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Revision Nose Surgery and How Far Can I Expect to Reshape and Fixing the Function

Dear Doctors I had a nose surgery 3 years ago and now I have running problem mostly and If I tape it hard on the middle part of the nose i can breath easier ,why ?? Am I able to do the following: 1-narrowing sides and front 2-reduce nostrails show 3-symatrical 4-no bump on the tip 5-fixing function is it covered by OHIP, health card i have attched photos of nose before and one after photoshop please give me your idea, price if i can afford, in L.A and Toronto yours

Doctor Answers (6)

Composite grafts fix high nostrils

+4

When the skeleton is reduced, things change.  Your breathing is worse because your bridge was reduced and so your internal valves have been weakened.  That is why pulling the sides out helps.  Breathe Rite strips would help also.

New airway obstruction after rhinoplasty often happens but is avoidable and correctable.

Your nostrils can be lowered by placing "composite" grafts of cartilage and skin from one of your ears into incisions in the insides of your nostrils.  The added skin pushes the rims down.

Your desired result is narrower than can be achieved. You have had a reduction and have lost airway and shape.  If you reduce more it will get worse, and I doubt that your skin can shrink more.  Be careful of the advice you get.

Your airway problems should be covered by insurance, though I do not know the Canadian system well. Good luck.


Nashua Plastic Surgeon
5.0 out of 5 stars 20 reviews

Revison Rhinoplasty goals for you.

+3

 From the photos, it appears that the nasal bomes are wide due to an open roof deformity and there is excess scar tissue over the nasl tip and supra tip making it appear wide and thick.  This would, IMHO require a revision closed Rhinoplasty with medial and lateral osteotomies to narrow the nasal biones and move them closer together in the midline.  The tip could be thinned using a retrograde tip plasty technique to remove excess scar tissue and residual tip cartilage (if any) is found during the surgery. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Breathing problem may be related to collapse of the nostrils (i.e., nasal valve) during deep inhalation when you exercise

+2

Your breathing problem may be related to collapse of the nostrils, otherwise known as the nasal valve, during deep inhalation when you exercise.  This may be related to your excessive nostril “show” if the remaining cartilage along the edges of the nostril is either weakened or deficient. 

This can be corrected by placing cartilage along the edges of the nostril, to act as a strut or support for the remaining cartilage that you have in place.  A cartilage graft in this location could also be used to lengthen the sides of the nostril, to reduce nostril “show”.  Cartilage to be used for this purpose could be obtained either from any remaining nasal septal cartilage that you have in place, or from the cartilage in one of your ears. 

It looks like the nostril “show” is a little worse on the right side than on the left.  This could be corrected with carefully positioned cartilage grafts. 

The bump on the right side of your nasal dorsum may simply be scar tissue, correctable by serial Decadron or triamcinolone injections.  This would be a much easier solution to address this problem alone, rather than surgery.  The excessive width of the nasal dorsum “sides” may also be improved with simple triamcinolone injections before proceeding to revision nasal surgery.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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Realistic expectations with reshaping

+2

The sides of the nose can be narrowed by moving the nasal bones closer together. The tip would have to be narrowed as well, most likely through an external rhinoplasty.

Elliot M. Heller, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 28 reviews

Revision rhinoplasty to improve shape and function

+1

The long list of issues you have with your nose can all be addressed, as well as improvement in the internal valve to correct the pinch in your airway. The photo-shop work you have will help your surgeon to understand what you are looking for the second time around. Secondary rhinoplasty take a good bit of experience so choose carefully.

Best of luck,

peterjohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 26 reviews

Nasal obstruction and poor aesthetic result after rhinoplasty.

+1

 Nasal obstruction and poor aesthetic result after rhinoplasty can be repaired with all of the items you mentioned but the nose will be improved not perfect. The septal deviation and narrowness can be improved as well as your nostrils, pinched tip, middle vault narrowing, etc. Make sure you see an experienced rhinoplasty surgeon since your nose is requires advanced rhinoplasty techniques.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 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.