Revision rhinoplasty

Andrew Pichler, MD answers: Revision for smaller nose after Rhinoplasty?

I had a rhinoplasty a while ago in CA. I feel my nose isn't "right". It's like my nose went from size extra large to something small. I have thick skin, since the surgeon made my nose literally 2 1/2 times smaller. Is it the thick skin that is making it look odd since my nose is so much smaller? The surgeon cut about 4-5mm off the bridge (entire). Will the skin shrink to fit my nose? My nose looks undefined and the bridge looks flat (especially from the side view). What are my options for it to look normal again?


Andrew Pichler, MD
25 days ago

First, it is difficult to make a judgement based on just one small photo and one view. Palpating (feeling) the nose is also important to determine skin quality. All this goes into the decision making process when deciding what  to do. But, based on the one photo it does appear that perhaps your lateral osteotomy (the bone cut along he side of the nose to narrow the nose) was made too high so there appaears to be a "step" deformity. This can be easly felt on exam,. This may contribute to the unnatural look but can be corrected relatively easily upon revision by doing a secondary lateral osteotomy. As to the skin shrinkage you can expect that to continue up to 12-18 months after surgery pending the thickness of your skin. Hope this helps. Good luck.

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