How to address dissatisfaction with my rhinoplasty? Can a revision be done for just the tip? (Photo)

Question

I am exactly 12 months PO. I do not like my nose, its crooked and bulbous (less bulbous than it used to be) and my scar is horrible. How do I approach this without offending my doctor? I mostly hate the tip, can a revision be done for just the tip? Is it possible its still just swollen? I want my concerns to be heard, but am worried i will offend them and then there will be no solution.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision.   Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. 
Here is some general advice when thinking about a revision.  I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

William Portuese, MD · Answer

You appear to have thick skin in the entire tip area of your nose, so you might try a series of steroid shots before embarking on another rhinoplasty procedure

How to address dissatisfaction with my rhinoplasty? Can a revision be done for just the tip? (Photo)

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Everything you need to know about Revision Rhinoplasty

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How to address dissatisfaction with my rhinoplasty? Can a revision be done for just the tip? (Photo)

Answers (2)

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.