Do I need a third Rhinoplasty to reduce bulbous and wide tip or should I wait 18 months ? (photos)

I am now 1 year post revision rhinoplasty to reduce swollen tip I have had 3 courses of steriod injections which did not help My tip is swollen and wide Is the swelling likely to reduce further or should I consider a third rhinoplasty now My surgeon thinks that the tip is still swollen and I should wait until 18 months post surgery In addition the tip now appears to droop . Is thus likely to change without further surgery ? Advice would be greatly welcomed

Doctor Answers 4

Wait before deciding on a third rhinoplasty

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It is possible to have another revision rhinoplasty, although it may be a good idea to wait longer, as it can take longer for the nose to completely heal after a revision rhinoplasty than for the first rhinoplasty. However, revision rhinoplasty is one of the most challenging of all cosmetic surgeries, and each time a rhinoplasty is done, it becomes increasingly complex. Keep in mind that there are many factors involved, so your nose may not turn out exactly the way you want the third time either. I recommend getting a second or even third opinion in person from a well-experienced revision rhinoplasty specialist.

Toronto Facial Plastic Surgeon
4.7 out of 5 stars 170 reviews

Tip refinement in revision rhinoplasty

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This is a tough problem. I have come across it a few times. I think that the results become harder to predict the more revisions you have. Without knowing what was exactly done, it seems as though your skin at the tip is thicker than for the remainder of your nose. It might be more difficult to refine that further. You should wait two years to revise a revision nose. So maybe the tip will reduce more, but I think the difference will be small.

Samir Undavia, MD
Princeton Facial Plastic Surgeon
4.9 out of 5 stars 51 reviews

How long to wait for a revision surgery?

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The thicker the skin the longer it is going to take to decide about the final outcome of the rhinoplaty, especially in the tip area. Rarely, some noses may take 3 years to reach the final outcome. So, your surgeon is correct in asking you to wait. When the time comes and if the revision becomes necessary, your surgeon may suggest to reduce the projection of your tip slightly and correct the deviation of the columella (the column between the nostrils). Additionally, in 3 out of the 4 photos your lips are open. This means to me that you may have breathing problems and you may want to discuss this with your surgeon, if my observation is correct.

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.7 out of 5 stars 23 reviews

Tip refinement

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Your surgeon is correct that you may still expect changes after the one year mark. However, I believe the changes you will get at this point are relatively small and may not correct the issues you are asking about. I would see if your initial surgeon would consider operating at this time, or maybe consult with another revision rhinoplasty surgeon.

Best of luck

David Reinstadler, MD
Newport Beach 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.