Revision Rhinoplasty Q&A
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Need a 4th Revision Rhinoplasty. Will It Help?
asked 1 year ago by busyMommy in Gurnee, IL
Latest answer by Sam Naficy, MD
Question viewed 490 times
Tags: columella, hanging, results
I'm very scared of doing another revision on my nose. Every time I try to get something corrected it ends up worse. The first Dr did two, first time I ended up with acrooked nose. The second time I ended up with a piggy nose. Last one was in December 2008 with a different Dr, my main concern was the columella hanging, now I have no assymetry and hanging columella. does my nose have hope or do I just live with it? Thanks for your opinions.
13 answers to Need a 4th Revision Rhinoplasty. Will It Help?
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Will a 4th revision rhinoplasty help
You never HAVE to have a revision rhinoplasty. The main issue is whether the problems that concern you can be improved with surgery and whether the risks, recovery time, and expense are worth it.
In experienced hands your nose can be improved. If you are seriously considering revision surgery I would be sure to consult with a few surgeons who have extensive experience with revision cases like yours.
A better sense of what could realistically be done would come from an examination of...
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4th rhinoplasty - to do or not???
My advice to you would be to either not do any more surgery or go to one of only a handful of national experts in revision rhinoplasty. You live in IL so Dr. Toriumi is excellent but my personal top choice is Dr. Jack Gunter in Dallas. Ask them if there is a hope of improvement and if they say no, don't do any more surgery.
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4th Revision
As long as the tissues are healthy, you are motivated, and your expectations are realistic there is room for improvement. You may very well need a rib graft to correct the contour deformity of the bridge
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4th revision rhinoplasty
One should be very careful when undergoing a fourth revision rhinoplasty. An alar retraction is best treated with a combination of composite grafts from the ear along with any alar baton grafting. Columellar hanging and show are best treated by resection of both membranous and cartilaginous caudal septum. Look for a very experienced rhinoplasty surgeon who has lots of experience performing both primary and revision rhinoplasty before embarking on your next rhinoplasty...
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Multiple revisions
After multiple revisions often the scar dictates what is possible. I would suggest if anything very modest goals.
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4th Revision Rhinoplasty
You are smart to proceed cautiously. Sit down with a very experienced revision rhinoplasty surgeon to determine what you both want to achieve with safe limited intervention. A careful review of previous operations will be helpful.
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Need a 4th Revision Rhinoplasty. Will It Help?
If all you are looking to improve is the hanging columella, then, yes, I think a minor revision done with particular techniques would give you an improvement (see link).
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A well-performed Injectable Filler treatment may be helpful for restoring symmetry to your nose. Video attached.
I read your concerns and reviewed your photos. In my view, you should reserve any further revision rhinoplasty surgery as a last resort. You have some tip asymmetry, and nostril retraction on both sides. You may want to consider a non-surgical rhinoplasty procedure to add some volume to your nose, lower your nostril margins, and restore tip symmetry. I prefer to use Silikon-1000, an off-label filler, for permanent results.
I hope this is helpful for you.
Regards from NJ:
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" Quit While You Are Ahead"
Hello, Mom from Gurnee.
Know your city well; Six Flags Magic Mountain + consulted for the Gurnee School District just before entering US Army, following residency at U of Illinois.
I advise no further surgery. You are an attractive lady. While your nose is not perfect, few -- natural or operated upon -- are. "Quit while you are ahead" makes sense. What if the next operation leads to infection or tissue loss? You would kick yourself.
Need I remind you, or our...
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Revisoin rhinoplasty
I would avoid repeated rhinoplasties on your nose. Each time back is like a time bomb ticking. The skin may not handle the repeated trauma.
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Non-surgical rhinoplasty with fillers works very well for revision rhinoplasty
There are several reasons non-surgical treatment with fillers is a great choice in revision cases like yours.
Using fillers is more of an additive process, building your nose, not weakening it further.
Fillers may be placed without having to separate the skin from the bone and cartilage again.
Fillers are actually better at small to medium changes than surgery as they can be more precise.
If you use temporary fillers like perlane or juvederm, there is a chance that...
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Need a 4th Revision Rhinoplasty. Will It Help?
I think your nose has hope.
You need to find an experienced revision rhinoplasty surgeon. Did your other two surgeons specialized in rhinoplasty? Did they have years of experience with this type of surgery?
Revision rhinoplasty is a difficult surgery, and the outcome will be highly variable on who performs the surgery. Ensure that you interview many surgeons and you look for an experienced FACIAL plastic surgeon, as usually they have more experience when it comes to rhinoplasty...
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4th Rhinoplasty Revision
Hi,
Its unfortunate that you have had a bad experience 3 times in a row... However, from the pictures you sent, you are definitely a candidate for a revision. You really have to take the time out to choose your surgeon wisely the 4th time around. There are certain things that could be made better, such as the profile and collumela. Make sure to choose an experienced rhinoplasty surgeon, this is not an easy revision.
Best,
Dr.S.
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