23M Considering Revision Rhinoplasty for Symmetry and Function (Photos)

Question

Hi, I’m a 23-year-old Caucasian male, 173 cm tall and 70 kg. I had a rhinoseptoplasty at 18 to correct breathing issues and nasal asymmetry. I chose a local surgeon based on reviews but, in hindsight, may have rushed the decision. The procedure involved septum straightening and dorsal hump removal, though I believe only the cartilage was addressed. My deviation is genetic, and my nose has redeviated. My main concern is restoring symmetry, including bone structure. Cosmetically, I’d like slight nasal tip refinement and alar width reduction. I understand the importance of realistic expectations. What can I reasonably expect from an experienced surgeon in terms of symmetry correction? Thanks in advance!

Alejandro Nogueira, MD · Answer

Congenital facial asymmetry, more in mild cases like yours, can't be corrected, in the best and more demanding scenario can be palliated; pay attention to your facial features, one half of your face sits higher and is larger than the other, affects the overall face and thus also the nasal pyramid and nasal tip and alae.

I detect open roof deformity as a sequel from the previous poor work, you have reasons to seek revision, your nose looks overly broad at the bridge because of this reason, attributable to failing to perform the mandatory osteotomies (every time a hump is removed the dorsum has to be re-closed with infracturing, it is a must, else...).

There are severe congenital and iatrogenic too asymmetries between the alar cartilages, this can be efficiently fixed by means of building a brand new cartilagenous structure at tip and alae, something feasible with complex structure rhinoplasty procedures that any revision rhinoplasty specialist is supposed to master. It may help too a unilateral alar base reduction. What can be fixed is the tendency of the whole nose to lean towards one side, but in your favor I have to say it is a very small problem that only very critical eyes might notice.

I should see your underneath, lateral and oblique photos to give you a more grounded opinion.

In any case, do research for and consult with several expert in complex revision rhinoplasties.

Eric M. Joseph, MD · Answer

Compared to what you started with, you do not appear to have a deviated nasal appearance. You appear to have some slight nasal tip asymmetry and nasal sidewall asymmetry which may be addressed with microdroplet Silikon-1000 injections for a permanent result. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. The overall nose can be made straighter also. 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

23M Considering Revision Rhinoplasty for Symmetry and Function (Photos)

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