Quite the contrary, the results are better when the nose is completely healed and the edema gone, and the contractures and scarring has matured. At this point we know what is there and what needs to be corrected. You seem to have a mature attitude with realistic expectations. Now you need to find a experienced expert in revision rhinoplasty . Best of luck.
Dear Peony, Waiting a long time between a primary and secondary rhinoplasty is not a problem. It sounds like you had a bad experience the first time around and often this leads to patients insecurity and concerns of having a secondary procedure. You need a full examination during consultation to diagnose whether you are suffering from a deviated septum or other problems (i.e. turbinates) that may need addressing during secondary surgery. Once you have a consultation and examination the surgeon can discuss with you in detail what needs to be done to attain your desired results. These results should be inclusive of a nice natural looking nose that balances well with your facial features and also a fully functional nose to enhance your current breathing difficulties. Your age is not a concern for rhinoplasty and I have many patients who come in over 50 seeking rhinoplasty and this is a very rewarding procedure for both patient and surgeon alike. Best regards, Michael V. Elam, M.D.
A revision rhinoplasty can be performed at any time one year after the primary rhinoplasty. At age 50, is not to old to undergo the revision procedure as long as your in great health. The nose can be de-rotated, a hanging columella reduced, valve collapse can be repaired with spreader grafts and any functional breathing work can be performed at the same time.
It sounds like you are a prime candidate for revision.Your age is not a factor.
You have diagnosed your problems and all but the "over rotated nose" should not be difficult to correct. I would guess when the columella is corrected, the tip wont attract too much attention anyway.
In general, there is no harm in a delayed procedure. In your case, you can have a septorhinoplasty that is partially covered by your insurance, your surgeon can create new support for your valves, straighten your septum and improve your breathing (covered by insurance), at same time, he or she can revise your nostril show and columella.
Look for expereicned and properly trained Plastic Surgeon certified by the American Board of Plastic surgery (or Facial). See more than one consult. Make a well informed decision.
In terms of timing you have nothing to worry about. The nose settled a long time ago. Whenever you're ready to improve the breathing function and appearance to your nose consult with a revision rhinoplasty specialist whose photos you like and move forward. I would be hesitant to undergo surgery with anyone who is not a revision specialist as the revision rate for a first time rhinoplasty is between 5-15% amongst the best surgeons in the country