Bad Nose Job? (Photos)

Question

Got my nose done 2yrs ago sometimes it looks swollen,is it still healing? Also my nose is crooked,my surgeon said it wasn't&he'd prob make it worse be4 better,I think it's crooked&2 big&bulby looking(tip)&slight bump still there(he said he could fix the bump). I had a bit of trouble breathing through my right nostril after the rhinoplasty it's double worse,I need a nasal spray just to sleep,my regular dr said it looked swollen inside,why is that? I'm going to have to get another surgery?

Michael A. Persky, MD · Answer

Hi NY in NC,

	Well, it's not good if you have so many problems after your surgery.  Cosmetically from the side it appears that your tip is over projected, and from the frontal view it is slightly crooked and full.  Since you are unhappy with both the appearance and the breathing function of your nose, it would benefit you to consider revision rhinoplasty.  Choose your rhinoplasty surgeon most carefully.  Good luck and be well.

	Dr. P

John Bitner, MD · Answer

I sorry you have not been happy with your nose job. It's frustrating that you are not only unhappy with the appearance, but that it doesn't work well. From a cosmetic standpoint most of the problems seem to be with the tip. I can see that it is still very ptotic and overprojected. I think you need the tip rotated up and brought back closer to your face. Unfortunately, there aren't any non-surgical options for this. You need a revision. There are some other things that can be done to improve your breathing but I would need to see you in person to assess the functionality. I have posted a link to one of my revision rhinoplasty patients who had similar "tip" problems.

Steven M. Denenberg, MD · Answer

After two years, your swelling is probably all gone. On the profile view, your nose is still strongly forward projecting from your face. I'd like to see it closer to your face. Also, your nose looks long, where we measure "length" from the tip of the nose up along the bridge to where it begins between your eyes. Click on the Web reference link for a morph of your current nose to a proposed after photo, correcting those features, and links to some other patients who had similar changes to their noses. From the front, your nose does look somewhat crooked still, and somewhat wide. Revision rhinoplasty is very difficult, so if your doctor doesn't describe these changes and show you other patients with similar problems where he's had success, don't let him operate again. The good news for you is that, in expert hands, decreasing the nose's length and projection are two of the most predictable changes to make in revision rhinoplasty.

Toby Mayer, MD · Answer

Revision rhinoplasty for multiple problems. All of this can be corrected by a very experienced revision rhinoplasty surgeon. So choose a surgeon based on his actual results in noses like yours!

Eric M. Joseph, MD · Answer

I read your concerns and reviewed your photos:

	On profile, you appear to have a long nose with an overprojected, underrotated tip along with the residual small bump you describe. On front view, your skin appears thin, and your nose appears wide with your tip deviating to your left.

	Revision rhinoplasty surgery will be exponentially more difficult than your first surgery, so your choice of surgeons will be critical.

	Hope this helps you.

	Dr. Joseph

Richard H. Tholen, MD, FACS · Answer

Your surgeon has performed all the proper steps during your rhinoplasty, but proportion, amount of tissue removed, symmetry, and harmonious coexistence of your nasal skin, support structures, and soft tissues (including scarring) require significant adjustment to yield a better result.

	Your osseocartilagenous junction requires additional resection, and the alar cartilages require resection and tripod retrusion for the over-projecting (and slightly dropped) nasal tip. Your bones and/or upper-lateral cartilages require rebreaking and centralization to the midline. Finally, your septum requires centralization (if not already), plus appropriate inferior turbinate partial resections for symmetrical and opened-up airways that are equal in cross-sectional area to prevent compensatory hypertrophy of your turbinate mucosal tissues leading to ongoing airway problems.

	That pretty much means another surgery!

	After 2 years, things have healed, softened, and settled so that revision is possible any time you feel sufficiently informed by your next rhinoplasty surgeon that you are willing to proceed with the cost and recovery of another rhinoplasty. This one will NOT be easier because it is a "touch-up" or redo surgery--in fact secondary rhinoplasty is more difficult and requires at least as long a recovery as primary rhinoplasty because of the scar tissue from your first operation--this is why repeat surgery is recommended no sooner than 6 (and usually 12) months post-op. Your 2 years of healing and scar maturation make secondary surgery safe at this time, so long as you choose an expert revision rhinoplasty surgeon! Best wishes! Dr. Tholen

Remus Repta, MD · Answer

Hello,

	Thank you for the question and the photos.  There is no doubt that additional improvements can be made in the shape and appearance of your nose.  They key will be to find an experienced board certified plastic surgeon that does difficult rhinoplasty procedures.  You will benefit from work to your tip, septum, and dorsum with the overall goal to make your dorsum straight and appropriately tall, a shorter nasal length, more defined nasal tip, and improved breathing.

	All the best,

	Dr. Remus Repta

Carlo Honrado, MD, FACS · Answer

I would suggest getting multiple opinions from board certified surgeons to correct any issues from your previous rhinoplasty. It has been enough time to see the results of your surgery, so consult with with a surgeon who is very experienced with revision surgery who can correct not only the aesthetics of your nose but also your breathing problems.

Guido P. Gutter, MD · Answer

It appears you have two problems: You have problems breathing and you do not like the cosmetic result of your surgery. You waited long enough for your healing to have settled and can think about revision. The nose does not tolerate repeat surgeries well and therefore you should find now a surgeon well versed in revising your cosmetic concerns and also you "functional" (breathing) problems. There are several surgeons who have made themselves a name for being very skillful in revising nose jobs. We all know their names and can recommend them to you. You may want to have a frank discussion with your surgeon if he is willing to recommend one of them to you and to refer you to him.

Ramon Navarro, MD · Answer

yes you would need  firstly a thomography to correct your breathing problem besides to put  your nose  in a wright way and correct bumping.my council is to go with a certified plastic aesthetic surgeon to correct thew 3 problems

	si requeririas  corregir los 3 problemas  acudiendo con un buen especialista  con amplia experiencia

Bad Nose Job? (Photos)

Answers (15)

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