I had Rhinoplasty 3 months ago and the tip of my nose is droopy now. Is it ok to have a revision at 6 months? (photos)

im thinking of taking a revision only on the tip to lift it up a bit just like in the photo and im not bothered by the hump when i touch the tip there's like a gap that need to be filled so looking at the pictures should i go with open or tip rhinoplasty? and is there's any other way to lift the tip? and is it ok to do revision after 6 months from the first surgery

Doctor Answers (9)

Revision rhinoplasty

+1
Dear Dentistx,

After a rhinoplasty procedure, either open or endonasal (closed), there are a number of dynamic and static changes that occur over time. It is extremely important that you be patient and wait a full year before assessing the final aesthetic quality and outcome of your nose job surgery. Quite often, patients are surprised that the aesthetic result that they see at three months and concerns they may have at that point are completely gone at 12 months.

I know it is difficult to wait to achieve your aesthetic goals and, in the interim, in my own rhinoplasty practice of 20 years, I have found that injection rhinoplasty techniques performed at the 12-week mark, can camouflage small dorsal irregularities or bumps as well as provide tip rotation and support. The products that I use in these injection rhinoplasty procedures, such as five minute nose jobs, can be used to provide the camouflage and support for tip rotation, tip irregularities and bump irregularities, camouflaging the healing process while the edema and swelling of your nose surgery settles.

At the one-year mark, the soft tissue gel used in the injection rhinoplasty can be dissolved away with a simple enzyme and the final appearance of the nose then assessed. Revision rhinoplasty should involve returning to your original nose surgeon, as they will have a vested interest in you achieving the best possible outcome. Discuss your concerns with your original rhinoplasty surgeon to ensure that they understand the concerns you have. Most qualified and experienced rhinoplasty surgeons can achieve a significant degree of improvement with revision rhinoplasty, but this needs to occur at no sooner than the 12-month mark.

Hope this helps.

Sincerely,
R. Stephen Mulholland, M.D., Private Plastic Surgeon, Yorkville


Toronto Plastic Surgeon
4.5 out of 5 stars 37 reviews

Revision at 6 months

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No way I would do a revision at six months. Like building a house on settling ground after the first one collapsed anyway. Be absolutely certain things have stopped changing and the tissues have softened adequately before even considering this.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 27 reviews

Revision rhinoplasty candidate

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At 3 months, the nose is still healing so it's not a good idea to try to hit a moving target With another surgery until  the nose is completely healed. Best time to perform a revision rhinoplasty especially on the tip of the nose would be 12 months after the original procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

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Tip of nose revision

+1
It is difficult to tell from the photos posted what you might need, but you want to wait about a year for the swelling to go down.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

How long to wait before revising the tip of the nose.

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I know it is hard to wait but ideally you want to give 9-12 months before revising the nose.  Even though most of the swelling is down, and not much is going change visibly, there is still some small amount swelling going on as well as scar tissue organization.   Doing surgery later will make the surgery easier and thus insure a higher likelihood that you will get a good result.   

Adam Hamawy, MD
Princeton Plastic Surgeon
5.0 out of 5 stars 13 reviews

Rhinoplasty revision

+1
Hi there and thanks for your question.

Whilst it is difficult to assess your nose from the photos you have provided and without seeing your preop photos, however, it would seem the concern you have with your tip is not going to change much over time, however there may still be some swelling in the dorsum which is making things look worse. 6 months would be the absolute earliest time for revision, but 9-12 would probably be better. Although you dont feel your nose swelling is decreasing, it invariably is.

In terms of the approach, revision surgery is alway more difficult than primary surgery and what seems like a small problem to you may be difficult to correct. With that in mind I think an open approach, would be best. It will allow your surgeon, the best access as well as control surgically.

In terms of technique, from what I can see, you will need the hump to come down a bit, that will give you a better relationship between your dorsum and your tip and then you will need a columelar strut to help support your tip in a better position.

Good luck

Richard

Richard Bloom, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 19 reviews

Tip Drooping after Nose Surgery

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It's advisable to wait 9-12 months for a revision. If your tip is drooping and that's the only issue you have, a revision at 6 months is possible. I would use a columellar struct graft to maintain the tip in the desired position. The graft can be taken from your septum if cartilage is still there, or from a rib. The most important determining factor in deciding the timing of a revision is the amount of swelling present in the tip. If it's still swollen you need to wait. Work with your surgeon to discuss and decide together.

Best

David Shifrin, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 52 reviews

Tip elevation with Rhinoplasty

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At this point, it is important to be patient.  You will not see your final results from your rhinoplasty for 9-12 months.  If you still are concerned, there are a variety of procedures to address the problem.  Often, removal of the dorsal hump will elevate the tip by itself.  You appear to have fairly thin skin- tip grafting can sometimes be problematic, as edges of the grafts can be visible.  As always, it is important to personally consult with a board-ceritfied Plastic Surgeon who specializes in Rhinoplasty

Jarrod Little, MD
Louisville Plastic Surgeon
5.0 out of 5 stars 12 reviews

Revision rhinoplasty

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I know it can be a long wait, but you should definitely wait until near the one year mark for revision rhinoplasty. At that time, the nose will be healed appropriately and you may want to consider seeing an experienced rhinoplasty surgeon who can add support and increase the rotation of your tip. Your goal should be quite achievable. 

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
5.0 out of 5 stars 45 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.