Should I get a revision? (Photo)

Question

I guess I’m wondering what anyone thinks on this. It is risky? Is it worth it? How bad do you think my nose currently is. My first photo will be the before. I am over ten months post op. I still feel like my nose is big.

Eric M. Joseph, MD · Answer

I agree that your nose is still too large. You appear to have an overprojected tip appearance and a dorsal hump. It may be helpful if you could procure a copy of your operative report and preoperative photos. Then it would be a good time to visit reputable rhinoplasty specialist who offer computer Imaging so you could see what might be best for you moving forward. I hope this helps. Sincerely, Dr Joseph

Steven M. Denenberg, MD · Answer

You have that distinct bump on the bridge, which could go in a revision. Then, you should look at your nose and see what else you might like to change if you decide to go for a revision. I can't tell, really, what to recommend because of the non-routine angles of the photos, but: is the nose short enough for your tastes: would you like to have the tip higher at the same time that the bump comes down? Is the tip narrow enough: do some of the three-quarter views make the tip look more prominent than you like? Those are examples of considerations that might lean you toward a revision, even if the bump doesn't bug you all that much.

How *much* to elevate the tip, or lower the bridge, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

William Portuese, MD · Answer

Your nose is significantly smaller and less projecting than your prior surgery. The only issue a revision rhinoplasty would accomplish is to give you more of a feminized profile and shave down the residual dorsal hump.

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