I had rhinoplasty preformed 1 year ago. While I like the results I had honestly hoped for a bit more refinement on the tip and the width of my nose. (the picture on the left is my current nose) However I am scared a second rhinoplasty could make my nose look pinched and unnatural. Is it possible to get results more similar to the picture on the right (photoshopped) or is a second surgery to risky?
Considering Under Going a Second Rhinoplasty? (photo)
Doctor Answers (7)
Considering Undergoing a Second Rhinoplasty?
Preoperative photographs and an assessment of skin thickness would be imperative in a case like yours. I do not think you would have to worry about a pinched tip if the surgeon produces natural results on a consistent basis. 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
Considering a Revision Rhinoplasty
Your photoshopped results show that you have reasonable expectations. You will avoid a pinched unnatural result if you select a rhinoplasty specialist.
You could have a secondary rhinoplasty to further refine your tip but the risks are higher with a revision surgery. Your photos look pretty good. You may continue to have further definition past one year post op. Donald R. Nunn MD Atlanta Plastic Surgeon.
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According to a recent publication, revision rhinoplasty to tweak a nose that already looks better is usually sucessful
A recent publication in a Plastic and Reconstructive Surgery found that patients who like the results of their rhinoplasty but want just a little more refinement are usually very happy with their results. Of course, the author is a very well known Rhinoplasty specialist.
You should discuss this carefully with your surgeon. If they don't specialize in revision rhinoplasty, consider another opinion. Even minor tweaks involve more than just shaving a little more cartilage. Often, support using grafts may be necessary to prevent pinching or other potential problems.
Considering a second rhinoplasty
Sometimes a secondary rhinoplasty can clean up any imperfections, however we feel the best effort is the first time, and 'small revisions' can be misleading. Could the tip be narrowed without pinching, or the bridge narrowed without an airway issue? Select a surgeon very carefully.
Secondary Rhino: Good or Bad idea?
If you do a second rhinoplasty, you definitely want it to be your last -- so it's critical for your surgeon to be certain of his/her results. In order to assess what can reasonably be done and expected in rhinoplasty surgery, the surgeon usually works with at least 5 photographs taken from at least 5 different angles -- so to give good advice on a revision rhinoplasty, either the surgeon should be able to evaluate that many angles (taken with a 60mm camera lens to avoid distortion) or would need to see you in person. When being seen in person, the surgeon can also better evaluate what's already been done, which can also effect how much more can still be done. Short of being seen in person, an operative report is very helpful. However, given the single photo you've provided, my guess is that at least a little more could be done to bring the result closer to your ideal. However, the nose you have presently certainly doesn't look bad and even at a year, you will still get some additional refinement of the tip as time goes on. So you definitely have to ask yourself whether it would be worth the money or worth any risk at all.
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.