Can a Revision Rhinoplasty help me? (photos)

I had Septo-rhinoplasty with a maxillofacial surgeon 8 months ago. At first I was happy with the result but now I'm concerned. My concerns: - Stupidly narrow from frontal view Too much nostril show especially on side profile Tip enlarged compared to rest of nose - therefore profile looks 'scooped' out at the bridge. Tip and bridge do not align Can't breathe properly despite septum being re-aligned Anterior nasal spine was removed Fake / unnatural look Can anything fix these problems? Please

Doctor Answers 4

CAN A REVISION RHINOPLASTY BE DONE

All overly done noses can be revised to a point.  Your first priority is to get improvement in breathing. While 8 months is a good period of followup after a primary or secondary rhinoplasty, you may be eligible for some action at this time to get the airway open, and reverse the changes created by the first operation.  More than likely camouflage or onlay grafting with septal and ear cartilage will benefit you significantly.  I would advise against the use of any plastics polyethylene or silicone whatsoever, as these do not work well in complex and secondary nose procedures. One or both ears can donate some conchal cartilage and whatever bits of septal cartilage can be harvested as well, to bolster the bridge and nostrils.  This is a routine procedure for an experienced plastic and reconstructive surgeon or facial plastic surgeon  board certified in those specialites. A report of your procedure should be available for the next consulting surgeon.  At times less than ideal results can occur even in the best of hands, yet choosing a surgeon from the above two specialties in order to handle a problem of this magnitude, seems most prudent.  When you have a long upper lip, the nasal spine should not be overly reduced, but can be augmented thereafter with cartilage.  Best wishes but take a look at some additional professional opinions in your area. Check credentials with the state boards for each specialty you interview.


Los Angeles Plastic Surgeon

Can a Revision Rhinoplasty help me?

Hello Mikeusa - Thanks for your question.  Yes, revision rhinoplasty can be used to soften the look over your over-operated nose.  There are ways to widen the bridge with cartilage grafts.  It is also possible to inset your tip to decrease the overprojection and better match the transition between the bridge and the tip.  You might benefit from composite grafts to both rims to improve upon the alar retraction.  Intranasal exam would be necessary to determine how to improve your airway patency to improve breathing.  I would recommend that you consult with a revision rhinoplasty specialist in your area for more information and to have simulations performed to understand what your desires might look like.Good luck,Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 47 reviews

Revision rhinoplasty candidate at one year

A revision rhinoplasty procedure can accomplish improvement of the nose. The bridge line can be made wider with spreader grafts. The dorsal bridgeline can be built up with an additional cartilage craft. The hanging columella can be reduced. The nostrils can also be made narrower to balance with the remainder of the nose. It's important to note  if there is any cartilage left on the inside of the nose for potential grafting purposes. For more information and many examples, please see the video and the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Revising an overdone, over-narrowed rhinoplasty

Your nose is overdone. The bridge was over-narrowed, the cartilage side walls (upper lateral cartilages) have been weakened at their dorsal attachments, your tip projection is increased and over-rotated, and your nostrils have widened and retracted. The good news is that revision rhinoplasty can correct most, if not all, these problems. The caveat is: you need to choose your revision surgeon wisely. Consult with a board-certified facial plastic surgeon or plastic surgeon with a lot of revision rhinoplasty experience. Although revision rhinoplasty should not be done prior to one year from your primary rhinoplasty, now is the time to start finding the right surgeon for you. 

Minas Constantinides, MD
Austin Facial Plastic Surgeon
3.9 out of 5 stars 7 reviews

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.