Nose is crooked years after primary and revision rhinoplasty - how can I fix this? (Photos)

Question

I had a septoplasty in 2021 where they said they could tweak my nose a bit, i didn’t like the results so i had a “revision“ rhinoplasty in december 2022. In the mirror and selfies it looks fine to me but once i see an inverted picture ive noticed it looks VERY lopsided?? what am i able to do? The surgery was already significantly more expensive because it was considered a revision, it also still swells up easily if i’m sick or crying, it also looks bulbous at times (like in the picture)

Semih Yildiz, MD, FEBOPRAS · Answer

The frontal photo shows some deviation of the nasal axis and asymmetry through the middle vault and tip, with a rounded tip appearance. A single close image, especially with glasses and a piercing, cannot show whether the asymmetry comes from the nasal bones, septum, cartilage, scar tissue, or camera position. Inverted images often make familiar facial asymmetries feel more striking, but the underlying contour still deserves a proper examination if it bothers you.

At more than three years after the revision, persistent structural asymmetry is unlikely to be routine healing swelling. Temporary fullness during illness, crying, heat, or allergies can still occur because nasal tissues are vascular and lymphatic. Keep standardized straight-on and profile photos when the nose looks calm and when it swells; this helps separate a stable contour issue from episodic edema.

A further revision might involve targeted osteotomies, septal or middle-vault straightening, tip sutures, or cartilage grafting, but the correct choice depends on the operative records and an in-person examination. Perfect symmetry is not realistic, and every revision adds scar tissue and unpredictability. Consult a revision-rhinoplasty surgeon after obtaining both prior operative reports, and consider surgery only if the expected improvement justifies those added risks.

Eric M. Joseph, MD · Answer

Based on what we see, I agree that you appear to have a bulbous, droopy nasaltip appearance, and a slightly crooked nasal appearance. It would be difficult to advise you how to move forward without examining you. Please consider meeting with your surgeon, or with another reputable rhinoplasty specialist who has favorable revision before and after galleries, and favorable online reviews. Wishing you well moving forward. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include differential nasal tip deprojection to pull your tip centrally and straighten your nose, tip refinement, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

Best wishes and good luck.

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

Darryl J. Blinski, MD · Answer

You one post a photo gives limited ability to give a definitive response and diagnosis. Best of virtual consult with, but a revision rhinoplasty are much more difficult to obtain the results desired. In the poster photo there is a slight deviation of the tip of the nose with a bulb tip. Recommendation for tip revision septoplasty with cartilage graft. Expect fee fees to range from $10,000-$20,000. Again, best of virtual consult with.

Nose is crooked years after primary and revision rhinoplasty - how can I fix this? (Photos)

Answers (4)

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