20 years post rhinoplasty - is fat grafting a good option to help address asymmetry?

Question

I had a surgical rhinoplasty 20 years ago and now I am noticing some asymmetry that I'd like to correct (and maybe lower a bit the tip to see less of the columella/nostrils (frontal view). I am not interested in temporary results. The 2 permanent fillers I have made research on (Bellafil, Silikon-1000) are too controversial and I would not have them injected in my face. Is fat grafting for revised rhinoplasty an option?

Jonathan Kulbersh, MD · Answer

Thank you for your question. Revision rhinoplasty can improve your nasal symmetry, though cartilage grafting is generally performed rather than fat grafting. During this procedure, the tip can also be lowered to reduce the appearance of your columella and nostrils and create a favorable, natural-looking result. Keep in mind that each subsequent nose surgery becomes more complex due to loss of structural support, scar tissue, and other factors. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to review your surgical history and concerns to determine the best course of action.

Donald B. Yoo, MD, FACS · Answer

Revision rhinoplasty will certainly be able to reshape and create the changes that your described. The decision to undergo rhinoplasty is a strictly personal one, as only you can weigh the pros and cons of the recovery and financial aspects relative to how much the nasal appearance bothers you. A rhinoplasty specialist will be able to comprehensively address the issues you have with your nose. While there are a variety of approaches and techniques employed by various surgeons, it is up to you to do your due diligence to find a rhinoplasty specialist in order to achieve the best results possible. Looking at computer-morphed images with your surgeon during consultation will give you a good idea of what is possible, and also give you a great chance to convey to your surgeon what you envision. @drdonyoo

William Portuese, MD · Answer

Fat grafting is not a very good option regarding revision rhinoplasty, and cartilage grafting is the preferred method to address your asymmetries.Much more information is as a full set of facial photograph from all angles to see what your issues are regarding your nose. It's also important to know how much cartilage is left over on the inside of your nose for potential grafting purposes. Revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery, so choose your Surgeon wisely best on extensive experience, and have reasonable expectations

20 years post rhinoplasty - is fat grafting a good option to help address asymmetry?

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