How soon can I get a revision rhinoplasty to fix a shortened over rotated tip?

A revision rhinoplasty could be done earlier, but the surgeon would have to closely evaluate that. The earliest we have done a revision is 9 months in someone with thinner skin. The nose can be lengthened again and derotated, but it is a difficult procedure, so it's very important that the nose is ready to be operated on again. Be sure to see a rhinoplasty expert for consultation.

Your case with over scooped and over shortened nose, and very likely with tip collapse, alar collapse, rim retraction and other issues like inverted v, open roof, etc... this is a full-equipe catastrophic primary nose job, is of extreme difficulty, hence the utmost importance you prepare your mindset for a deep and thorough investigation, not a research, a pure detectivesque investigation spanning for 6-10 months, travelling to places, doing multiple online consultations, taking notes, comparing, etc so that you can get the proposal from no less than 10 highly experienced complex revision rhinoplasty surgeons, 20 would be a recommendable number.

Do not accept:
-cadaver rib cartilage
-procedures in less than 5 hours
-magical and luring options (fillers, prostheses, etc)
-rigid and highly detailed technical plans in the preop consultation (the surgeon won't know the findings, damage and repair requirements until intraoperative visualization)
-no way ultrasound stuff, lasers, cosmic rays, gravitational forces or so, stay feet on ground
-3D simulations offered? walk away
-overloaded CV, acronyms and medals hanging the chest? better humble hands-on real surgeon

Hope this helps

Sometimes revision surgery can be performed sooner, and the earliest we have done so is 6 months post-operative, when somebody had thin nasal skin and very little if any palpable swelling. Consider re-asking a question with photographs, since the feasibility of revision rhinoplasty always requires an examination. Thank you for your question. Sincerely, Dr Joseph

This is Dr Özge Ergün
As a standard practice, we recommend waiting one year post-rhinoplasty for the skin to fully redrape and settle. Based on your description, as I don't have a photograph, it seems the nasolabial angle has been over-rotated. In such a case, the nose needs to be lengthened again, which can be done using an extended septal graft. Waiting longer will only provide a limited amount of skin redraping. Therefore, you should consider a revision surgery in the near future.

You almost certainly will still have to wait the full year. It's not just because the nose will keep evolving (which it will), it's also for your safety and for the surgery safety. Esp with you having thinner skin, your skin blood supply is likelyl to be comrpomised if you go back in to it too soon and that can cause issues with ischemia and worse case scenario the skin dying on your nose. As for the surgical difficulty, you are likely to have way worse scarring this early on than if you wait, which also puts more risk to you.

Hello and thank you for your question. Based on your description, you may benefit from a revision rhinoplasty. Maneuvers for your surgery would include placement of extended spreader grafts to derotate your tip, among other maneuvers. Depending on anatomy, I will start revisions in some patients as soon as eight months post-op. With good surgical technique, you could likely 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

It's true that "one year before revision" isn't a totally hard-and-fast rule. We can shave it, depending on what was done, what we want to accomplish, and (as you pointed out) how rapidly the swelling goes down. But besides swelling going down, the scar tissue that forms under the skin needs to soften, too. In my practice, 9 or 10 months would typically be a minimum amount of time to wait, which may not seem so much different from a year.
It's not too late, though, to see what needs to be done. Pictures would sure help. For example, an over-shortened nose and scooped profile can actually be over-projection of the tip, and de-projecting the tip might turn out to be main change to accomplish. As I intimated, some planned operations require a longer healing time after the primary than others.

You really don’t have to wait the full 12 months in every case, but in most cases waiting a full year is best to allow all swelling, scar tissue, and the nose’s structure to settle so your surgeon can see what you're really dealing with. At 6-8 months, some things can be assessed well (shape issues, tip rotation, etc.), but it’s often tricky to predict final contour until closer to a year. When you do go for a revision, you’ll want a rhinoplasty specialist whose practice is focused on difficult revisions—someone with a strong before-&-after gallery, especially of cases like yours (shortened nasal length, over-rotated tip, columella changes). If a surgeon says “let’s wait until 12 months” it’s often because messing too early risks making things worse by revising something that hasn’t fully healed. I like waiting as close to the 12 month mark as possible.