Over exposed nostrils and crookedness - Am I a good candidate for Revision Rhinoplasty? (Photos)

It appears that the nasal bony vault has shifted to the left, while the tip has remained near the midline, resulting in a C-shaped nasal deformity. This can be corrected with a revision rhinoplasty.Lateral osteotomies would need to be performed to reposition the nasal bones back to the midline. Additional structural grafts may also be required — such as spreader grafts and a tip-support graft — to improve alignment and stability. Alar rim grafts may further help refine the alar contour and shape.I personally began using an ultrasonic bone-cutting and shaping device about two years ago for all my rhinoplasties. In my experience, it provides greater precision and finer refinement compared to traditional chisel and mallet techniques.

Based on your photos, we can see an indentation along your right tip, and write nasal sidewall, and this is associated with asymmetrical and excessive nostril show. Microdroplet Silikon-1000 injections may be considered for achieving a Strader and more symmetrical nasal appearance, with decreased visibility of the inside of your nostrils. This may be a welcome alternative to the uncertainty, expense, and downtime associated with revision surgery. I hope this helps! Sincerely, Dr Joseph PS, the video shows a similar example. Thanks

Question:
Do I need a secondary rhinoplasty? I had prior surgery but still see a crooked nose and visible nostril asymmetry. Photos are included.
Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery – Frisco, TX:
Thank you for your question and for sharing your photos. From your description and the images, it appears that you’re experiencing some post-rhinoplasty irregularities, including nasal deviation and nostril asymmetry. These are common reasons patients consider revision rhinoplasty.
⸻

Based on your photos, you are a good candidate for revision rhinoplasty. As time goes by after primary rhinoplasty, the skin can tighten and contract, creating asymmetrical tip cartilages and a pinching effect. Revision rhinoplasty can help make the cartilage appear more symmetrical as well as improving the pinching. Be sure to see a rhinoplasty expert for consultation.

Hello and thank you for your question. Based on your photographs, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include release of scar tissue followed by placement of extended spreader grafts to derotate the tip, tip refinement, placement of extended alar contour grafts, 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

Many technical issues appera on these images, to be brief:
-total alar collapse, seems there is almost no lateral cural support after its aggressive resection, the nose looks massively "pinched"
-over rotated, too high, and over sharpened tip, probably aggressive caudal septum resection and also too tight domal plication with sutures
-dislocation between lateral cartilages and nasal bons, alla inverted V deformity, also unlitateral open roof, with crookedness as result
-unclear from the lack of good profile views, but seems like a saddle too (over scooped dorsum)

I recommend you research the experience, talent and passion of your future surgeon for difficult cases of revision rhinoplasty, you'll need a vast set of grafting and structural repairs, accessible only for top notch professionals, do travel and perform online consultations if needed, dozens of them, before choosing.