Revision rhinoplasty 7 months post op - losing faith

Question

I had a primary rhinoplasty back in 2017- I always wanted a curved (ski slope) I was unsuccessful and was disappointed in the result unfortunately as my nose remained dead straight. Fast forward November 2023 (7 months ago) I finally tried again for a revision. The on the table photos seemed to show a big difference but unfortunately they look nothing like my actual results - I’m confused it feels like it’s not going to change- why did this happen again ? 7 months out and lost hope.

Eric M. Joseph, MD · Answer

The good news is that if you have a persistently under operated nose, it's an easier fix than a nose that has had too much taken away. We have seen cases similar to yours where somebody goes for a second operation and things simply don't change that much. Please consider getting a copy of your operative reports and meeting with another reputable rhinoplasty specialist so you can gain clarity. Wishing you well moving forward. Sincerely, Dr. Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from an another revision to achieve the goal you want.  I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results.  With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Revision rhinoplasty 7 months post op - losing faith

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