Crooked Nose One Year After Septo-rhinoplasty, If This Possible to Fix?

I am ONE year post primary septo-rhinoplasty. Pre-surgery, I had an almost perfect profile and straight nose & even nostrils. What I asked for was correction of breathing problem and narrower nose. My nose is much bigger than before, crooked and noticeably shifted to the left, tip is hard and bulbous and nostrils uneven. I also have chronic pain in the bridge and tip areas. I consulted 3 different surgeons, all say different things. My own surgeon says he can't help further. Any Suggestions?

Doctor Answers (6)

Crooked Nose after SeptoRhinoplasty

+2

I'm sorry to hear about your experience.  Unfortunately, you are not alone.  If your original surgeon cannot help you any further, get a copy of the operative report and seek out a Board Certified Surgeon who is a specialist in the face who can help address the problem.  The issues involved are two-fold: 1) underlying anatomy that is contributing to the crooked nose and 2) external aesthetics (tip, uneven nostrils, etc.).  Depending on how much work needs to be done, revision surgery can be challenging.  Please get a personalized consultation from a board certified specialist in facial plastic surgery who can assist you in achieving the results you seek.


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Crooked nose after rhinoplasty

+2

It does sound like you need a revision procedure. Time now to take a deep breath, start doing your research and move forward. Deviated noses by themselves are difficult to correct  but adding the revision factor increases the complexity. You need to find a surgeon with skill, experience, interest and comfort at both. Make sure you see plenty of before and after pictures of previous patients he/she has worked on with these problems. Try to sort out in your own mind what is your highest priority-straightening, refining etc. Above all take your time and don't rush your decision. You lose nothing by being patient. Good luck.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Rhinoplasty

+2

I am sorry to hear about your predicament.

If you are able to post any photos, I may be able to give you an opinion. 

Sounds like you need a revision surgery done.  The plan for revision will have to be done in a personal consultation with assessment of photographs etc.

But I want to give you hope that there are ways to improve the situation.  Rhinoplasty is such an operation, that there may be differing opinions.  You should try to revisit one of the surgeons with whom you felt comfortable, who spent time explaining the problem and how to correct it. The operative plan should make sense to you. 

Since you are already a year out, waiting any longer may not change or improve things much more.

Good luck to you.

Shashidhar Kusuma, MD
Plantation Plastic Surgeon

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Steroid injections can improve the apparent larger size and shift if related to scar tissue

+1

My strongest advice to you is to wait at least 1 year from your initial septo-rhinoplasty surgery before considering revision surgery.  You’ve been patient enough to do that – so good job!   Patients are often surprised at how much change can take place so long after their initial surgery – so much so that revision surgery is sometimes no longer even considered. 

If your problems do persist more than a year after the surgery, certainly revision surgery could be considered.  Multiple revision surgeries, however, should be avoided.  Very careful planning and consideration of your revision procedure should take place before you proceed.  Sometimes, simple steroid injections can improve the apparent larger size, and even the apparent shift to the left, if this is related to scarring of the soft tissue in the nose.  Any revision procedure should involve a very detailed analysis and carefully tailored individualized plan.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Crooked Nose One Year After Septo-rhinoplasty, If This Possible to Fix?

+1

I have performed Rhinoplasty for over 20 years and IMHO, you already seem to have your answer.  After 3 consultations, what were the recommendations regarding a Revision Rhinoplasty?  They have the advantage of examining your nose and ascertaining what would need to be done during the Revision Rhinoplasty.  If during the previous Rhinoplasty, a hump was removed, you might have an open roof deformity from incomplete in-fracture of the nasal bones.   

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Avoiding problems in revisional rhinoplasty or septoplasty

+1

There are many possible causes for your dissatisfaction.  Without pictures it is very difficult to comment.  The good news is there is nearly always a reasonable solution.  I would seek out a plastic and reconstructive surgeon with craniofacial training as this is where I developed my technique and skills in treating secondary and tertiary rhinoplasty.  Unfortunately most patients slide down a slippery slope after one unsatisfactory rhinoplasty.  they often visit another surgeon with limited rhinoplasty expertise that does not identify the root problems and actually worsens the situation by removing more and more cartilage.  This is when patients get to the point of 'tertiary rhinoplasty' where rib cartilage is actually needed to recreate aesthetic structure.  Avoid this path by seeking an appropriately trained practitioner with this expertise!

 

 

All the best,

 

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 31 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.