What is wrong with my nose post-op, and how this could be fixed with revision surgery? (Photo)

Question

Hi, I had rhinoplasty surgery around 3 years ago and the post-operative result was extremely dissapointing! I went into surgery with the request to get rid of my bump as you can see from the pre-operative image, however as you can see in the post-op pictures my nose was left deviated. I was wondering if anyone can tell me what they think went wrong, how this coud be fixed and roughly how much it will cost for revision surgery? All I want is a natural looking nose.

William Portuese, MD · Answer

A revision rhinoplasty can accomplish shaving down the poly-beak deformity, building up the bridge of the nose, and addressing the inverted V. deformity. The inverted V. deformity is treated with cartilaginous spreader grafts placed underneath the concave upper lateral cartilages and osteotomies placed in the nasal bones. It is important to know whether or not there is any cartilage left on the inside of the nose for grafting purposes after the primary rhinoplasty. Choose your second surgeon very wisely based on extensive experience since her revision is much harder than a primary rhinoplasty. For many examples and our current price list, please see the link and the video below

Peter Callan, MBBS, FRACS, MBA · Answer

Hi there and thanks for posting the pictures which enables your question to be answered. I'm sorry things haven't turned out for you.There is a lot to rhinoplasty.  There is a lot to explain here.  Rhinoplasty involves 20 to 30 steps to get a great result so the long explanation can be abbreviated here.  You have been over-resected (too much off the dorsum), and then not had what dorsum remains reconstructed. In addition your tip cartilages have not been oriented and shaped correctly.The good news is that this is all correctable. It means another operation however. You need a consult with an expert rhinoplasty surgeon.I hope this helps

George S. Miguel, DO · Answer

I am sorry to hear you had a bad experience with your rhinoplasty. Thank you for sharing your experiences and pictures. You have what we call a "saddle nose" deformity. The nose functions like a house. It has to have a strong foundation for the house to stay up. The nose has the septum as one of the main supports. The septum is what divides the internal nasal structure in half(that's why you can block one nostril and still be able to breath out of the other side. A saddle nose occurs when one has resected too much septum, thus the nose essentially 'falling down.' There is also a result, with the loss of the septal support, midvault collapse causing an 'inverted V' deformity. The inverted V, as a result of the middle part of your nose collapsing, is compromised of the lower portion of your nasal bone being more prominent. You might even be complaining of subjective breathing problems because of all this.A revision rhinoplasty will compromise of building up your nasal bridge again. This will require cartilage grafts. This is where you should ask your PS what their preference is because there are a number of different approaches. There is the rib cartilage graft where they use your rib's cartilage to build up your nose. There are also doctors who use cadaveric rib which is nice and won't subject someone to chest pain post rib harvest. There are others who also use 'alloplastic' implants synthetically made to mimick the nasal dorsum bridge however an argument against them is a high extrusion rate. I hope this helps and good luck. -Dr. Miguel

Barry M. Weintraub, MD, FACS · Answer

Please do not fret about the name that describes your post-operative nasal configuration:  "Polytip Deformity."  It does not mean that you are deformed; it means that scar tissue has heaped up on the cartilaginous part of your nose.  Your nose is comprised of half bone (the upper half), and half cartilage (the lower half).  Revision rhinoplasty done by a qualified, board-certified plastic surgeon with much experience would be advised to remove this scar tissue.  The good news is that this condition can be fixed!  You have lovely features and with a revision rhinoplasty, your face can look even more beautiful than it currently is. In addition, the base of your nose (its "takeoff") appears low, which can also be addressed in a revision rhinoplasty (the nose should begin opposite your blink crease of your eyes).  I hope this information is helpful to you.

Matthew Hansen, MBBS, FRACS (retired) · Answer

Unfortunately you have a very poor result from your previous rhinoplasty with an obvious operated looking postoperative distortion.It appears that the previous operation was an amputation of the dorsal hump without proper structural reconstruction leaving a disjunction between the tip and upper dorsum as well as an inverted V deformity and polybeak. Correction of this would require substantial rebuilding of your nasal structure using cartilage grafts particularly over and around the mid-dorsal area and septum as well as rebalancing the tip. There are some great rhinoplasty surgeons in Melbourne and Geelong who would be able to advise you regarding your options. I would avoid whoever did this operation on you previously. Take your time choosing your surgeon and perhaps get a couple of opinions from experienced rhinoplasty surgeons.

What is wrong with my nose post-op, and how this could be fixed with revision surgery? (Photo)

Answers (5)

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