Issues after revision rhinoplasty - can I get it corrected? (Photo)

Question

Hello This is me 18 months after revision rhinoplasty and osteotomy. My nose looks like it has a-ton of issues. What problems does it have and can it get corrected? Is it worth going for 3rd revision???

Eric M. Joseph, MD · Answer

If you have a line down the lower 1/3 of your bridge, that could be your dorsal septum showing through your thin nasal skin. If that is the case, depending on your examination, micro droplet Silikon 1000 injections may be considered for smoothing this out and adding volume to the area just above your tip for a less operated nasal appearance. Thank you for your question. Sincerely, Dr. Joseph

Gianfranco Frojo, MD · Answer

I would recommend a potential revision using a rib graft. It appears that there is an inverted V deformity.  There is also some significant asymmetries of the cartilages and nares. I would go back to discuss with your original surgeon. If this is not possible, seek a distinguished revision rhinoplasty expert. I recommend finding a board-certified plastic surgeon with experience in rhinoplasty surgery.

Andrew Miller, MD · Answer

It's hard to tell from only front photos, but your nasal bridge looks a bit washed out and flat. Also you middle and lower thirds of the nose look pinchy. So spreader and possible alar grafts are needed as well as a dorsal graft to normalize the appearance. Be sure to see a rhinoplasty expert for consultation.

Jeffrey H. Spiegel, MD · Answer

There is a lot going on in your nose. But, sometimes it's not as hard a fix as you may believe.  The bottom line is you will want to come in to be seen for a personal consultation.  This looks like something we can fix.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you appear to have collapse in your mid-vault, dorsal aesthetic lines, and lateral crus. This can all likely be improved with a revision. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic 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

Barry M. Weintraub, MD, FACS · Answer

I am sorry you have gone through this hardship not only once, but a second time. Patients who undergo first-time rhinoplasty want the problem solved so that they can live their lives in a joyous and confident manner. If you are still seeing in the mirror that which displeases you, you absolutely have options. The nose is comprised of half bone (on the upper part of the nose) and half cartilage (on the lower part). Your issues are present in both areas. On your upper nose, the bony pyramid is irregular with slight lumpiness on the right side, which can be addressed with a series of fine rasps in order to file the bone rather than breaking it. It appears that your lower-lateral and upper-lateral cartilages were removed too aggressively, particularly on the right side. From your photos, it is difficult to discern exactly what is needed in the tip and therefore an in-person exam would be suggested. In regard to the central part of your nose, you'll need bilateral spreader graphs to reconstitute it and eliminate the contour deformities. If you've had two rhinoplasties already, it is possible that you no longer possess your septum. You would want to seek out a plastic surgeon who has deantigenized cartilage kept at -40°C. In my practice, I find that it is excellent for difficult cases such as yours. I hope this helps to bolster your spirits. A much improved result is in your future..

Issues after revision rhinoplasty - can I get it corrected? (Photo)

Answers (6)

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