June 2009:1st procedure, great result, but swiped tip on BF's chin,tried fixng myself (smart i know), resulted crooked. Jan 1 2011:same doc did revision, and came out worse- one side too long, other side too short, doc said he "bent" cartilage or sthg. Oct 1: 2nd revision w/ different doc, short side looks great but other side looks unchanged. Left nasal tip pinched, overall nose too narrow. Possible to recuperate volume and achieve better brow-tip aesthetic lines? With same doctor?
Go to Same Doctor for a Revision Rhinoplasty?
Doctor Answers (5)
If you are comfortable with your last surgeon, you can have him evaluate you for another operation. If you're questioning your relationship with him, it might be reassuring to get a second opinion from another surgeon.
You may consider a Non-Surgical Rhinoplasty to add volume to your nose.
I read your concerns and reviewed your photos: 2 months post-op is way too soon to consider a 4th Rhinoplasty Surgery. In my practice, Rhinoplasty Surgery is reserved as a last resort. In many cases, a pinched nasal tip, and a nose that is too narrow from previous surgery, may be improved with an injectable filler treatment. I prefer to use Silikon-1000, an off-label filler for permanent results.
Hope this is helpful for you.
If you are uncomfortable with your current surgeon, I suggest a second or third opinion. Revisional rhinoplasty is really a subspeciality of plastic surgery. It requires extensive experience and judgement. In addition, not many surgeons are able to perform revisional rhinoplasty through a "closed technique." A large portion of my practice is revisional plastic surgery, particularly revisional rhinoplasty. Virtually all of my rhinoplasties are through a "closed technique", with no incisions on the outside of the nose.
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Maryjayne, it appears that it is possible for your to recuperate the desired volume with a better brow-tip aesthetic line. With regard to going back to the same doctor for another attempted revision - it really depends on your surgeon's expertise in this particular procedure. Does he/she have dedicated experience in cosmetic nose reshaping? Or do they happen to do all other types of plastic surgery as well like breast augmentation, tummy tucks etc? If you think it is a matter of your nose simply not healing properly, then perhaps you should give the surgeon another opportunity to correct things. If your confidence level has dropped, you might be best off cutting your losses and seeking another opinion. There are not many revision rhinoplasty experts out there - do your research. Wishing you luck.
Who should perform revision rhinoplasty
You appear to have a collapse of your left lower lateral cartilage. This can lead to the pinched nasal appearance. This can be addressed with additional surgery but is complicated by the prior rhinoplasties you've had. The main issue is that cartilage grafting would likely be needed and you may have already had your septum used up with the prior procedures.
You can discuss your concerns with your surgeon to see if he feels comfortable with addressing the problem. If you have reservations you could visit with another surgeon to get another opinion.