Revision rhinoplasty for the third time? Asymmetrical and crooked results after second rhinoplasty

It's been 9 months since my prior (2nd) rhinoplasty. Main reason for 2nd rhino was to fix deviated septum. The results are disappointing this far, my nose is asymmetrical and looks crooked. The left side is bulbous creating the crooked look and the tip is uneven. I'm considering a third rhinoplasty but am extremely nervous because my skin is very thin and doesn't seem to adapt to changes well. What is causing this bulbous appearance? What are my options for correction?

Doctor Answers 4

Take Your Time and Choose Your Revision Rhinoplasty Surgeon Carefully

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Sorry for your troubles. Your problem illustrates why rhinoplasty as such a difficult operation. Your concern about your thin skin is a reasonable one.  The thinner the skin, the less of the minor asymmetries it's able to hide. From your photos, it does look like your septum is still a little bit crooked, the nasal bones are still off to the left, and there may be some pull from the upper lateral cartilage on that left side as well. I would recommend you make appointments to see several well respected surgeons who specialize in revision rhinoplasty.  It certainly is possible to get the result that you desire but it is becoming more and more difficult with each surgery you have. Take your time, research the surgeons carefully, and you will increase the likelihood that you are happy in the end.

Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 28 reviews

Asymmetrical and Crooked Nose after Revision Rhinoplasty

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Unfortunately you will need a second revision to straighten your nose and correct the tip asymmetry. Thin skin can be unforgiving because every irregularity of the underlying bone and cartilage is visible. However, a better more defined result can be achieved. Consult with a surgeon who does specialize in revision rhinoplasty.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nasal crookedness after 2 rhinoplasties?

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Sorry for you having to do this a third time but your septum AND NASAL BONES are still crooked.This can only be fixed with a revision rhinoplasty done by a very experienced revision rhinoplasty surgeon. Have several consultations and look at the surgeon's results with noses like yours. It can be much better. Also the tip can be defined as well.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Revison Rhinoplasty Questions

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Thanks for your post and photos. I am sorry that things did not turn our as you had hoped. It would be difficult to determine the reason for your persistent concerns by viewing your photos and descriptions alone. There are several structural and cosmetic issues which may be responsible for your current nasal appearance. Fortunately, once a proper explanation is determined, your nose can be corrected. If your surgeon feels that he/she has done all that they can to help you, please consider another opinion.  You need a comprehensive consultation and examination in-person from a truly experienced, reputable Facial Plastic Surgeon so that the appropriate cause for your appearance can be properly understood. In my view, it would be helpful to bring pertinent old photos, original and secondary operative notes to this consultation. If your nose does not improve in the next 3-6 months, it may be necessary to consider more surgery. Search for a plastic surgeon with strong revision rhinoplasty expertise for your evaluation. Best wishes. 

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.