Seven years post-primary rhinoplasty for dorsal hump reduction left me with an over-rotated "piggy" tip. A revision using rib cartilage (harvested via 8 cm incision by a thoracic surgeon) provided minimal radix augmentation and no tip improvement. Key questions: Does large incision/non-plastic surgeon suggest technical issues? Can another revision de-rotate the tip and restore a natural profile?Are grafts/tissue expansion viable for reconstruction despite limited skin? Thank you.
March 17, 2025
Answer: Revision rhinoplasty 7 years This is not uncommon after scar from a primary rhinoplasty sets in. Again, an in-person exam of the nasal skin would need to be done. But likely what someone could do would be to derotate the nasal tip, use donated rib graft (I use MTF cadaveric frozen rib for revision rhinoplasty patients that I see) to support the tip in its new lowered position, and lengthening the nose with grafts. Starting massage of the nasal skin at least 5 times 5 minutes daily to stretch the skin pocket can help with breaking up the scar and stretching the pocket. Typically revision rhinoplasty rates especially if needing cartilage grafts can range from 25-65K. I see many of this type of patient but I always strongly suggest people to see the original surgeon first as he or she will best know what they have done. However, because many surgeons prefer not to address revision noses I do see many of these from the midwest as well as the coasts. Thanks for your complex but specific question! I hope this helps.
Helpful
March 17, 2025
Answer: Revision rhinoplasty 7 years This is not uncommon after scar from a primary rhinoplasty sets in. Again, an in-person exam of the nasal skin would need to be done. But likely what someone could do would be to derotate the nasal tip, use donated rib graft (I use MTF cadaveric frozen rib for revision rhinoplasty patients that I see) to support the tip in its new lowered position, and lengthening the nose with grafts. Starting massage of the nasal skin at least 5 times 5 minutes daily to stretch the skin pocket can help with breaking up the scar and stretching the pocket. Typically revision rhinoplasty rates especially if needing cartilage grafts can range from 25-65K. I see many of this type of patient but I always strongly suggest people to see the original surgeon first as he or she will best know what they have done. However, because many surgeons prefer not to address revision noses I do see many of these from the midwest as well as the coasts. Thanks for your complex but specific question! I hope this helps.
Helpful
