Devastated after bad rhinoplasty. Can revision rhinoplasty fix my nose? (Photos)

Question

I a rhinoplasty to fix my deviated septum and reduce a little hump I had. I am devastated with the results of my rhinoplasty as I liked my old nose. The changes I thought I'd have were minimal and wouldn't change the overall appearance of my face. My nose is now small, pig-like and flat. (said changes we never discussed with surgeon!) I am aware that 2 weeks post op is too early to see the final results but I doubt it will get bigger. I feel fake and overdone. Is there anything I can do?

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, thank you for your question. I m sorry what you are expriencing, as you said you are in very early process of healing. During your healing process which is at least one year, edema and swelling will go down and come back they are part of healing.After completing your healing, you can benefit from a detailed physical examination to be evaluated by professional then if your result  requires a Revision Rhinoplasty you need to find the best surgeon for you. Regards,

Thomas A. Mustoe, MD, FACS · Answer

I agree that the nose will not get larger with time after surgery but the tip may drop a little.  At this point you simply have to wait it out and hopefully with time you will feel more comfortable.  Revision rhinoplasty is always an option to add back cartilage but could not be considered for a year.

Manish H. Shah, MD, FACS · Answer

Hello Fernanda,I'm sorry that you are feeling this way. Yes, two weeks is too early for you to see your full results. Your tip will most likely rotate back down as the swelling goes away. If it is still too rotated after one year, then you can consider revision surgery. Ask your surgeon about the use of oral steroids to speed up swelling reduction. You can also take a look at my Youtube video on managing swelling after rhinoplasty. I've included the link. Please try to be patient. If you need to discuss this further, I'd be happy to discuss this over Skype/Facetime. You look really swollen and since your nose was fairly rotated to begin with, this can happen early on. Only time will tell.Good luck,Dr. Shah

Umang Mehta, MD · Answer

So sorry to hear about your negative experience. You will certainly see more tip definition as the swelling goes down over 6-12 months. Your tip may drop slightly as well, to make it less upturned. However, as you mentioned in your post, your nose won't come forward or project more. Projection can be restored in a revision rhinoplasty by adding a caudal septal extension graft. This can be made of septal (if available), ear, rib, or donor rib cartilage. This graft is attached to the front of your septum and pushes the tip forward. It can also be used to push the tip downward or upward, depending on the patient's desires. Additionally, the graft can help straighten the tip in the left to right dimension. I use caudal septal extension grafts in almost every case I perform, both primary and revision, to establish solid tip support. The tip cartilages are then attached to the extension graft using what's called a tongue-in-groove or septocolumellar suture. The tradeoff of this technique is some tip stiffness, but it helps to ensure predictable tip position and durability. Be sure to bring up your concerns with your primary rhinoplasty surgeon but also seek consultations with a few revision experts, even if it means traveling. Computer imaging can help communicate your aesthetic and allow the surgeon to show you what's possible. Wishing you all the best,Dr. Mehta

Thomas Trevisani, MD · Answer

At two weeks - it's too early to pass final judgements. I suggest that you give it time and re-asses in 6-12 months.

Tarek V. Copty, MD, FACS · Answer

Dear Ferrnandapena, 
It is understandable that you are unhappy with your results if you feel the result is that of an over rotated (rounded up) and over resected (too much curve) nose. 
This can be fixed, so I advise you to be patient and know that whatever the result is... it is fixable. 
That said, Myself and all of the other plastic surgeons answering your question are educating you that it is way too early to judge your result at two weeks and sometimes even at two months.
You can start making plans and decisions at the six month point after your surgery, and the first person you should be discussing this with is your primary plastic surgeon before seeking other advice. 
I am certain you will be satisfied in the future whether with this result or if a revision is deemed necessary in the future. 
I wish you all the best, 
Tarek V. Copty, MD FACS 
American Board of Surgery American Board of Cosmetic Surgery Jordanian Board of Plastic & Reconstructive Surgery Fellow, American College of SurgeonsFellow, American Academy of Cosmetic Surgery Fellow, International Society of Aesthetic Plastic Surgeons

Michael Elam, MD (retired) · Answer

Dear Ferrnandapena, You are very early in the recovery phase and will see more tip definition and some drop of the tip as the swelling resides. This can take up to six months and the final tip swelling can take a full year to dissipate. With this said, I am very sorry for your negative experience and this is another example of why digital imaging prior to rhinoplasty is so important so that the surgeon and patient are on the same page with the desired results. I would see your surgeon often for follow up appointments as he/she knows best what techniques were used, what and your expected results should be. Hopefully this can provide you some peace of mind during the recovery phase. Best regards, Michael V. Elam, M.D.

Richard W. Fleming, MD (retired) · Answer

At 2 weeks after surgery it is impossible to evaluate your results. Your nose will not get bigger but hopefully will become more balanced as healing progresses.

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