Botched, Butchered Nose Need Revision Info Please? (photo)

Unforunately I got butchered by an ENT. he used the tongue and groove. I think I have alar retraction on the left and right.I will probably need bilateral composite grafts. I want the sutures from the tongue and groove removed and my tip derotated slight. I want D-C fascia for the birdge bcause probably half of the height is chopped off this butcher. further i want deep temp fascia for dents on sidewals. I am very depressed its been 4 months. what else needs to be done to reach the goal pic?

Doctor Answers 5

Revision rhinoplasty

I agree that butchered is a strong word.  Also, don't blame the techniques used, blame the surgeon (if anything).  The main issue I see is alar retraction.  This might require composite grafts to fix, depending on what the internal nasal lining tissue looks like.  You have more of a "pseudo hanging columella" than anything.  There may be a slight actual hanging columella, but the main issue is alar retraction.  I also agree with you that your bridge is somewhat low as well.   Don't freak out.  Your nose can be improved, but may require another surgery.

Richmond Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

14051 St. Francis Blvd
Midlothian, VA 23114

Revison Rhinoplasty


I do see the collumelar show and the alar retraction, I dont think its botched and butchered. However, you can get a revision rhinoplasty to correct these things. I l dont think you'll look like the soccer player though.




Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 235 reviews

44 East 65th Street
New York, NY 10021

Tongue in groove, composite grafts, in dice cartilage fascia wrap in revision rhinoplasty

You've already described a pretty reasonable surgical plan.  The tongue-in-groove technique itself is probably not to be blamed.  You do have a hanging columella, and an appropriately placed suture could elevate it into a position more like your goal picture.  Otherwise, composites, DCF, tip counterrotation, and fascia for irregularities sound like reasonable preoperative plans.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

120 South Spalding Drive
Beverly Hills, CA 90212

Revision Rhinoplasty

I agree that a revision will be necessary. However wait another 6 months before having more surgery. Your columella can be elevated and the nostril margins lowered with cartilage grafts. Rather than requesting specific surgical techniques consult with a revision specialist to discuss alternative approaches.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

416 N Bedford Dr
Beverly Hills, CA 90210

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