18 Months After Rhinoplasty and Unhappy with Results, Revision Options? (photo)

18months after & I'm unhappy with the results - bulbous tip & looks too big, still. I've discussed with my surgeon & he's suggested tip refinement, I'm just concerned about getting it done with the same surgeon - did he something wrong/not very skilled, or do these things happen? What are the risks with a revision - does it weaken the nose, scar tissue? Surgeon is well credited etc - great experience. Harley street, London. Any advice on what I need to get done for a sleek nose would be great.

Doctor Answers 4

18 months after rhinoplasty and unhappy with results

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Hello, and sorry to hear you are not happy with your result. Sometimes less is more, and it is better to take a conservative approach at first, as it is easier to further refine the nose with a touch up than fix a nose that has been operated on too aggressively. Every patient heals different, and sometimes a touch up is necessary even when the procedure is performed properly. Revisions increase the amount of scar tissue present, and increase in complexity with each successive surgery. I would recommend the following:

1) Establish excellent communication with your surgeon, as this will help get an idea of whether or not they are able to help you achieve your goals.

2) Ask them what will be performed during a revision to help you achieve your desired result.

I hope this helps, and I wish you the best of luck.

18 Months After Rhinoplasty and Unhappy with Results, Revision Options?

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      There is no question that your nose is much improved compared to the preoperative photos.   However, the nose can be further improved with regard to the hanging columella and possibly the tip.  If cost is a real concern, I would stick with the current surgeon as this is not a poor result at all.   If cost is no issue, find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Revision rhinoplasty for bulbous tip and columellar show

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At 18 months it certainly acceptable to undergo a revision rhinoplasty. The bulbous tip can be addressed by narrowing and refinement of the nasal tip cartilages, and a trimming of the caudal septum by performing a columellar-plasty  and prevent the columella from hanging down too much. This involves trimming the caudal septal cartilage and skin on the inside of the columella. See the link below for examples of columellar-plasty the we have performed our rhinoplasty practice

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Tip revision needed

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Hi there,

Theres a lot about your rhinoplasty that is fine. The issue is the lower lateral cartilage.  You've had a cephalic trim of this, which is visible in your pictures.  This is reduction of the size of the LLC and is frequently performed in rhinoplasty.  In your case, the LLC are large and a little more vertically oriented than is ideal.  This is what gives you the full supra tip area.  

So I think you will need a tip revision and management of the size, shape and orientation of the LLC is the key to that.  

I suggest to discuss a detailed plan with your surgeon.  A tip revision is not enough detail. What exactly will be done to the tip to improve the shape of the tip?

If you're in agreement about the aims then there is no reason to change surgeons.  You'll decide this.  All the very best.



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