1st rhino 1/2010: no fine tip, pollybeak, long nose revision Nov 2011: initially fabulous nose, turned into pollybeak after 1 month. 3rd: same doctor reoperated June 2012 (steroids did not help.) 5 months into recovery and the exact pollybeak is starting to reform again. My tip has never been the small angular one I had hoped for: tip is going down or the supratip is coming up. Is it too early to blame the doctor? what is wrong? I shot of steroids given after reoperation to take down tip swelling.
Third Time No Luck: Pollybeak Deformity Forming Again. Is my Dream Nose Ever Possible to Achieve? (photo)
Doctor Answers 4
Pollybeak after Primary and Revision Rhinoplasty
Although I cannot see your entire nose in the pictures provided, you do have a pollybeak because your tip is not adequately projected. You will need a cartilage graft to narrow and define your tip. Steroid injections will not help. Unfortunately you must be patient and wait another 6-12 months before another revision.
You may consider getting an opinion from another reputable rhinoplasty specialist about your nose.
Your photos are limited, but I see that your bridge is too high just above your tip. Based on your photo, the issue appears to be that you have little or no tip support. Another revision rhinoplasty may be considered, but at this point you should consult an experienced surgeon that could provide tip support with a strong columellar strut, and reduce the height of your lower bridge.
Hope this helps you.
Pollybeak deformity forming again
From the limited photographic views there does appear to be tip ptosis along with the pollybeak. There are ways to treat this. I typically use an open approach which allows for direct visualization of the supra-tip and also stabilizes the tip in the proper position.
You can check out my link below for more information.
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It looks like a classic cartilagenous pollybeak with a ptotic tip. Where any of your revisions done open?? if not, it should be done open to get a full view of the cartlige and resect it properly plus revise and augment the tip.
Sorry, you will need a 4th surgery.