3 years ago I had a rhinoplasty. I only asked to make my nose slightly small and less wide. But now I have: -A scoop nose; -Tip bigger&harder than before; -A slightly alar collapse; -Wich makes me more unhappy is my nose when I smile (dropped tip and hanging columella).-What was done to my nose, that led to this state? -Is possible to return to a nose similar like the original (same smile expression), and what techniques are needed?
3 Years Post Rhino, Unhappy With Results. What Was Done? What Can Be Done? (photo)
Doctor Answers 6
Revision rhino issues
The alar collapse can potentially be addressed with alar rim grafts
do you know if you had them in your first surgery
your tip is not supported - a columellar strut among other things can help restore tip positon
In my opinion almost all primary rhinos deserve the items in the following list in order to reduce risk of post operative disappointment
1-spreader grafts if separation of components and Osteotomies were performed
2 - columellar strut if open rhino
3- alar rim grafts
Unfortunately rhino revision rates are 15% - I think If the procedure was given its due respect with regards to its true complexity , the rate of disappointment would be a lot lower
Good luck and get multiple opinions
Btw - your nose is a straighter in the post ops but with that said there is room for improvement. I see what you see and you are not being too picky. It is reasonable to desire and expect natural results the are at the same time subtle and profound
subtle because they don't look " done"
Profound because there is actually a change that made the surgery worth while
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3 Years Post Rhino, Unhappy With Results. What Was Done? What Can Be Done?
Your photos demonstrate the differences of which you speak. Best is seek IN PERSON vs over the internet advise from experienced rhinoplasty revision surgeons.
Rhinoplasty with lack of tip suport and low bridge.
Your tip is not supported, your bridge is slightly low and the cartilage above the tip is slightly high. These can be reversed with tip support bridge graft and shaving the excess cartilage above the tip. Look at our website under revision rhinoplasty for noses like yours.
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3 yrs post rhinoplasty
From looking at your photos, it appears that your surgeon did an excellent job. It sounds like you asked for minor changes, and he delivered. If you closely look at the pictures you could scrutinize and come up with many slight asymmetries, but this will be true with any result. I would leave it alone and thank your surgeon for his minimal and conservative approach.
Post-rhinoplasty issues 3 yrs laters
It is always helpful to know what exactly was done during the first operation if possible. An exam in person to evaluate the nose and to determine your desires is important.
Post Rhinoplasty Revision - What can be done?
A major part of a Rhinoplasty consultation is finding out what the patient wants - what is their aesthetic 'ideal' and then determining how the patient's baseline anatomy will permit the changes or 'look' they're trying to achieve. You are looking to restore some of the fullness over the bridge of your nose and to get better tip support and improve the contour of your ala - all of which are 'doable'. The individual plan may vary based upon your desires or the surgeons vision but improvement should be able to be made, provided those improvements are spelled out and expectations are realistic. Best of Luck Dr Harrell
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