If my Revision Rhinoplasty Resolved Some Issues, but Caused Others, Should I See the Same Surgeon Again?

He sees the upturn, nostril show and the nostril assymetry, and is willing to revise (for a reduced fee-- not free), but if he promised me no upturn originally, should I go back to him to try and correct it now? He says he is wary of lengthening my nose for fear of necrosis but said he could redo the right nostril graft to try to get it more open like left side. I also want him to try to fix the tip skewing to the left. How would that be done? He is not willing to lengthen, fearing necrosis

Doctor Answers (6)

Another revision

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Correction of nasal asymmetry is one of the most difficult challenges in rhinoplasty and I agree with other that even with another surgery you will likely have some residual asymmetry present


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 145 reviews

Revision

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Revisions of any surgical procedure should be proceeded with, with caution. Remember, the enemy of good is perfect. Meaning, sometimes striving for perfection can lead to other problems that you did not contemplate and can leave you less satisfied. Consider each surgery with care. 

Marc Schneider, MD
Fort Myers Plastic Surgeon
4.5 out of 5 stars 10 reviews

Should you consider a third Rhinoplasty after second wasn't completely successful

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 The issue is whether or not the things that bother you about your nose, at this point, are important enough for you to have a third Rhinoplasty?  When consulting with my Revision Rhinoplasty patients, I'm very focused on sppecific changes that we are trying to achieve and even more specific about the ones that pose more risk than reward if attempted.

 Noses, tips in specific, are crooked for several reasons.  They either have asymmetric tip cartilages that cause the tip to sag, droop or rotate up unevenly, making the nose appear crooked.   They have a crooked anterior septal angle or they have nasal bones that are asymmetric.  The correction depends on the cause and what was done previously, to your nose, during the prior two Rhinoplasties.

 As far as whether you should return to the same surgeon for the third Rhinoplasty comes down to whether, or not, you still have faith in the surgeon.  It's always in the best interest financially for the patient to return to the previous surgeon as a new surgeon will surely charge you and most likely more for the revision Rhinoplasty than your current surgeon.  If however, you have lost faith in the surgeon's ability to make your nose more attractive, at this point...you should consult with at least 2 experienced Revision Rhinoplasty surgeons moving forward.  Hope this helps and good luck.

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

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Revision rhinoplasty

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It sounds like you are talking about your third operation. I would proceed slowly and try to be realistic in my expectations. You will likely always have some nostril asymmetry. Your nose is deviated and that needs to be corrected as well. Don't try to solve every problem as the more you attempt the more problems can be potentially created.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

If my Revision Rhinoplasty Resolved Some Issues, but Caused Others, Should I See the Same Surgeon Again?

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It would be helpful if you indicated how long ago was your last surgery, as swelling may have not resolved and the full shape of your nose may have not been achieved.

As for your concerns, you must decide if you trust your surgeon. There are many issues that you want corrected and a small revision may just lead you back to where you are now-some issues are resolved and new ones have arisen.

Is your surgeon a revision rhinoplasty specialist? Are you willing to undergo another full nose revision surgery? That is what you must decide. Also, even if a full revision is done, you may end up with new problems, granted that the chance goes down with the expertise of your surgeon.

I recommend you consult with rhinoplasty specialist in your area, and you get a sense of whether you want to undertake this.

Michel Siegel, MD

 

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.5 out of 5 stars 83 reviews

Rhinoplasty revision

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Revision should be done at least 6 months after the original surgery if the problem is too much, if not wait one year.

The upturn I may talk you out of.

However the nose seems deviated in the pictures, wide dorsum, and collapsed right nostril.

To correct all this is a complete complex secondary rhinoplasty, that requires cartilage graft to the collapsed nostril, a spreader graft and an osteotomy.

Samir Shureih, MD
Baltimore Plastic Surgeon

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.