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I Need a Revision Rhinoplasty. What Needs to Be Done to Make my Bridge Straight?

asked 1 year ago by NNNN in New Haven, CT
Latest answer by Elliot M. Heller, MD
Question viewed 566 times
Tags: breathing, options, post nasal drip, unsatisfied

I had a closed rhinoplasty done over 2 years ago to remove a small hump and to refine a slight bulbous tip. I am very unhappy with my results. What needs to be done to make my bridge straight. Do I need sreader grafts? Or do I need the tip to be reduced or do I need both the tip and bridge worked on. Do collapsed nasel valves make the middle of the brigde look dipped and bigger? Im wondering if this is the issue because I have breathing issues through my nose and post nasel drip.

11 answers to I Need a Revision Rhinoplasty. What Needs to Be Done to Make my Bridge Straight?

+1

Polly-Beak

Your picture looks like the nose has a "Polly-beak" deformity, which is a fullness over the tip. I would recommend having the fullness over the tip of the nose taken down and a slight build up of the bridge over the bone with a graft in order to get a straight nasal dorsom.
Elliot M. Heller, MD

New York Facial Plastic Surgeon
+1

Correction of polly beak deformity

You have the classic deformity of an over-resected nasal bridge You should be able to get correction of this with cartilage grafting of your bridge, possibly using a rib graft
Sam Naficy, MD

Seattle Facial Plastic Surgeon

seattleface.com

+1

Revision rhinoplasty for dent in nose

From your limited photos it appears that you have an over resected dorsum and collapsed middle vault. Augmentation grafting of these areas will restore balance and markedly improve your appearance. You need to find a surgeon with experience at revision rhinoplasty and reconstructive techniques. Good luck!
Michael L. Schwartz, MD

West Palm Beach Plastic Surgeon

www.palmbeachface.com

+1

Revision Rhinoplasty After Mid-Vault Saddle and Inverted V

Thank you for posting these photos, they are very helpful. The reason you have this shape is the mid-vault (which is all cartilage) has collapsed. This is because the cartilage that covers this area (upper lateral cartilage) attaches at two points - the nasal bones and the septum. If it is detached from both and not supported, it collapses in and causes cosmetic plus breathing problems. The solution is to re-suspend the upper lateral cartilages and place spreader grafts... more
Paul K. Holden, MD

Phoenix Facial Plastic Surgeon
+1

Correction of the Inverted-V Deformity in Revision Rhinoplasty

Thanks for the question and for posting your photo. You appear to have what we call an "Inverted-V Deformity." Placement of spreader grafts during a revision rhinoplasty would appear to be beneficial for addressing your concerns with both the form and function of your nose. These are thin cartilage grafts taken from your septum (ideally), or ear/rib cartilage, if the cartilage from your septum has been previously removed. The idea is that by placing these grafts on either side of... more
Umang Mehta, MD

Bay Area Facial Plastic Surgeon

www.mehtaplasticsurgery.com

+1

Straightening bridge and improving congestion

You do appear to have collapse of the middle third of your nose, giving you an inverted V deformity which can certainly lead to nasal congestion. Spreader grafts can help with this issue. Your profile line can also be improved. I would suggest visiting with an experienced revision rhinoplasty surgeon to examine your nose and see what specific changes you would like done to your nose.
Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon

www.drlamperti.com

+1

Low bridge affects your nasal shape and funtion

You have fortunately had a conservative closed rhinoplasty that limits your scarring and postoperative deformities. This puts you in an excellent place for a revisionary procedure. Your skin cannot shrink any more, which is why your nasal contours are blunt. If your dorsum is raised by a a cartilage graft from your septum or rib, nice things will happen: your nose will look narrower and longer; your airway will at least double (based on my published airflow studies); your... more
Mark B. Constantian, MD

Nashua Plastic Surgeon

drconstantian.com

+1

A non-surgical rhinoplasty procedure may be used to raise the height of the bridge of your nose after Rhinoplasty Surgery.

I read your concern and reviewed your photos. If you have nasal obstruction, you should consult a reputable, certified Rhinoplasty / ENT specialist to determine the cause. Sometimes a combination of antihistamine and steroid nasal sprays may improve your airway and post-nasal drip. If you can have your functional nasal issues addressed without surgery, you may wish to consider an Injectable Filler procedure to raise the height of your bridge. My personal preference is to use Silikon-1000... more
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+1

Breathing Problems and Depressed Bridge after Rhinoplasty

I'm sorry your dissatisfied with the results of your original rhinoplasty. You do have a scooped-out bridge, an inverted V deformity, and possibly a pinced tip. Spreader grafts and grafts to augment your dorsum (prifile line) will improve form and function. You need an experienced revision rhinoplasty surgeon.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Revision rhinoplasty for nasal bridge and more

The fact that your are experiencing breathing difficulty raises concern for internal nasal valve collapse and obstruction. It appears from photos that you would benefit from spreader grafts and additional nasal bridge modification (likely a small graft at the site of depression) to create an improvement in profile. Spreader grafts will help your breathing and appearance at the same time. Narrowing of the valve region, as seen in your photos, is a known complication following hump... more
Grigoriy Mashkevich, MD

Manhattan Facial Plastic Surgeon
+1

I Need a Revision Rhinoplasty. What Needs to Be Done to Make my Bridge Straight?

The dorsum is over resected and there is separation of upper lateral carilages from nasal bones causing an inverted V deformity and hence the nose looking wider in the upper portion. Spreader grafts will correct the middle vault problem as well as improvement in breathing and you will need dorsal graft to correct the ski slope dorsum.
Mohsen Tavoussi, MD, DO

Huntington Beach Facial Plastic Surgeon

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