Nose barely changed after septorhinoplasty - should I consider a revision? (Photos)

You got a beautiful result, no reason for objective complaints, however I acknowledge rights for being disappinted and it is reasonable aiming higher than 8/10 result.

I believe some rim grafting is over expanding the nostrils, a tiny tweak here may work well for you; tip is a tad too high / rotated and lacking projection, a shield-type en bloc columella-tip grafting is my choice to kill two birds with one stone; your tip was conveniently deprojected, this has increased the alar flare, a cautions alar reduction can also help you.

That's my proposal, seek different opinions from surgeons who convey the feeling of being self-confident for overcoming the 8/10 result.

Our experience, noses that have changed little after rhinoplasty maybe the most favorable type of revision rhinoplasties to perform, because they tend to involve making things smaller and narrower, rather than building things up that were removed previously. If you are going to consult with another specialist, it may be beneficial if you bring with you a copy of your preoperative photos, along with your operative report. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photographs, you may benefit from a revision with tip refining rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Photos show your nose was significantly and aesthetically de-projected, a technically demanding task. Your surgeon is a master. The skin sleeve does not shrink accordingly, although it may shrink more over time and corticosteroid shots may help.

The face and nose are not clay and not amenable to all desired changes. Bone, cartilage, skin, and soft tissue behave according to rules imposed by nature. Not sure revision would offer the change you want from the front. Dorsal augmentation for a more narrow appearance will require increasing tip projection, and further osseo-cartilaginous narrowing will likely impair nasal breathing.

Hello! Thank you for your question.
From the photos, I can see that the side profile looks improved, but the front view changes are very minimal. Since your main goals included narrowing the bridge and nostrils, it’s understandable to feel disappointed.
If it’s been a year and you’re still unhappy, seeing a revision specialist could be a good next step. Just make sure to choose someone with experience in revision rhinoplasty.
It would be better face to face consultation.
Best Regards!

Hello! Thank you for your question. It must be frustrating to not see the results you were looking for, now a year after your original rhinoplasty. It’s not uncommon for patients to feel that certain aspects of their nose, particularly the frontal appearance, haven’t changed as much as expected after a primary septorhinoplasty. While side profiles often show more noticeable improvement, subtle changes to the nostrils, tip, or bridge can sometimes appear minimal, especially if the tissues are thick, healing patterns vary, or the original nasal structure is more resistant to change.
Based on what you’ve described and shown in your photos, a revision rhinoplasty could be a reasonable option to further refine the areas that remain concerning. Revision techniques allow an experienced plastic surgeon to address nostril shape, tip definition, bridge width, and overall symmetry more precisely, while maintaining or improving nasal function. These procedures are highly individualized, and a careful evaluation of your healing, cartilage, and tissue structure can help determine the best combination of adjustments to achieve the more refined, balanced frontal appearance you’re hoping for. Many patients find that a targeted revision, such as one focused on the tip itself, can significantly enhance both aesthetics and confidence while preserving or improving breathing.
I hope that answers your question. Best of luck!
Justin Buro, M.D.

Based on your before, and after photos, I do agree with you from the front view the results are almost unchanged. The side view does show the hump being smaller as far as your tip. It still is bulbus, and the Aylor wedges were not done. It appears you had an open rhinoplasty With a scar on the columella therefore I would recommend revision with attention paid to the tip, cartilages and reduction of the wedges and possible refracture. Best of virtual consult with fee range from $10,000-$18,000. Best of virtual consult with.