Hi, I had my first rhinoplasty 3 years ago, had a revision 2 years later and a 2nd revision 5 weeks ago. I had bilateral spreader grafts, alar rim grafts, and alar batten grafts placed for nasal valve collapse, especially on the right. Now my scars look very obvious and my collapse is only partially improved. It seems that I have a lot of swelling still but can I get this outer appearance revised? Is there hope? I am looking for a surgeon and am willing to travel to someone who can really help.
Can my Nostril Asymmetry and Scars Be Revised, or Am I a Lost Cause? I Am 5 Weeks Post-op. (photo)
Doctor Answers 4
Should I have a 3rd Revision?
The recent columella incision has healed for only 5 weeks. I would give it at least 3 months before deciding on any scar revision -- but this can certainly be done at that time if the scar is still unacceptable. The alar base scars can also be improved with relatively minor scar revision surgery. The asymmetry of the nostrils is a bigger problem in that it may be due to asymmetric curvature of the rim and batten grafts. However, the asymmetry seems relatively minor and may only be noticeable from a base view (which only children and small animals might be able to see -- and they usually aren't very critical of such things). If these remain your major concerns after 3 revisions, be thankful. Don't expect perfection with revision surgery. Be happy with a nose that appears normal to others, with minor defects that others will not notice.
Improvements might be possible but you will have to be patient and wait.
Thanks for your question. I'm sorry to hear of your troubles. This last round of surgery was quite extensive it seems, and a lot of work was done to the structures at the tip. The blood supply to the tip is relatively small, and with repeated surgeries, takes longer to recover. At only 5 weeks postop your nose will have barely begun to really make any changes at the tip. I think that you need to wait and see what happens as the swelling starts to reverse. You could also ask your surgeon about the use of steroids and nasal tip taping to help accelerate decongestion of the tip.
Only 5 weeks after surgery, there is still lots of swelling. Wait 3-6 months then re-evaluate. The scars can be revised, the alar asymmetry can be improved.
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Can my Nostril Asymmetry and Scars Be Revised, or Am I a Lost Cause? I Am 5 Weeks Post-op.
I would give this at least a year for the swelling to resolve. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA
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