional surgery so this is not uncommon.
I have specific advice for you, as there are some features of your nose which might explain your sense that all is not right. Having said that, the pictures you provide are not good enough and a lateral view pre and post is necessary to advise you completely, particularly to look at your tip projection and the supratip shape. However:
1. Your preop nose is the most difficult to achieve good results with. Its broad on front view and thick skinned.
2. Your type of skin takes 2 years if not more to shrink as much as it will do. That is, we normally tell our patients that the final result is seen in one year after surgery. This is not true in noses like yours, where the final result is not seen for at least 2 years. It's really important to understand that. Indeed, some thick skinned noses take even longer to shrink after surgery.
3. I can see the "bump" which looks like an exaggerated supratip break from the front view. We need to see a side view to understand whether the tip is overprojected or not. If it's not, then its likely that time alone will turn your result into a good one. If this tip is overprojected, a fairly small revision to deproject the tip might be needed, however I'd definitely say wait another year before being sure of that. If you take good pictures now, and in a year the nose will definitely look different and I suspect better in a year.
4. If the projection looks ok on the side view, but there is a little hollow above the tip, a revision is not needed as that can be corrected by injectable filler in the office, pretty easily and with no recovery time.
5. Can you breathe well?
Revision rhinoplasty to fix depression on bridge
It's hard to fully assess your nose without other views. Revision surgery could be considered to improve the areas that concern you such as the bridge.
You do have a somewhat fuller tip and it may be that improving this would help the depressed area.
Being about a year out from surgery would allow for a good assessment of what is leading to your concerns. You could visit with your original surgeon to see what his or her opinion is. If you're not satisfied you could get another opinion from other rhinoplasty specialists as well.
Seeking revision rhinoplasty
Ask your surgeon what he or she thinks. Then get a second opinion. Remember rhinoplaty is the most diffcult cosmetic operation but, revision rhinoplastt is the most fifficult of all. I need to see better pictures
Rhinoplasty revision is the only way to correct the nose after 1 year.
Rhinoplasty revision is the only way to correct the nose after 1 year. The tip can be refined and the balance of the nose restored to a more aesthetic look. I would need to see the profile view as well. See an experienced revision rhinoplasty surgeon for a second opinion.
Revision Rhinoplasty in Thick and Oily Skin
It appears that your skin is thick and perhaps oily. Thick and oily skin is difficult to work with when performing rhinoplasty. The changes after rhinoplasty especially in young patients with your type of skin can take a few years. You should discuss your concerns with your rhinoplasty surgeon, and perhaps get a few other opinions from rhinoplasty experts. I would likely wait and see if your nose changes favorably over the next year before having another surgery. Good luck and be well.
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.