Is minor tip plasty common after revision rhinoplasty? (Photos)

Question

Hi! Thank you for reading my question. I had my first nose surgery 13 years ago, and then I had a revision rhinoplasty one month ago. I live in Italy, but I traveled to another country just to have this surgery. Because of my visa and travel limits, I can’t stay long enough to wait the full 6 to 12 months that’s usually needed to see the final results. Now, about one month after surgery, I see some depressions and uneven shape on the tip of my nose. My surgeon told me to wait about 3 months total, and if the tip still looks the same, he will do a small touch-up surgery (tip plasty) — only under local anesthesia, with no cast or tampon, and just a few stitches. My question is: Is this kind of second, small surgery — just to fix the tip — common or safe among experienced nose surgeons? Is it normal to do a tip correction just a few months after a revision rhinoplasty? I really appreciate any help or answers. Thanks so much!

Alejandro Nogueira, MD · Answer

We need to see your current situation with updated images, however a retouch after a major revision rhinoplasty SHOULD be delayed 10 to 18 months, no less, doing it at earlier stage is a guarantee of suboptimal results, complications or even a disaster.

It is neither true that 3 months are needed to assess the result, it is as I said a much longer period, x3 or x4 longer.

Seek other opinions if your revision is not successful.

Bianca Knoll, MD · Answer

give it some more time. It is nice that your surgeon is trying to help you out, but healing is not completed and changes will continue to occur.  Depending on what was exactly done during your preceeding surgery, it is often advised to wait a minimum of 1 year. Some cases will need even longer. I hope this helps.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have very thin nasal skin, along with an asymmetrical nasal tip appearance. When you're swelling is resolved after your revision, microdroplet Silikon-1000 nasal injections may be considered for improving upon your nasal tip symmetry for a less operated nasal appearance. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I would recommend waiting longer than three months. 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 with standardized lighting and standardized background. 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, or all patient selfie’s without real longterm in-office formal 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. Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website. 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

Best wishes and good luck.

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

Is minor tip plasty common after revision rhinoplasty? (Photos)

Answers (4)