Will Getting Rhinoplasty for the Third Time Be Possible?

I had Rhinoplasty done twice by the same doctor back to back and it's been 2-3 years. Both times, during the healing process, my nose started to come out crooked and uneven. All I want is for my nose to be straight and look even from both sides.

I'm worried that if I get it done the third time it will look over done or that my nose will fall off. What procedure will the doctor perform to make it straight? Is this procedure difficult? Can you recommend a good surgeon in NYC and FL?

Doctor Answers (13)

Revision rhinoplasty to straighten the crooked nose

+2

In general, I counsel patients who seek me for opinion on revision rhinoplasty as follows:  While it may be possible to make your nose straighter, it is unlikely that *any* surgeon can get such a nose perfectly straight.  The reasons for a crooked nose are quite complex and may involve a number of issues, from asymmetries of the entire facial skeleton to isolated nasal asymmetries.  The treatment for this is highly individualized and would require a personal examination.  

Regarding your concern about the safety of a third procedure, it is highly unlikely that your nose would 'fall off' (I know you don't mean this literally).  A safe procedure should be feasible.  However, the real issue is, will you be happy if it is not 100% straight?


Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Nasal Revision

+2

First of all you can have another revision. I'm not going to suggest techniques. the most important question is not what is done, but who does it . Find a rhinoplasty surgeon who is very experienced in revision work. Ask for multiple before and after pictures of other patients. It might be helpful to get more than one consultation. Do your homework. Good luck!

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Revision rhinoplasty for the third time

+1
 Revision rhinoplasty is always more difficult than a primary rhinoplasty, that's why it's  a good idea to find a very experienced rhinoplasty surgeon who has performed thousands of rhinoplasty procedures. Tio straighten the nose, medial and  lateral osteotomies of the nasal bones will need to be performed. A cartilaginous spreader graft harvested from inside the nose will also be required to be placed  underneath the concave upper lateral cartilage.  For many examples of nose is similar to your own we have repaired in our practice, please see the link below to our rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

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Tertiary Rhinoplasty

+1

Having a rhinoplasty the second or third time is very complicated and one has to look seriously at this because one can only have so many rhinoplasties before needing significant nasal reconstruction. I would definitely seek a Board Certified Plastic Surgeon that has significant expertise and experience in  secondary and tertiary rhinoplasty procedures because these are completely different operative procedures that require additional experience and judgment.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 15 reviews

Crooked septum after revision rhinoplasty

+1

You may need revision rhinoplasty that addresses the bony and cartilaginous septum of the nose.  Simple cartilaginous tip work will not correct the problem.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

Revision rhinoplasty for the third time.

+1

Each time a nose is operated on, it becomes more difficult. And therefore the success decreases and the goals of surgery are lowered. The first time is the best time. That isn't to say revision surgery can't be successful. Its just more difficult and takes longer. This is reflected in the cost. A primary nose job usually takes between 1 to 2 hours, while a revision takes between 2 and 5 hours. There are outliers, minor 'touch ups' or complete complex nasal reconstructions using multiple ear, rib or skull grafts.

I have recently set a new personal record of sorts. I operated on a young lady for the eighth time! She had, over the years, had 7 surgeries of one description or another by the same surgeon. I wouldn't recommend this. If a surgeon can't achieve mutually agreed upon goals after 2 surgeries, it time to move on or up. Will your nose fall off? No. Will your nose be straight? Maybe. And you increase your chances by taking the time to find the best, most experienced rhinoplasty surgeon you can find.

Oakley Smith, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Revision Rhinoplasty Possibilities

+1

Revision rhinoplasty is definitely more challenging than primary - or for that matter, secondary- procedures, but these are procedures in which I specialize. Given that it has been 2 plus years since your last surgery, this is sufficient time to allow for healing and therefore help to reduce the risk of complications, in particular poor healing and scarring of the skin. I will tell you that you really need to make sure that this procedure gets done correctly, to finally achieve the results you seek. My offices are in Miami and NYC, but all my rhinoplasty surgeries are done here in Miami.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 45 reviews

The risks in multiple revision rhinoplasties

+1

When a patient has had a previous rhinoplasty or several previous rhinoplasties the next rhinoplasty can be exceedingly difficult. This is because the surgeon not only needs to perform techniques to help you meet your aesthetic goals, but must also battle the scar tissue and the deformities from the previous surgeries. Many times your tissue has suffered extensive trauma after all of the surgeries and may not be pliable enough. It is often necessary for surgeon to bring in healthy tissue including cartilage from another area that has not been previously used such as a rib. Before proceeding with yet another revision rhinoplasty, be sure that you receive multiple consultations from a variety of board-certified plastic surgeons who will be able to examine your nose and the quality of your tissue to help determine if you would benefit from even more surgery.
 

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Causes of a crooked nose

+1

 Your nose could be asymmetric for a number of reasons:

  1. Your septum is deviated 
  2. Your nasal bones are deviated
  3. Your nasal cartilages have inherent asymmetry
  4. You have facial asymmetry

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 137 reviews

Correcting the crooked nose

+1

It clearly looks like your nose is quite crooked and this can be a very difficult problem to correct if the appropriate techniques are not used. The one caveat here is that you have blacked out your eyes and mouth so it is impossible to determine what if any are the severity of facial asymmetries you may have. If your face is very asymmetric then there will be no such thing as a perfectly straight nose for you. Often times someone's mouth will be off center when compared to the eyes in which case the nose will not ever look straight because by definition if the nose is centered with the mouth then it will be off with the eyes and visa-verse. Best of luck.

Jason B. Diamond, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 2 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.