I have breathing problems after a Revision Rhinoplasty. Should I consider another Revision Rhinoplasty?

In '05 I had a primary rhino to reduce a bulbous tip and ended up w/a very poor result. I had a revision in '07 and now I'm having breathing problems again and my nostrils are retracted/uneven and have a V shape. Would those with experience in revisions advise for/against a 3rd surgery?

Doctor Answers 7

Revision or not?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is very difficult to answer your questions without seeing your photos or examining you – it would be very helpful to post images showing your areas of concern

There is no absolute maximum number of rhinoplasties that you can get as long as the skin is healthy.  If you are still unhappy after multiple rhinoplasties you must consider a couple of possibilities:
1. Are your goals realistic
2. Are you choosing the best possible surgeon for your procedures

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Considering second revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It is acceptable to undergo a third revision rhinoplasty surgery, but it is very important that you seek a surgeon who has lots of experience in revision rhinoplasty. The surgery can be more difficult the third time around than the first time. It is important to have open communication and dialogue with your revision rhinoplasty surgeon so that you have clear expectations and goals on what needs to be performed. Make sure any breathing problems caused by allergies are well managed. These are typically controlled with antihistamine and cortisone nasal sprays.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Consider 2nd Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A 2nd revision is not necessarily bad, but the decision depends on the patient's and surgeon's goals and expectations. I strongly recommend several consultations with very experienced surgeons.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rules for revisions

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

A professor of mine used to say" those that seek a third or fourth revision often wish that they were back to the first or second, and more than likely will need a fifth or sixth."

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Teriary rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From the picture you posted, the nose is NOT bad. Do not do a third rhinoplasty.

See an ENT surgeon to deal with the breathing problems ONLY

Samir Shureih, MD
Baltimore Plastic Surgeon

You may be a candidate for a Non-Surgical Rhinoplasty.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Most breathing problems after Rhinoplasty will not require further surgery. You should look into turbinate reduction (office procedure with local anesthetic), or start with some prescription nasal sprays like Nasonex (steroid) and Patanase (antihistamine).

I reviewed the frontal photo you posted. You appear to have an indentation of your left bridge. This can be filled, and your nostril margins can be lowered with an Injectable Filler Treatment. My personal preference is Silikon-1000 for permanent results.

If any of my colleagues wish to learn more about my experience with Silikon-1000, I am giving an instructional course at the upcoming Fall Meeting of The American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). The course is titled "Off-Label Applications of Liquid Injectable Silicone (LIS)", and I will be presenting on 9/24/2010 at 4pm. Common conditions treated include: volume replacement, wrinkle reduction, lip enhancement, acne scarring, and correction of many nasal irregularities (“Non-Surgical Rhinoplasty”). I will also be describing the serial puncture, microdroplet technique that is essential for achieving desired results.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Perhaps a revision rhinoplasty is in order

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The number of previous surgeries is not the key in your decision.  The important factor is to be able to come up with a list of problems that can safely be improved at least 50% with another revision rhinoplasty.  I have seen patients who had one horrible previous rhinoplasty and needed a revision and I have seen ones who had 4-6 poorly performed previous surgeries and needed a good definitive correction.  If you find a great surgeon and you both decide on specific issues that can be improved greatly then that's fine, otherwise leave it alone for now. You have to decide.

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 119 reviews

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.