What should I do about bad nose job results?

If the patient believes they have had a bad nose job, full healing must occur prior to embarking on any revision rhinoplasty surgery. Look for a surgeon who has done thousands of rhinoplasties and specializes in both rhinoplasty and revision rhinoplasty.  Consider a surgeon whose original background is ear, nose, and throat to make sure that there are no further breathing problems as well.

We all hate to hear about the large number of bad nose jobs out there. It is a very common reason plastic surgeons get sued.

I think that part of a good nose job entails educating patients about the possible consequences of surgery. Despite good surgery, some noses go bad! However, some patients get bad surgery.

I tell patients to wait a year at least after surgery to let healing complete. A re-analysis of the nose from the outside and inside is necessary after that point to figure out what went wrong.

Reoperative rhinoplasty is much harder than primary rhinoplasty. I recommend that patients seeking revision find a surgeon who specializes in corrective/revision rhinoplasty. This increases your chances of improving the outcomes.

Rhinoplasty is considered to be the most difficult of all cosmetic surgical procedures. Even the best surgeons have revision rates of 3-5%. Bad nose job results are usually due to many factors, the most important of which is choosing your surgeon carefully. I am continually amazed that many patients are more careful, and spend more time picking out the color and model of their new car than they are in selecting the surgeon who will operate on their nose.

As we know, the nose is smack dab in the middle of our face, and cannot be covered by clothing when things go wrong.

• You need to discuss with your surgeon what bothers you about your nose during the initial consultation.
• Your surgeon needs to make the proper diagnostic evaluation in order to correct what bothers you.
• You need to be assured that your expectations are realistic.
• Look at before and after pictures.
• Ask to be scheduled when other post-operative patients are in the office so that you can see and speak with them.
• Look at the before and after photos.

Once the surgery has occured, one needs to wait 6-12 months before correcting the bad result. If you still have confidence in your surgeon then schedule a revision surgery. You may want to get one or two other opinions from respected rhinoplasty surgeons (in the Chicago area, Dean Toriumi, M.D. is among the finest in the world).

Fillers may temporarily help particular problems, but truly bad results will need surgical correction.

Remember that the best chance for sucess is the first time, so choose carefully.

As the other doctors here have said, waiting a year is important. After that, however, you need to consider all of the options available to treat your nose if you are unsatisfied with the cosmetic result.

One of the options currently available is Non Surgical Rhinoplasty - injection of fillers like Restylane, Radiesse or Artefill to correct post-surgical imperfections. I have found that a 5 minute injection will fully correct a minor irregularity that would have required a long, complicated procedure if done operatively.

The kinds of post-rhinoplasty imperfections that I have corrected with fillers over the years include: indentations on the bridge of the nose, cartilage collapse on the bridge or the sides of the nose,  indentations above the nostrils caused by scarring, or tip droop bumps on the side of the nose caused by an impant that has become visible.

Sometimes revision surgery is your only option, but often it is not. As we have seen with so many celebrities, every time you have your nose operated on, it causes more scarring. With any aesthetic surgery, your first procedure is the safest procedure. It is the one most likely to produce the desired results. Revision surgery is always more dangerous and difficult. There is a generally a higher frequency of scarring and side effects.

As with any procedure, you will want to choose someone who is very experienced in it, so ask any physician you're considering what their experience is with surgical and non surgical techniques.

Sometimes bad nose jobs resolve themselves

The most important thing is to wait for at least one year. All noses evolve and continue to shape themselves, even beyond a year. I have seen noses change even 5 years out. Once that task is complete, then ask yourself what you truly do not like about your nose as far as the way it looks and how well you breathe.

• Do you breathe worse or better than before your nose surgery?
• Are you now a mouth-breather, when you were always a nose-breather?

With regards to looks, the more specific you can be with your Plastic Surgeon the more he/she will be able to communicate with you about what can be done and an agreement that fits both your sense of beauty/aesthetics and your surgeon's can be reached. When choosing a surgeon to do your revision, it is important that the surgeon is experienced with revisions and can take the necessary steps needed which sometimes involves taking ear and rib cartilage grafts because the cartilage within the nose itself is depleted.

Talk to your doctor about your bad nose job concerns

Rhinoplasty is generally acknowledged as one of the most difficult of all facial plastic surgery procedures. The reasons for this are multiple, and include the complexity of the three-dimensional structure of the nose, nasal physiology, in addition to the required technical skills and an aesthetic eye. Final results in rhinoplasty really should not be judged until one year has passed; in some cases, things may continue to change even after that. If you have had a rhinoplasty and are unhappy with the results, it is important to communicate this with your surgeon. It may be that time will remedy the situation, or (in rare cases) interval measures may be required. Either way, this communication is important. If a revision is required (after 1 year), it is important to choose a surgeon who is experienced in revision rhinoplasty surgery. The Internet has made it easier to identify potential surgeons, but always meet with a few and ask for examples of results and perhaps speak to a few former patients.

Further treatment for bad nose jobs

It’s important to recognize that full healing and shaping of the nose can take over a year.  At that time, if someone is unhappy with the result they can consider a revision rhinoplasty.

Revision rhinoplasty is typically much more complicated than a primary rhinoplasty, and it’s very important to select an experienced surgeon who performs a great deal of rhinoplasty procedures.

Revision rhinoplasty can be a very challenging procedure for the surgeon and patient. I therefore recommend selecting a surgeon that has experience with revision rhinoplasty. It is not uncommon for patients to travel to other cities for consultation with other surgeons. I recommend that patients do their homework and consult with experienced surgeons and select one with which they feel comfortable. The surgeon should perform a high volume of revision rhinoplasties.