Need a 4th Revision Rhinoplasty. Will It Help?

I'm very scared of doing another revision on my nose. Every time I try to get something corrected it ends up worse. The first Dr did two, first time I ended up with acrooked nose. The second time I ended up with a piggy nose. Last one was in December 2008 with a different Dr, my main concern was the columella hanging, now I have no assymetry and hanging columella. does my nose have hope or do I just live with it? Thanks for your opinions.

Doctor Answers 13

4th rhinoplasty - to do or not???

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My advice to you would be to either not do any more surgery or go to one of only a handful of national experts in revision rhinoplasty.  You live in IL so Dr. Toriumi is excellent but my personal top choice is Dr. Jack Gunter in Dallas.  Ask them if there is a hope of improvement and if they say no, don't do any more surgery.

" Quit While You Are Ahead"

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Hello, Mom from Gurnee.

Know your city well; Six Flags Magic Mountain + consulted for the Gurnee School District just before entering US Army, following residency at U of Illinois.

I advise no further surgery. You are an attractive lady. While your nose is not perfect, few -- natural or operated upon -- are. "Quit while you are ahead"  makes sense. What if the next operation leads to infection or tissue loss? You would kick yourself.

Need I remind you,  or our visitors to, that certain celebs, one of  whom shall be nameless but whose last name is the same as the President on a US $20 bill, was the poster boy for bad judgement regarding repeated operations on the nose?

Gambling is what you do in Vegas; don't gamble with your nose.

Best wishes.

- Robert Kotler, MD, FACS


Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

4th Revision

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As long as the tissues are healthy, you are motivated, and your expectations are realistic there is room for improvement.  You may very well need a rib graft to correct the contour deformity of the bridge

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

4th revision rhinoplasty

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One should be very careful when undergoing a fourth revision rhinoplasty.  An alar retraction is best treated with a combination of composite grafts from the ear along with any alar baton grafting.  Columellar hanging and show are best treated by resection of both membranous and cartilaginous caudal septum.  Look for a very experienced rhinoplasty surgeon who has lots of experience performing both primary and revision rhinoplasty before embarking on your next rhinoplasty endeavor.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Multiple revisions

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After multiple revisions often the scar dictates what is possible. I would suggest if anything very modest goals.

4th Revision Rhinoplasty

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You are smart to proceed cautiously. Sit down with a very experienced revision rhinoplasty surgeon to determine what you both want to achieve with safe limited intervention. A careful review of previous operations will be helpful.

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

Need a 4th Revision Rhinoplasty. Will It Help?

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If all you are looking to improve is the hanging columella, then, yes, I think a minor revision done with particular techniques would give you an improvement (see link).

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

A well-performed Injectable Filler treatment may be helpful for restoring symmetry to your nose. Video attached.

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I read your concerns and reviewed your photos. In my view, you should reserve any further revision rhinoplasty surgery as a last resort. You have some tip asymmetry, and nostril retraction on both sides. You may want to consider a non-surgical rhinoplasty procedure to add some volume to your nose, lower your nostril margins, and restore tip symmetry. I prefer to use Silikon-1000, an off-label filler, for permanent results.

I hope this is helpful for you.

Regards from NJ:

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

Will a 4th revision rhinoplasty help

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You never HAVE to have a revision rhinoplasty. The main issue is whether the problems that concern you can be improved with surgery and whether the risks, recovery time, and expense are worth it.

In experienced hands your nose can be improved. If you are seriously considering revision surgery I would be sure to consult with a few surgeons who have extensive experience with revision cases like yours.

A better sense of what could realistically be done would come from an examination of your nose.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Revisoin rhinoplasty

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I would avoid repeated rhinoplasties on your nose.  Each time back is like a time bomb ticking. The skin may not handle the repeated trauma.

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