I have had two surgeries already, first was to correct deviated septum and fairly large nasal hump. The second was to further reduce the nasal hump completely and to shave the right side of the bone a little bit. Now, from the front view, my nose appears crooked. After consulting with my original surgeon, it appears that there is fatty tissue in excess on the right side of the nose, primarily in the tip region. I am wondering if it is difficult to remove scar/fatty tissue from the tip?
Options For A Revision to Correct Assymetric Tip? (photo)
Doctor Answers (6)
Asymmetry after two rhinoplasties
The picture shows a definite concave-left contour. It is hard to evaluate without seeing you in person: the diagnostic challenge is to figure out whether this is due to weakness on the left or fullness on the right. Once this is established a plan can be formulated for revision, either reduction on the right or the addition of tissue or filler on the left. One key point is to evaluate breathing: it is important to avoid airway collapse secondary to too much tissue removal.
Asymmetric Nasal Tip Following Prior Rhinoplasty
At the appropriate time, I would probably try and manage this type of issue using injectable steroids to shrink down the undesirable soft tissue prominence. This has to be done by a rhinoplasty surgeon is experienced in using steroids. This is actually an area of debate with some rhinoplasty surgeons avoiding injectable steroids at all costs. But in my opinion, injectable steroids can have a significant role in managing issues like this postoperatively. There is always a risk that a prominence can be turned into a depression as a result of the steroid response, but in a good majority of cases this can be avoided.
Correction of Asymmetrical Tip
Fat and sccar tissue can be removed from the nasal tip, but you have several issues that should be addressed. There is asymmetry of the nasal bones, septal deviation, asymmetry of the tip, and asymmetrical flaring of the nostrils. Examination would clarify my concerns.
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You may be a candidate for a Non-Surgical Rhinoplasty to improve the crooked appearance of your nose.
I read your concerns and reviewed your photos which are limiting.
You appear to have a concavity along your left nasal-bridge that is contributing to your crooked appearance. A well-performed Injectable Filler procedure to fill the concavity may restore symmetry, and improve your appearance. My preference and experience is with Silikon-1000, an off-label filler for permanent results. My practice philosophy is to reserve further surgery as a last resort.
Hope this helps you.
I think an examination by an individual with experience in secondary rhinoplasty would be worthwhile. To my eye there are multiple issues here which include the position of the nasal bones ,the septal position and issues related to the nasal tip.
I believe this is due to persistent deviation of your septum which will need to be totally freed, straightened and secured in midline position in order to correct the deviation of your nasal pyramid. Majority of deviated noses are due to deviated septum as well as facial asymmetry.