Advice on Revision Rhinoplasty for my Still Very Crooked Nose

asked 1 year ago by KAPM in England
Latest answer by Sam Naficy, MD
Question viewed 1,022 times
Tags: female, crooked

I had a reconstructive septorhinoplasty done in December 2009. My nose had been very crooked from about 14 years old. I was initially really happy with the results but after a lot of the swelling went down it seemed to shift back to the deviated position. I had biodegradable material in the septum that dissolve after six weeks. Also the cartilage on the opposite side of the deviation are deficient. I would really like some advice pls.

9 answers to Advice on Revision Rhinoplasty for my Still Very Crooked Nose

Revision rhinoplasty for crooked nose

There are many techniques for revision rhinoplasty that are used to improve and straighten the nose. These involve both medial and lateral osteotomies to straighten the nasal bones and cartilaginous spreader grafts to widen, spread, strengthen, and bolster the upper lateral cartilages. The spread graft can also hold nasal bones outward when pinched inwards. Make sure your revision rhinoplasty surgeon has performed thousands of rhinoplasties and revision rhinoplasty procedures... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Revision of Crooked Nose

I'm sorry you've had a disappointing result after your previous surgery. Although it is difficult to get the ideal result when operating on a crooked nose i think you will have significant improvement if you see an experienced revision rhinoplasty surgeon. Although I cannot make specific recommendations without reviewing the previous operative report and examining you, I always do revisions like yours using the open rhinoplasty technique.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty Revision Treatment

If your nose is still crooked after rhinoplasty there can be several potential reasons. These include, (1) bad luck - your bones just didn't heal straight, even though they were put in a good position. Revision should help this. (2) septal deviation. A facial plastic surgeon will typically correct this, but other surgeons may not. You'll need a facial plastic surgeon to look inside your nose and see if the bony or cartilaginous septum is effecting the nose. (3) twisting of the... more

Jeffrey H. Spiegel, MD
Boston Facial Plastic Surgeon

Recurrent septal deflection after revision rhinoplasty

Unfortunately, it is difficult to state whether the recurrent deflection is due to fibrosis from the healing process or an undertreated condition. You may require more rigid grafts such as a rib graft but this could involve substantially more complicated surgery.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Crooked nose after rhinoplasty

First, a crooked nose can be very challenging to correct. That being said, most patients should expect at least a 50-60% improvement in the deviation. I would consider another opinion. Tony Bull is a very well respected nasal surgeon in London.

Andres Bustillo, MD
Miami Facial Plastic Surgeon

www.drbustillo.com

Revision rhinoplasty

I am sorry that you think that your nose shifted. It looks like the nose is off to the left but the photo has a weird reflection on it. It is always best ot be evaluated in person. Absorbable material may not have been the best thing for you to correct your deviation. But, even with striaghtening noses, they are never perfectly straight after surgery. Usually they are straighter but not perfect.

Steven Wallach, MD
Manhattan Plastic Surgeon

Nose still crooked after rhinoplasty

Without knowing all the details regarding the surgical maneuvers performed, or knowing what your nose looked like preoperatively, it is difficult to know what might have caused your nose to become ( or remain) crooked after surgery. You are now about 9 months postoperative, so most of the swelling should be gone. The force of scar contracture under the skin is one of the factors that make rhinoplasty so difficult and challenging. You should discuss your concerns with... more

Matthew Bridges, MD
Richmond Facial Plastic Surgeon

Return of crooked nose

Cartilage does have memory and will return to its original curvature. The resorbable PDS plates do not offer long-term support. You may very well require a rib graft to help straighten your bridge.

Sam Naficy, MD
Seattle Facial Plastic Surgeon

seattleface.com

Persistently crooked nose after rhinoplasty

Straightening a crooked nose is one of the most challenging goals of rhinoplasty. Postoperative swelling can hide how deviated your nose was after surgery initially or you may have had a shift when you were further along in healing. Certainly, revision rhinoplasty surgery is a possibility. Ensuring the structural framework of the nose afterward is vital and may require cartilage grafts from the septum, nose or rib (can be determined after an examination). In my experience,... more