I'm not happy with the results of my rhinoplasty and I'm thinking for a revision. Is it possible to achieve this result with a revision rhinoplasty? And any opinion on how it should be is welcome.
Considering a Revision? Are My Expectations Realistic? (photo)
Doctor Answers (7)
Charles, you are close to excellence
We suggest nonsurgical, injection revision rhinoplasty. Your photos show that the cartilage just above the tip is a little bit high. Now, surgery could correct that. On the other hand, you may want to consider a non-surgical revision in which the lower portion of the bridge just above that small rise is filled to the level of the rise, therefore, obliterating its prominence.
The best way to have confidence that such a non-surgical alternative to revision surgery with grafting is to have the "Kotler Saline Demo." That is a technique by which sterile saline is injected to mimic the benefit from a permanent filler; it's an excellent way to envision the result and see if the procedure would make you happy.
Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION
Revision rhinoplasty for multiple issues
The photo shows a scooped out bony dorsum and a mild poly-beak which can be a result from multiple issues such as scar tissue, fluid retention and residual cartilage left in the tip or the lower bridge. Cartilage grafting to the bridge line harvested from the nasal cartilage, and slight trimming of the poly-beak should be all that's required. Please see the link below for examples of noses similar to your own where we have built up a low bridge line
The high point of the nose should be the tip
You posted a photo of an "after." this is a mild poly beak. This can be due to a number of things. Too low a dorsum (the upper part of the nose), scar tissue or residual cartilage in the area just above the tip, or a slightly drooping tip. Depending on the cause, the treatment will differ. However, the desired profile posted should be achievable.
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Considering a Revision? Are My Expectations Realistic?
Provided that you are beyond the one year mark from the previous rhinoplasty, that result can be achieved with a revision. Kenneth Hughes, MD Los Angeles, CA
Subtle grafting of your bridge will most likely achieve what you are looking for. Depending on what was done surgically the first time, the cartilaginous graft may be obtained from inside your nose. Make sure you see a board-certified Facial Plastic Surgeon for a consultation. All the best.
- It does appear that a little too much was removed and this result can be achieved with revision rhinoplasty
- It would require a little cartilage grafting to get the result you are looking for
- When you are ready, please see a rhinoplasty specialist who can address all of your concerns
From the photos you submitted it appears that you have a small polly-beak deformity, a low radix, and an over-rotated tip.
It appears that you want the polly-beak removed and the radix augmented.
In experienced hands, I believe that it is achievable.