What are my options with this? I'm so depressed. I don't know how to confront my surgeon?
One Year Post Op Rhinoplasty. Worst Results Ever. Need Advice? (photo)
Doctor Answers (13)
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You may benefit from a second opinion regarding your nose after Rhinoplasty Surgery.
You appear to have very thin skin with significant tip asymmetry, nostril retraction, and an exaggerated curvature of your nasal lobule. This may require revision rhinoplasty, and it may be best to visit several reputable rhinoplasty specialists to see what you might expect to achieve after revision rhinoplasty surgery. It would be helpful to obtain a copy of your operative report and pre-op photos.
All the best to you.
Web reference: http://ericmjoseph.com/index.cfm/PageID/4044
Revision rhinoplasty, strong cartilage, thin skin
Not an insurmountable problem. Indeed an unfortunate outcome from elective rhinoplasty, but the problems that are visible are not impossible to correct. In your favor it appears that you have strong cartilages that have become misshapen, but not over resected. This means that there is an adequate amount of tissue to reshape and reconstruct your nose. This sometimes requires cartilage grafting from the ear or rib. Another issue that adds some complexity is that the nasal skin is relatively thin and it may be necessary to try and camouflage the cartilage abnormalities by grafting. Grafting may be performed with cartilage or soft tissue. I would try to find a surgeon whose practice includes at least 20% revision rhinoplasty. In the right hand your nose can be made to appear symmetric and normal.
Revision or Secondary Rhinoplasty
So sorry you are unhappy with your result. Your feelings are understandable. If you still have confidence in your original surgeon, go back to that office and voice your thoughts. I would hope he/she would be receptive and agree that revisional rhinoplasty is clearly needed. This is not a simple case, however. From studying your photos, without the opportunity to examine you, I see this surgeon employed an open approach, as the stairstep scar is visible. The major problem is that almost the entire lower lateral cartilage on the right side has been amputated leading to collapse of the alar rim and leaving what's left to spring up to an obvious point. There is subsequent notching of the rim with what appears to be a bit of a hang to the columella (the part of skin and cartilage that separates the 2 nostril openings). Repairing this problem is detailed and complex requiring septal or ear cartilage to recreate and support the deficit in the right alar rim. This is called secondary rhinoplasty and requires significant skill and experience. All the best to you and I hope you can look forward to a successful repair. Barry M. Weintraub MD, FACS.
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I am sorry that you have problems withyour surgery. Clearly this is not the look you were hoping for.
You will need revision surgery. Normally this is not considered before 12 months and you are beyond that.
If your surgeon is very experienced and this was a total mishap you canspeak to them about revision. In either case you should get a second opinion.
Seek out a board certified doctor (AAFPRS or AAPRS) who does at least 30-50 cases per year and ask to see their revision results. If they cant show you great cases then move on. You MAY need to travel to find a qualified doctor.
Asymmetry at 1 Year after Rhinoplasty
Your asymmetry can be corrected and your nose can be improved - no doubt about it. Do not think about this as confronting your surgeon. Your surgeon will want to fix it. If not, I want to fix it.
How to proceed when unhappy with results of rhinoplasty
When was the last time you followed up with her/him? I would guess that your surgeon would not find your result satisfying. First start by following up with your surgeon and sharing the concerns you have regarding your nose. She/he may offer revision surgery. If you have lost faith in your surgeon, do your research for revision rhinoplasty specialists. In the right hands, your nose can be restored to an attractive appearance.
Poor outcome with deformity after rhinoplasty
This result needs to be be corrected. The revision should provide you with a much more normal shape and could be performed as early as 12 weeks after the primary surgery. If you like and trust your surgeon he/she should be the one to fix this. If he/she does not feel confident, or if you have lost confidence, you should see a Board Certified Plastic Surgeon who has had a significant amount of experience with revision rhinoplasty. Make sure to see a comprehensive portfolio of pre- and post-op rhinoplasty and revision rhinoplasty pictures so you can gauge the surgeon's experience and expertise. DON'T PANIC. This can be fixed. Just make sure you find the right surgeon. I personally do not post pre- and post-op face pictures to protect patient confidentiality, so don't just go by web pictures.
One Year Post Op Rhinoplasty. Worst Results Ever. Need Advice?
You need revision with cartilage grafting to correct the displace rotated lower lateral alar cartilage.
Suboptimal Results One Year After Rhinoplasty Surgery
You really only have one option, unfortunately. That is to undergo a revision rhinoplasty procedure. At one year out, you can entertain this option at any time now since adequate time has passed. If you don't feel comfortable having your surgeon perform the revision procedure, you are best off just getting your medical records and seeking another opinion.
Web reference: http://www.drhilinski.com
Sorry for your issues. A revision rhinoplasty may be possible. Best to seek out opinion form several surgeons in person to formulate a plan. Good luck.
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.
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