Still bulbous after revision rhinoplasty. Is there any hope to fix this?

Question

It has been three years since my revision rhinoplasty and my nose is wider than it’s ever been, I don’t even recognize myself. The tip still droops as well. I know there is no going back, but is there any hope at this point to fix this? I just don’t understand how my nose still looks swollen after this long.

Donald Groves, MD · Answer

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 3 years post-op, all the swelling should be fully resolved. A revision (tertiary) open septorhinoplasty can best address the entire nose, and is particularly effective for addressing the issues you are concerned with- 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. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision/secondary procedures are even more complicated. Therefore 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 a description, especially if no photos are 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

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs. However, if the thickness of the tip is related to the fat then that can be removed at surgery. However, the tip can be more defined by manipulating the cartilage.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Steven M. Denenberg, MD · Answer

In my experience, it's rare for a too-wide and too-long nose to look the same after surgery despite expert work during a rhinoplasty, or a revision. The question is, how were your cartilages handled? What was done to them? Were techniques used that had a high possibility of success, or was the surgery inexpertly performed? Was it the same surgeon who did both operations?

For most people in your position, it's reasonable to see another revision rhinoplasty, but being quite careful in selection of surgeon. If it turns out that another operation can't help you, the expert surgeon would be able to tell you that; the inexpert surgeon might just take another try.

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.

Jacob Tower, MD · Answer

Hello, hope you are well. The only way to answer your questions is to examine your nose with photos or in-person, and understand more about your history and specific goals. There is usually some room for improvement with almost any nose, but the devil is in the details--especially in revision cases.
Best,Dr. Tower

Andrew Kornstein, MD, FACS · Answer

There is almost always a proper solution to difficult noses

Photos are important for any advice to be given

Still bulbous after revision rhinoplasty. Is there any hope to fix this?

Answers (5)

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