Do I need a rhinoplasty revision? (Photos)

Question

I had a rhinoplasty but keep being told it’s fine and normal. Wondering if it looks right? It seems so odd in photos / life

Semih Yildiz, MD, FEBOPRAS · Answer

Across the five patient photos, the nose looks generally proportionate, but there is mild asymmetry of the tip, columella, and nostril shape, especially on the base and close frontal views. Lighting, lens distance, facial expression, and camera angle vary considerably, so these images cannot show whether the difference is stable or clinically significant.

If your rhinoplasty was less than about 12 months ago, swelling and scar maturation can continue to change the tip and nostrils. Contact your surgeon for an in-person examination and compare standardized photographs over time. A revision is usually considered only after healing is complete and when a specific, reproducible concern causes meaningful cosmetic distress or breathing difficulty.

Revision rhinoplasty is more complex than primary surgery because of scar tissue and altered cartilage support. Trying to correct a subtle asymmetry can introduce new irregularity, stiffness, breathing change, or the need for grafting. Perfect nostril symmetry is not a realistic goal.

Ask your surgeon to identify the exact anatomy behind what you see and whether observation, a small limited correction, or no further surgery offers the best risk-to-benefit balance. If you remain uncertain after full healing, obtain an independent consultation from a surgeon who performs a high volume of revision rhinoplasty and bring your operative report and preoperative photos.

Eric M. Joseph, MD · Answer

Based on your up close photos, you appear to have a small indentation along your right nasal sidewall, and you also appear to have a bit of nostril asymmetry. Both of these issues may be improved upon with permanent non-surgical nose job treatments, which may be a welcome alternative to additional surgery. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining revision rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. Nostril asymmetry can also be corrected with tensioning the tip and placement of extended alar contour grafts . With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Alejandro Nogueira, MD · Answer

Yes, revision rhinoplasty is indeed worthy and indicated; many issues here:
-one sunken nasal bone, probably due to unilateral fracture and not bilateral (don't ask me why, it's beyond me)
-asymmetric resection of alar cartilages
-inverted V and open roof (unilateral, as corresponds with the first item)
-poor nostril support, alar rim retraction
-poor tip definition
-over pinched with suturing nasal domes on a preop boxy bulbous tip which actually required lateral crura repositioning

Seek well trustworthiness and talent for the revision surgeon.

Do I need a rhinoplasty revision? (Photos)

Answers (4)

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