Should I consider a revision rhinoplasty? 4 years post op, nose is beginning to twist. (photos)

Question

I am a 25 year old Caucasian female with thin/oily skin. I underwent a septorhinoplasty in 2018. The surgeon removed too much cartilage and attempted to build the tip of my nose with some sort of graft that is now visible on the tip. My nose is beginning to twist. Too much was shaved off my bridge and underlying curvature is now visible as well. Should I consider revision with a reputable surgeon or count my losses? I know this will worsen as I age. Any insight/knowledge/advice is appreciated ❤️

Nima Shemirani, MD · Answer

Hi @Brave9480. I'm sorry you are unhappy with your results. I recommend seeing an expert revision rhinoplasty specialist for an in person examination. There are options for you that can be determined after examination.

Best of luck,

Dr. Nima

Best of luck,

Dr. Nima

Eric M. Joseph, MD · Answer

Based on your photos, You appear to have thin nasal skin, and a crooked nasal appearance, Depending on your examination, a permanent non surgical nose job may be considered for achieving a straighter and less operated nasal appearance. Hope this helps. Sincerely, Dr Joseph.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. Though a thorough physical exam and surgical history are necessary, you are likely a candidate for revision rhinoplasty to address the graft visibility and overall nasal symmetry. 
Keep in mind that each subsequent nose surgery becomes more complex due to loss of structural support and scar tissue. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to conduct a more in-depth analysis and make the best recommendation for you.

Gianfranco Frojo, MD · Answer

Yes I would highly recommend a revision with cadaveric rib cartilage to help support the nose and tip. This would be a complex procedure that would require a consultation prior to discuss many parts of the surgery and the expectations can be discussed as well.

Waleed Ezzat, MD, FACS · Answer

Thank you for your question.  Undergoing, or even contemplating a revision rhinoplasty, can be a very taxing experience emotionally.  However, when you think you may need a revision, it is always best to find a board-certified specialist who is well-versed in revision rhinoplasty and get an opinion on what can and what cannot be done through surgery.  Without examining your nose or reviewing the operative notes from the first procedure, it will be very difficult to comment on whether you are a candidate or not.

A good surgeon will not just tell you that it can be done, they will perform a full exam and then take the time to review realistic expectations on what one can and cannot expect from a revision procedure.  If needed, get multiple opinions.  With nearly everyone offering virtual consultations, it has never been easier to find the right surgeon for you.

Best of luck!

Dr. E

Barry M. Weintraub, MD, FACS · Answer

Just based on the photos, I do see the curve that you are referring to, as well as the graft. It does appear that you would be a good candidate for a revision rhinoplasty, but a physical exam would be necessary to be certain. It would also be helpful for you to obtain your surgical operative report to bring with you. The pressure on the tip of your nose is of concern, as it can lead to real issues down the line. I recommend consulting with a board certified plastic surgeon who has decades of experience with revision rhinoplasty as these surgeries are always more technically challenging compared to primary rhinoplasties.

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning! Thanks for your questions. If too much cartilage was removed and graft visibility in addition to twisting is occurring, the problem will not likely improve over time. Often, the problems get worse. Revision rhinoplasty certainly can make improvements to the nasal structure. Adding grafting material to create a strong nose with overlying camouflage grafts would help tremendously to keep the nose smooth and straight. It depends on how much the problem bothers you. Seek consultation with a facial plastic surgeon to learn more about what may be realistic for you. Hope that helps!

Should I consider a revision rhinoplasty? 4 years post op, nose is beginning to twist. (photos)

Answers (7)

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