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Should I Consider Revision Rhinoplasty?

I am a 22 year old female and in December 2008, I had a Rhinoplasty and a Septoplasty. I went back to see my doctor a week ago because I have a hard bump at the tip of my nose that hasn't gone away. He injected some type of steroid but I haven't noticed a difference.

I was advised that it may take some time to see if the steroid injection will actually work, I was told I should wait at least three months. He told me this bump is common and may just be extra cartilage and if I really want I can consider having surgery again to correct it. I would be okay with surgery because right now my nose doesn't look even. However, I am worried that this may have been caused because he may not be a good surgeon and I don't want to come out looking like Michael Jackson.

Please give me advice. I don't know what to do. Should I wait considering it's been only about a year and a half? Thank you!

Doctor Answers (25)

Should You Consider a Revision Rhinoplasty procedure?

+2

These are some general comments about revision Rhinoplasty:

  • If your are unhappy with results but have realistic expectation and more than a year has passed since the initial procedure, you can be a candidate for revision procedure.
  • Revision Rhinoplasty is a challenging field.
  • Choose your surgeon carefully.
  • To get the best result, you need a surgeon with extensive training and experience in all aspects of nose surgery and rhinoplasty.
  • If your initial surgeon is not comfortable with doing the procedure, seek someone who is...
  • You really want to have this as your last rhinoplasty procedure.

Best wishes and hope this was helpful.

Dr. Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 90 reviews

Revision of the nasal tip-timing

+2

Generally, one year is an appropriate time to wait prior to considering revison rhinoplasty. In your situation, one would probably want to wait an additional few months after steroid injection to see what effect this has.

Evaluation by an experienced revision rhinoplasty specialist would be good, after you have communicated with your primary surgeon. He/she may be comfortable taking care of this issue.

This type of irregularity is not uncommon and is not an indication of the skill of your surgeon.

Hope this helps,

Dr. Sam Most

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Revision rhinoplasty for swollen or full nasal tip

+1

You may have a displaced cartilage graft vs. residual swelling.  I would consider revision rhinoplasty about 1 year after your last surgery. 

Web reference: http://surgery90210.com/face/77/rhinoplasty-revision.aspx

Los Angeles Plastic Surgeon
5.0 out of 5 stars 43 reviews

Revision Rhinoplasty

+1

You seem to be a candidate for a revision rhinoplasty. To verify, ask yourself 3 questions:

1) Are you are unhappy with the results of the surgery since the original rhinoplasty surgery either did not achieve one of the primary objectives or led to unexpected outcome?

 

2) Has at least 1 year passed since the original surgery?

 

3) Are your expectations and desired goals realistic?

 

If your original surgeon is not caring for you in a manner that you are comfortable with, consult with 2 - 3 experienced, repuatable, and expert board certified plastic surgeons to understand your options.

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 14 reviews

When to do revision surgery...

+1

Experienced rhinoplasty surgeons may need to do a touch up here and there.  In experienced hands, the revision rate should be in the less than 5% range.  

The first thing to consider with revision surgery are...what are your goals?  What do you want?

After you have thought about these things, you need to find a surgeon that is experienced in revision surgery and is willing to undertake your case.

Things I like patients to ask...

1. Are you board-certified?

2. How many rhinoplasties have you done?

3. Do you do a lot of revision rhinoplasty?

4. Do you have computer modeling to discuss what my nose may look like?

5. Do you have pictures of other patients you have done?

6. Do you have references I can get in touch with?

7. Where do you operate? Is it accredited? Who does your anesthesia? Are they board-certified?

8. How long do you think my case will take?

9. Can I have copies of my preoperative and postoperative instructions?

 

After you have done your homework, it is my job to examine you, analyze you and see if revision surgery is possible, and if I think revision surgery can achieve your expectations.

Houston Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Need for rhinoplasty revision is not uncommon even for experienced surgeons

+1

The fear of having a "Michael Jackson" nose has become a standard among patients in most facial plastic surgery practices. This is obviously not the result that any of us desire. If you trust your surgeon and they are experienced with nasal surgery, it sounds like a revision surgery might be in order. Rhinoplasty is the most challenging surgery that is performed by Facial Plastic Surgeons. Revisions are not uncommon even among the most experienced surgeons.

Stephen Weber MD, FACS

Web reference: http://weberfacialplasticsurgery.com/rhinoplasty/

Denver Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Small Surgical Revision May Be Considered

+1

It sounds like you have a bit of extra cartilage at what we call the “supratip” region of the nose, and this can be due to either a bit of cartilage was not removed, and/or the nasal tip with healing settled back and reduced tip projection, exposing the cartilage. This is not necessarily an “error” on the part of your surgeon, and it sounds like he is taking the proper steps by giving steroid injections which can work if there is scar tissue in the area. I will say that, if there is no improvement, that because it has been over 18 months, you are likely going to require a (small) surgical procedure to correct the cosmetic problem.

Miami Facial Plastic Surgeon
4.5 out of 5 stars 40 reviews

Revision rhinoplasty can occur in the best of hands

+1

Most surgeons like to wait one year for a revision procedure.  The best person to do a revision is often the initial surgeon since he knows exactly what was done and may have a good idea how to address your concern.  I suggest you outline your concerns to the surgeon and see if the surgeon can address your concerns.

Web reference: http://purefacialaesthetics.com

Toronto Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Revision rhinoplasty timing

+1

Most likely waiting more than a 1 1/2 year after initial rhinoplasty will make no difference.  Likewise, steroid injections into a bump are unlikely to cause the bump to go away at this point.  Revision Rhinoplasty is a field for an experienced and talented surgeon.  Whether it is a minor fine tuning, or a more advanced correction, do not be shy asking your surgeon how confident he/she is in correction this.  If you are unhappy with your nose now, most likely you will not get used to it's  sub-optimal appearance.  Get a few opinions on  your surgical options from a well regarded and experienced rhinoplasty surgeons.

Newport Beach Plastic Surgeon
5.0 out of 5 stars 18 reviews

When to Consider Revision Rhinoplasty Procedure

+1

Revision rhinoplasty is sometimes considered after the original rhinoplasty surgery to further improve the nasal appearance. Deciding on revision rhinoplasty is usually a difficult decision for both patient and surgeon. Some revision procedures are much easier than other rhinoplasty surgeries. If you're not satisfied with the tip, then a revision may be considered. Revision procedures are generally not performed right away, but after sufficient time is allowed from the first procedure. One year may be sufficient time for revision rhinoplasty consideration. Repeat steroid injection may also be appropriate. Only after a comprehensive evaluation by a revision rhinoplasty specialist can he/she determine the complexity of the potential procedure and appropriate options for you.

Web reference: http://www.potomacplasticsurgery.com/facial-plastic-surgery/rhinoplasty.cfm

Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 43 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.

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