A third rhinoplasty? Or another solution? (Photo)

I did the first Rhinoplasty 4 years ago to remove a big bulge from one side and to shorten the front. After a week, I noticed two bulges. After 2 years, I did another Rhinoplasty but those bulges still remain. Now, after 2 more years, I still notice them and additional bulges as well! Should I try a third Rhinoplasty with a new doctor? Are there any other solutions? What should I do? I have a thin skin and it looks worse with makeup than without. Please assist. I'm in a deep depression. Thanks

Doctor Answers 2

Postage stamp rhinoplasty, multiple revisions, thin skin

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Unfortunately there is really no other solution than to have a third rhinoplasty( seconds revision rhinoplasty).  It appears to me that during the  revision rhinoplasty the surgeon attempted to  camouflage and hide the  deformities of the first operation rather than to  completely revise and rebuild the structure of the nose.   It is a common practice for  surgeons to use small pieces of cartilage to camouflage deformities rather than correcting the deformity which frequently results and what I referred to as a postage  stamp rhinoplasty.  I do not believe that this is the best way to perform a rhinoplasty or revision rhinoplasty .  The structural integrity of the nose should be completely reconstructed in a symmetrical fashion.  Because of your thin skin I would advise a temporalis fascia graft to thickened the soft tissue envelope over the nasal skeleton.  This will soften the nose and yield a less surgical and more feminine appearance.

Revision Rhinoplasty Considerations

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I share your concerns about the nasal dorsal irregularities and appearance of your nose after two surgeries. A thin skin and soft tissue envelope may be one factor, but I suspect that a trusted, experienced revision rhinoplasty expert would identify others structural areas for improvement. Alloderm or Flex acellular skin grafts could be considered intranasally, along with a comprehensive revision surgery to address structural issues. An opinion from a new surgeon may shed some new insight for you regarding the best path forward. The best way forward for you personally is to remain positive and optimistic while you search for the best physician to help. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.