How close to my old nose can I get with revision rhinoplasty? (photos)

Question

I had open rhino/septoplasty and it dramatically changed and imbalanced my face. I want to know whether once the healing period has passed I can get revision to get as close to my old nose as possible. I want the bridge widened slightly and the tip derotated and length put back in so it's pointy and long like before. Is this achievable? I want my nose to look natural & ethnic as opposed to 'done' which I feel I have now, it feels too short and stubby and the top of the bridge looks too narrow.

Vito C. Quatela, MD · Answer

While you might not exactly get your old
nose, a revision rhinoplasty can help you address your concerns to help improve
the appearance of your nose. During a
revision rhinoplasty you could widen the bridge of your nose with osteotomies
and cartilage grafts as well as derotate your tip and straighten the dorsum
of the nose. Depending on your first
surgery, additional cartilage obtained from the ear or rib may be required to
create the structure needed to give you the results you desire.

I recommended a consultation with an
experienced rhinoplasty surgeon who is comfortable with revision rhinoplasty
surgery.

William Portuese, MD · Answer

It is impossible to get exactly your old nose back. It is possible to make some adjustments to the nose which would include cartilage grafting techniques, however it's very dependent upon if there's any cartilage left on the inside of the nose. It's also important to wait at least one year after the primary rhinoplasty before embarking on a revision. It's also a good idea to try to get your old operative reports to  understand what was accomplished in the primary procedure.

Richard Mark Winters, MD · Answer

If you have had the opportunity to folllow this site, you should take comfort in your rhinoplasty having been done pretty well the first time around....that said, it is certainly reasonable to be critical and make the assessment/inquiry that you haveAlthough your dorsum is not significantly overresected (hence, your straight profile....not concave), you are a bit shortened...sometimes shortening alone or in combination with trimming tip cartilages can rotate the tip up in the absence of any specific maneuver intended to achieve upward rotation..... you seem to have nice nasal skin which is a prerequisite to lengthening and derotating techniques which usually include rib cartilage grafting when the septum has been used previously Good luck...

Edward Farrior, MD · Answer

From the photographs you provided your nose does look over rotated and surgical.  This can be corrected but the technique chosen depends on the degree of septal cartilage that was removed during the primary rhinoplasty.  In order to achieve a softer nasal tip and slightly broader nasal dorsum cartilage grafting will be required.  Cartilage grafts will also be required to lengthen the nose, counter rotating or derotating the nasal tip.  If a great deal of septal cartilage was removed with the primary rhinoplasty it will be necessary to acquire cartilage from the ear or the rib.  Both of these sources for cartilage are used frequently and reconstructive rhinoplasty. A very important question that any surgeon should ask is how long has been since your primary surgery? Some of the rotation created which surgery will resolve over time.

How close to my old nose can I get with revision rhinoplasty? (photos)

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