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Would Three Nose Jobs be Too Many?

I had my first nose job done 20 years ago. Not much difference, he narrowed the width. I had my second one done 18 months ago. he narrowed width and took down tip (I think he narrowed width too much where tip looks big.) Before he did it another Doctor said it would look more "elegant" if I also did a bridge, but the doctor who did the work said I didn't need one.

I believe now I did. Please let me know if three surgeries are too dangerous and do I need a tip? Many Thanks

Doctor Answers (13)

Revision rhinoplasty

+1
Depending what was done during your last two surgeries, and depending on what you prefer your nose to appear like this point going forward, you can certainly be a candidate for a third surgery. Your goals must be clearly communicatted and this is best done in an in-person consultation with a revision rhinoplasty specialist. I would be happy to provide you a comprehensive evaluation with a review of your history and goals along with a viewing of patients with your similar issues who successfully underwent revision rhinoplasty.

Web reference: http://bwfacialplasticsurgery.com/

Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Is a Third Rhinoplasty Safe and Reasonable?

+1

A third rhinoplasty is appropriate depending on what wasdone during the previous operations and what is necessary to achieve a reasonble result 18 months after your last surgery. Your bulbous tip can be refined. Have a consultation with a surgeon who specializes in revision rhinoplasty. Each procedure becomes more difficult - you want this to be your last. 

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

In my practice, a second Revision Rhinoplasty would be reserved as a last resort.

+1

I read your concern, and reviewed your photo. If you would like to have the height of your nasal bridge raised, you should consider an Injectable Filler procedure which would have no downtime, and would be a fraction of the cost of surgery. I prefer to use Silikon-1000, an off-label filler, for permanent results.

If you want to have the tip of your nose refined, that would require a second revision rhinoplasty surgery. Your outcome would be dependent on what's causing the fullness in your tip: scar tissue vs. excessive cartilage. You would likely require a cartilage tip-graft to see narrowing through your thick skin. If you feel you would require another revision rhinoplasty, you should consult several revision rhinoplasty specialists to see what could be accomplished.

I hope this is helpful for you.

Regards from NJ.

Web reference: http://nonsurgicalrhinoplasty.net/

West Orange Facial Plastic Surgeon
5.0 out of 5 stars 256 reviews

Rhinoplasty

+1
There is no hard and fast limit to a number of surgeries. However, each time you operate on the nose there is additional scar tissue and the support framework for the nose can get compromised. This can be a concern. Additionally, if you have thin skin every irregularity can be noticeable. Good luck and be careful

Web reference: Http://www.drabramson.com

New York Plastic Surgeon
3.5 out of 5 stars 3 reviews

Revision rhinoplasty to refine tip and augment nasal bridge

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In general there is no limit to the number of rhinoplasty surgeries that one can have. With successive surgery there may be limitations with what can be achieved due to scar tissue, disruption of the existing anatomy, etc.

Judging by the one photo you submitted I could see that augmenting your bridge may help a bit with refining your tip. It may sound a bit counter-intuitive, but by improving the projection of the bridge and tip the nose will appear narrower and more refined. This effect is especially helpful in patients with thicker skin.

Web reference: http://www.drlamperti.com/facial-plastic-surgery/rhinoplasty

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Tertiary Rhinoplasty

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Every surgical procedure adds a level of difficulty due to additional scar tissue, compromise of blood supply, and possible loss of key structural elements. One photo view is not sufficient to make a complete recommendation. However, one piece of advice I will share is that tertiary Rhinoplasty requires a very defined and realistic view of what your goals are with further surgery, shared with a very experienced Rhinoplasty surgeon.  Failure to do so will lead to a fourth Rhinoplasty and so on.

Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Three rhinoplasties

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Multiple attempt at revision rhinoplasty can be treacherous.  The quality of the tissues may make it more diffiuclt to mold and work with.  Defining the tip more, say in a thick skinned nose, may not be attainable as say it would in a thin skinned nose.  If you are considering addtional surgery, then I would recommend going with a very experienced revision rhinoplasty surgeon.


 

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

Bulbous tip after revision rhinoplasty

+1

Dear Kensome,
Reviewing your photo reveals a bulbous tip that is not in harmony with the rest of your nose. The third and final procedure, a tip rhinoplasty is a reasonable procedure, if it is performed by an expert revision rhinoplasty surgeon. The only limitation, if you have thick nasal skin. In this case reducing nasal tip to more defined form is challenging. Good luck. Dr. Kevin Sadati

Web reference: http://www.orangecountynosejob.com

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 70 reviews

Is rhinoplasty safe and indicated after 2 rhinoplasties.

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It is as safe as the surgeon is good! If your goals can be achieved then you can proceed. Make sure you see an experienced revision rhinoplasty expert. Whether it is done open or closed depends on what needs to be done to the nose. In 35 years of rhinoplasty I have never had vascular compromise with open rhinoplasty revisions. Some I do closed and others open.
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

There is no number limit to rhinoplasties, but should be done closed for safety

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You can almost always have another surgery--but what can be achieved and what has to be done depends on a number of issues.

The surgeon performing your next operation needs to be aware that the circulation is not what it was originally.  This is one of the reasons that I believe and teach that that closed rhinoplasty, which allows the surgeon to limit dissection and never close a wound under tension, is much safer than open rhinoplasty for revisions.  Data supports my beliefs.  Soft tissue loss can occur when the circulation is not normal, but almost never happens after closed rhinoplasty.  Even the best open rhinoplasty surgeons have healing problems on occasion.

It is also important that you and the surgeon have a well-defined and achievable goal, and that you have evidence (from photographs) that the surgeon has done your type of correction before, and that you like the results.

In your case, two reductions have not improved you because you need both dorsal and tip grafts to shape your skin--it cannot shrink to the shape that you want.  Assuming that you want a straight profile and a smaller lower nose, that strategy will definitely work, but must be performed by a surgeon experienced in the techniques--that you trust.  Good luck!

Nashua Plastic Surgeon
5.0 out of 5 stars 20 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.

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