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

Question

Hi , Almost a year ago, I underwent septorhinoplasty to address both functional breathing issues and the aesthetic concerns I had with my nose. I chose a local surgeon who seemed confident and experienced, so I truly believed I was in good hands. While I’m happy with the side profile, I have to admit I’m disappointed with the front view. We had agreed to make the nostrils smaller, the bridge narrower, and the overall frontal appearance more refined — but from the front, it honestly looks nearly unchanged. If anything, the nose appears even wider, and it seems like only the columella was slightly altered. I’ve attached some before and after pictures (left is before) for reference. At this point, I’m strongly considering a revision, as I don’t feel this result reflects what was discussed or hoped for.

Eric M. Joseph, MD · Answer

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

Richard G. Reish, MD, FACS · Answer

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

Steve Laverson, MD, FACS · Answer

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.

Selcuk Inanli, MD · Answer

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!

Darryl J. Blinski, MD · Answer

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.

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

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

Answers (5)

Answer: Rhiboplasty

Answer: Rhiboplasty

Answer: Septoplasty with cosmetic rhinoplasty minimal results

Answer: Septoplasty with cosmetic rhinoplasty minimal results

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.