I am looking to have a revision rhinoplasty. What can be done?

Dear nosejob111I see the issues you  are dissatisfied with. In terms of the graft between your eyes, that can usually be repositioned and secured with good consistency. The issue of nostril show is not as simple. De rotating your tip and lowering the ala without good cartilage is often difficult as useful septal cartilage is often used up in the primary African American rhinoplasty. I usually use an extended lateral strut graft harvested from the nasal septum for lowering the ala to reduce nostril show. There are other techniques but essentially all require good cartilage stock. Take your time and see more than one surgeon in consultation. Rhinoplasty experience and board certification are important factors to consider.

The issues that you have described are commonly addressed with revision rhinoplasty.  It is best to have an in-office consultation so accurate advice can be given.  I recommend consulting with a Board-Certified plastic surgeon who will thoroughly examine your nose, review your previous operative reports, and develop a plan tailored to your needs.  Best wishes!

A revision rhinoplasty procedure can adjust the dorsal graft if it is crooked, in an attempt to make it straight. A columellar- plasty is performed to reduce the columellar show. This involves trimming back excess cartilage and skin inside the nostrils to help  reduce the  nostril show.

Most of what you're interested in can be addressed with relatively straight forward rhinoplasty work.  However, to give you better advice we would need some profile photos.I would definitely focus your efforts as far as consultation goes with board-certified facial plastic surgeons.  The cartilage on the bridge can be repositioned or replaced or shaved depending on what is needed.  The hanging columella may not be hanging as much as it appears if there is significant alar retraction.Chase Lay, MD

The graft needs to be repositioned.  The hanging columella can be treated with surgery on the anterior columella and by unfurling the ala rims slightly.  Please obtain an in-office consult with an experience Board-Certified Facial Plastic surgeon.  Best wishes. 

The cartilage graft can be repositioned or smoothed out depending on what is necessary.  The hanging columella can be lifted. Without a profile view of your nose it is impossible to accurately address your questions but it does appear that these problems can be corrected with very limited surgery.