After tip rhinoplasty, septoplasty and osteoplasty, is this as good as it should be? (Photo)

Tip defined and septoplasty back in Nov 15. Aug 16, Dr. took out a graph he placed at the columella and did osteoplasty. Oct 16, he put in a filler to make an illusion of the nose being straight. I don’t like the indents, they look unnatural. The cartilage patch is very noticeable and I absolutely hate seeing it. The upper tip is very full on one side vs the other. I am not happy with paying almost $10,000 only to end up with more unevenness than I started with. Dr. suggested get other opinions?

Doctor Answers 2

As Good As It Should Be?

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Thank you for your question, and for the photos.

If your doctor is suggesting you get other opinions, it sounds like that doctor is at the limits of their comfort zone with rhinoplasty revision (not unusual, revision rhinoplasty can be a very complicated process to achieve good results).  While the pictures you provided are helpful, it's best to have an in-person consultation with a surgeon (plastic surgeon or facial plastic surgeon) who is experienced in revision rhinoplasty to discuss your options.  They will examine the nose from all angles (side, internal, etc.), as well as it's relation to the rest of the face, and then make a plan for what can be done to get you to where you want to be.


Dr. Michael Epstein

MAE Plastic Surgery

Northbrook, IL

Rhinoplasty Concerns

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If I understand you correctly, you had a septoplasty and tip rhinoplasty in November '15 and then underwent a revision procedure in August '16 to remove a cartilage graft and have osteotomies of the nasal bones. Subsequently, you have had injectable filler recently in October '16 to camouflage some indents and asymmetries. In my opinion, I would refrain from any further injections and allow your nose to heal at least 6-8 months from your second surgery. Then, I would recommend getting an opinion from a trusted and experienced Facial Plastic Surgeon who regularly performs rhinoplasty and revision rhinoplasty. Whatever concerns you may have at that point should be easily addressed by your chosen professional. Unfortunately, a longterm solution for you may require additional surgery for additional refinement. Best wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.