Revision Rhinoplasty Q&A
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Have I Had Too Many Nose Jobs?
asked 3 years ago by debra weintraub in las vegas, NV
Latest answer by Mario J. Imola, MD, DDS
Question viewed 3,912 times
Tags: nose, risk
I had 2 previous nose jobs when I was 18 and again at 20 I am now 37 and would like to shorten the tip of my nose but it seems the previous doctors left a hole between the nostrils inside. In other words, from what drs. have told me, there is no cartilage to hold up the tip to get it shorter.
Can you help me? Is there a way of correcting this and so there is no longer a hold from one nostril to the other.
Many thanks for anything you can suggest.
18 answers to Have I Had Too Many Nose Jobs?
+3
Rhinoplasty revision can be very safe
There are a number of reasons why patients seek a secondary (revision) rhinoplasty procedure. In certain situations, the initial procedure may have not fully corrected the undesirable features of the nose. In other situations, the initial rhinoplasty may have actually resulted in certain undesirable features. As long as the skin of the nose is healthy, and enough time (typically one year) has passed since the previous surgery, there is no problem with having one or multiple revisions. The...
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+2
Septal Perforation Repair and Rhinoplasty
It sounds like you would certainly be a candidate for revision rhinoplasty and repair of a perforation in your nasal septum. The septal perforation can cause issues for patients such as chronic crusting, bleeding, or whistling with breathing. In other cases, there may not be any symptoms at all. The septum can be repaired at the time of your rhinoplasty with the use of temporalis fascia, a soft tissue graft which is harvested by making a small incision behind your hairline, over your...
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+2
Possible Septal Perforation
It sounds like the "hole" you describe is a septal perforation.
Seek a well qualified surgeon for advice about repairing the "hole," restoring tip support and whether the change you seek are advisable.
Revision Rhinoplasty can be challenging!
+2
Maximum number of revision rhinoplasty surgeries
The answer to the question 'how many is too many' is highly indivualized and will vary from person to person. Problems such as the ones you describe may be correctable. However, a personal examination would be necessary to determine if these are feasible or recommended in your situation.
For example, it sounds as if you may have a septal perforation, or hole in the septum. In some cases, these can be repaired. In large perforations, a unique but extensive procedure can be used to repair...
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Sam Most, MD
Bay Area Facial Plastic Surgeon
Bay Area Facial Plastic Surgeon
+2
Revision rhinoplasty
We do many revision rhinoplasties, and they are sometimes indeed extremely complex. Sounds like you have a septal perforation, perhaps, and a droopy tip. The first thing you need to do is to see an experienced facial plastic surgeon and discuss your problems and expectations. Usually we can get cartilage from the ear, sometimes from the rib, to rebuild the structure that has been lost. It might be helpful for you to see several surgeons for their opinions, and decide whether the revision...
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Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
Seattle Facial Plastic Surgeon
+1
Revision rhinoplasty following 2 previous rhinoplasty procedures.
From your description it seems a good choice to undergo another well planned and executed reconstructive rhinoplasty to restore form and function. A third nasal surgery is not contraindicated when there is much to be gained and little downside.
Mario J. Imola, MD, DDS, FRCSC.
+1
Shorten my nose after 2 previous surgeries
As you gather it sounds like you have a septal perforation, and it can be treated or not depending on the level of morbity you suffer with it. Some people can be operated on many times. Their skin doen't seem to wear out, the infrastructure seems to continue to be modeled without difficulty or complications. Whether you ae one of those or if you are one who needs to run away from surgery as fast as you can is a decision you and a Board Certified Plastic Surgeon can make...
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Jon Sattler, MD
Glendora Plastic Surgeon
Glendora Plastic Surgeon
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Diminishing returns with multiple rhinoplasties.
You describe a septal perforation which would require reoperation to fix. It's not very easy if it's large. The aesthetic portion is impossible to predict but with each subsequent rhinoplasty a predictable result is harder and harder to achieve.
+1
You likely have a septal perforation
From what I understand, you have a septal perforation. This can be fixed, but it is very tedious and demanding surgery. Cartilage can be "borrowed" from other places like behind your ear and your rib to repair your nose. This surgery is very difficult and is very demanding. Please seek out a surgeon who specializes in complicated revision surgery. I undertake such cases, and they can take 4+ hours in the operating room. The reason to fix this...
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+1
Third revision rhinoplasty
It is difficult to assess what can be done with your nose, however, most experienced rhinoplasty surgeons can utilize creative solutions to achieve an improvement in the appearance.
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Revision rhinoplasty concerns
As you have probably learned, revision rhinoplasty requires a surgeon with experience and expertise to undertake this rather difficult procedure. It is not just the number of surgeries that you had, but the state of your nasal tissues that matters. A nasal specialist would assess the degree of scarring, residual nasal cartilage, need for additional cartilage (ear, rib, homologous) and prepare an appropriate surgical plan. Only in this fashion is there any hope to...
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Revision rhinoplasty can be challenging
Rhinoplasty is a popular and effective surgery to recontour the shape of your nose. A revision rhinoplasty can be a challenging surgery because the surgeon not only has to try to achieve the goals you are looking for, but to deal with the scarring and altered anatomy from your previous rhinoplasties. For this reason, it is essential that you only work with a board-certified plastic surgeon who has a great till of experience in rhinoplasty and cartilage grafts. In patients who have had...
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B. Pat Pazmino, MD
Miami Plastic Surgeon
Miami Plastic Surgeon
+1
Revision Rhinoplasty
The hole you describe is a perforation of your septum. Depending on size, this can be repaired with grafts of cartilage and nasal lining. Be sure that you are evaluated and treated by a surgeon with extensive experience in revision rhinoplasty.
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Revision Rhinoplasty Candidacy
Based on your brief history and description of your problem, it is possible that you could undergo a revision rhinoplasty procedure to shorten your nose. Much of this, however, depends on the location and size of your septal perforation (referring to the abnormal hole between the left and right nasal passage). From your description, some other surgeons have been concerned about having proper structural support to lift the tip in this critical area.
If the remaining internal lining is...
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+1
Redoing a nose job - revision rhinoplasty
A plastic surgeon can restore harmony to the nose despite previous surgery. The question really becomes whether there is enough intrinsic cartilaginous and bony structure, and if not, where to obtain the cartilage to lend nasal support and integrity. This can be done regardless of the number of operations in the past provided the nasal skin is well perfused.
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
Los Angeles Plastic Surgeon
+1
Revision Rhinoplasty
There are many factors that determine whether or not patients are good candidates for secondary (revision) rhinoplasty. The number of prior surgeries is less important that the quality and characteristics of the nasal skin, framework, and the amount of scar tissue present. Other factors include the extent of the deformities, the risk:benefit ratio of correcting problems without causing addtional ones, and also the patient's psychological stability.
These are all factors that must be...
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+1
Revision Rhinoplasty
Your question is difficult to answer without examining you. A hollow between your nostrils sounds like a septal perforation. In terms of the tip shortening request, it would be difficult without examining you. In general, each revision becomes more and more difficult because of thinning tissues, and lack of donor sites. But they can be done where indicated.
+1
Revision rhinoplasty is a discipline all and of itself...
Revision rhinoplasty is a discipline all and of itself and is an extremely difficult operation to execute.
After each surgery the nose goes through a healing process. Unfortunately, with each subsequent surgery the healing becomes less and less predictable.
It is best to keep the number of nose jobs at a minimum to prevent scar tissue, untoward healing, and an over-resected and operated look.
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