Is it safe and realistic to have a third revision/fourth rhinoplasty? (Photo)

Question

I had a primary in 2011, in 2012 I had the same doctor fix my primary with little tweaks here and there. Fast forward to 3 years my nose started to deviate. I trusted a surgeon ( whom at the time didn't advise me this was the first revision she's ever done) she used rib cartilage & the surgery lasted 6 hours, I almost died. Now here I am 8 months later with a nose that looks like a blob. I need help! Will my nose be salvageable. Is this rib cartilage or scar tissue. Can I get my old nose back?

Steven M. Denenberg, MD · Answer

... as long as you select the right surgeon.Obviously, you have a complicated problem. You should get a copy of the operation report from your last surgeon. You can just call her office, or the hospital where the surgery was done. They'll have you sign some form, but it'll be easy.Then, you should try to get some photos from before this last operation. Again, your surgeon should have them, and she can make you copies.Then, you must go visit some experts in revision rhinoplasty. See what they say. See what makes sense to you. You probably shouldn't have another operation until it's been close to a year after your last, so you have time to do some research.Read the "Web reference" link, just below my response here, for advice on finding the right surgeon.

Richard Mark Winters, MD · Answer

each time a rhinoplasty or revision is performed irreversible changes in the coverage, supporting structures and lining occur....even when subtle, these phenomena affect the appearance of the nose...the changes in your nostrils appear to be the most challengingthat said, many of the changes made in rhinoplasty can be changed dramatically to change the appearance and function of the nose what what it is or what it's been made to be.... these maneuvers depend on type and degree of the abnormalities they are meant to address... suturing techniques, cartilage grafting and other methods can be utilized with precision to yield desired results...provided that your skin is still supple, scarring is not extraordinary, and alternative sources of cartilage are available you should be a surgical candidateyou need a thorough evaluation and a well thought out plan....you will need to gain the confidence that your surgeon has the skills and aesthetic judgment to fix your problem....do your homework and be sure that your revision rhinoplasty surgeon has:1. many years of rhinoplasty practice experience2. judgment and techniques that have evolved over time3. a practice focused on rhinoplasty 4. a willingness to do difficult, secondary and reconstructive cases5. an interest in teaching others how to evaluate and do rhinoplasty properly6. a willingness to share rhinoplasty resume, photos and patient experiences with prospective patientsgood luck...

Sean Freeman, MD · Answer

EasternEuroRhino, of course your nose is salvageable but you need to be evaluated by an experienced specialist that does "only faces". In addition I would make you wait one year. Make sure you bring your operative notes. Good luck!

Fred J. Bressler, MD, FACS · Answer

Thanks for sharing your post. I am sorry that your revision rhinoplasty procedures resulted in the nasal deformity in your photos. From the size of your current nose, it appears that any reconstruction rib cartilage grafts placed into your nose for whatever reason were too large or poorly positioned. There may be scar tissue as well. You truly need to speak with an experience, reputable Facial Plastic Surgeon with special expertise in revision rhinoplasty for an examination and recommendations. Though complex, additional revision surgery to remove or modified your most recent rib cartilage grafts could restore your nasal appearance. If you could obtain operative reports, notes, diagrams, photos and medical records about all of your surgeries, this information may be helpful to your chosen expert in planning for your case and judging the potential risks and benefits. Try to remain positive and work toward a safe solution. There is hope! Best wishes.

Arian Mowlavi, MD, FACS (license on probation) · Answer

I agree with you that your nose does not look attractive; all of the nasal features that make a nose aesthetically pleasing have been eliminated; You are going to need major revision surgery; I would request a team of two rhinoplasty surgeons who have worked together in order to harvest adequate graft material to reconstruct areas that have collapsed and narrow areas that have been inappropriately widened.

Cory Torgerson, MD, PhD, FRCSC - Account Suspended · Answer

Thank you for your inquiry and photos. It is possible to have another revision rhinoplasty.
However, revision rhinoplasty is one of the most challenging of all cosmetic
surgeries, and each time a rhinoplasty is done, it becomes increasingly
complex. Keep in mind that there are many factors involved, so your nose may
not turn out exactly the way you want the fourth time either. If you do decide to have
another rhinoplasty done, wait one year from the time the last rhinoplasty was done and look for an experienced revision rhinoplasty
specialist who has a strong aesthetic sense and the talent and experience to refine
the nose as needed. Bring reports and documentation from your previous procedures. And
be sure to get second and third opinions.

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