Badly botched 8 years ago. Is this fixable? (photo)

Hello and thank you for your question. I am sorry to hear you are so unhappy after your prior surgery, I truly empathize with you, as no one should feel uncomfortable in their own skin. By 8 years post-op, all the swelling should be fully resolved. A revision (secondary) open septorhinoplasty can best address the entire nose- there is no guarantee things will be perfect or fully back to "normal," but it can definitely make things better.
The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look, particularly in a revision/secondary operation such as this. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision/secondary operations are much more difficult than primary operations. Consequently, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from photos and descriptions provided. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best Wishes,
Dr. Donald Groves
Plastic Surgeon

It appears your lateral cartilages are quite wide and you may need to have these shortened, resected and tightened in the midline. This will be a revision rhinoplasty.

Best Wishes,

Gary Horndeski, M.D.

Of course, there is no law that you *must* have a revision, but just the fact that you're asking the question means you are exploring it and would like to get improvement. From this one photo, your nose looks long, with the tip drooping down. Correcting that feature, even in a revision, is one of the more predictable changes to make in a rhinoplasty. But you must do excellent research before you allow another surgeon to operate on your nose. Any revision is a difficult undertaking.

Rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

After reading your narrative, it's not clear what you dislike about your nose. Based on your singular photo, you appear to have somewhat of a curved appearance with a linear indentation along your left bridge. Depending on your examination, microdroplet Silikon-1000 injections may be considered for filling this indentation and for providing a straighter nasal appearance. I hope this is helpful! Sincerely, Dr Joseph

I am sorry you are so unhappy and find it hard to move forward.
Based on the one image included, I see a curved nose and perhaps a poorly defined tip.
What did your nose look like before?
What makes it "botched" or bad relative to what existed before?
What would your ideal nose look like?

Much more information is needed, such as a full set of facial photographs of your nose from all angles, and even a copy of the operative report. The nose is a three-dimensional structure, and rhinoplasty is performed in all three dimensions. Revision rhinoplasty is more difficult than a primary rhinoplasty, so it's imperative to have realistic expectations. It appears from the one very limited photograph that you had anosteotomy placed too high on the left nasal bone resulting in that line. Low lateral osteotomy's should be able to improve your issue, but that will be determined at the time of a physical examination.

Hello! What are your specific goals? Revision rhinoplasty can be used to achieve great improvements. Factors such as the technique used, current nasal structure, and breathing trouble would be taken into consideration. I would seek consultation with multiple surgeons to learn more about what may be possible as you may be surprised. Hope this helps!