Need Tertiary Rhinoplasty. How realistic would a good outcome be? (photos)

My primary rhino (14 years ago) was very minor but too much cartilage was removed from my left alar dome. My revision was 4 months ago. I just wanted simple improvements/repairs but wanted to keep my overall nasal shape because I know that usually what nature gave us is what suits us best. But in that surgery my columella was tucked, tip was derotated a lot, alar rims were lowered, and nose was shortened. Most of this I can handle, but the derotated tip and no columella are unacceptable.

Doctor Answers 3

Tertiary Rhinoplasty

Dear hanginginthere, I would look at the original imaging profile view that you discussed with your surgeon and compare that to your current results. Personally, I think your after profile photograph is more aesthetically pleasing then your before photograph. The before photo shows a hanging columella and an over rotated tip. I am not sure what your conversations were with your surgeon and if these were aesthetics you liked and did not want changed. I would see your surgeon for follow up appointments and a side by side comparison of profile imaging may be helpful in opening up the discussion of your concerns. It may be time to leave well enough alone. Best regards, Michael V. Elam, M.D.


Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

A Good Outcome Is Realistic

However, I say this with the caveat that your natural anatomy has not been essentially obliterated.  Only an in-person examination would provide this information.  I suggest that you choose your revision rhinoplasty surgery very carefully, seeking a board certified plastic surgeon with years of experience who specializes in revision rhinoplasty.  Revision rhinoplasty is one of the most challenging surgeries, which is why we surgeons who specialize in this find it exciting. It is always tremendously rewarding to create a good result for patients who had unsatisfactory results elsewhere. 

Tertiary rhinoplasty

It would be nice to see the pre-op computer morph of your profile. Your pre-op nose had excessive rotation and excessive columellar show. Those issues have been nicely corrected. Perhaps you did not want those issues corrected? It sounds like you need to revisit with your surgeon about the goals of the surgery. 

Bradford A. Bader, MD
Plano Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

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