Revision rhinoplasty - can my crooked nose be fixed? (Photos)

Question

Hi I had revision rhinoplasty over 10 years ago I noticed early on that my nose was still crooked, my nose is bigger because the Dr filled it with cartilage and also my nostril is crooked. I want to get another rhinoplasty because it really bothers me. Thanks

Eric M. Joseph, MD · Answer

We can see that you have a flat nasal appearance, with an indentation along your left nasal sidewall, and nostril asymmetry. The feasibility of correcting these with a third surgery would require an examination, in my opinion. Please consider meeting with several reputable rhinoplasty specialists for a definitive answer to your question. I hope this is helpful. 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. This can also be designed to make your nose straighter. 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

Cengizhan Ekizceli, MD · Answer

hank you for sharing your photo and history. Yes, a revision rhinoplasty can address the persistent crookedness, reduce bulk from previous cartilage grafting, and improve nostril symmetry. These cases are more complex due to prior surgery and scar tissue, but with an experienced revision specialist, significant improvement is achievable.
Correction typically involves removing or reshaping excess cartilage, realigning the nasal framework, and refining the nostrils. Structural grafts may still be needed, but placed with more precision.
A CT scan and in-person evaluation will help finalize the plan. You’re absolutely justified in seeking this revision, specially if it affects your confidence or breathing.

Sean Fisher, MD · Answer

persisting asymmetry after prior rhinoplasty can happen for a variety of reasons- this can be due to cartilage positioning, asymmetric position of the nasal bones, among other things. A second revision surgery is possible to address your concerns with the exact surgical plan being dependent on your specific anatomy and examination. often, in crooked noses, this includes repositioning the nasal septum, repositioning the nasal bones and addressing the nasal tip. Patients with darker skin often will have thicker soft tissues which can contribute to a lack of definition in the appearance of the nose, but this can also occur from too many cartilage grafts being used. Find a surgeon with specific training in rhinoplasty surgery who can discuss your goals with a second revision and provide a detailed plan on how to correct your issues. 
Sean Fisher Aesthetic Plastic Surgeon Seattle, WA

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