What is my Best Option for Revision Rhinoplasty? (photo)

It was originally broken in a sports accident. I had emergency surgery done by ENT, the bridge collapsed post surgery and had surgery 2 shortly after. It was still crooked and breathing wasn't right so I had 3rd surgery to fix this and my nose looks worse than when it was originally broken. All 3 surgery done by same ENT. What can I do to get it straight and normal looking again? Bruising under eyes never went away from last surgery. Broken blood vessels around nose now.

Doctor Answers 4

Best option for revision rhinoplasty

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A fourth rhinoplasty is always much more complex than the first.  Hopefully there is enough cartilage within the nose for grafting purposes.  The concaved side of the nose appears as though the upper lateral cartilage has been fractured off the nasal bone and will require a spreader graft.  Both medial and lateral osteotomies will be performed to straighten and realign the nasal pyramid.  This will get the nose looking straight and normal again.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Crooked noses are one of the most common reasons why patients seek revision rhinoplasty

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In patients who have a crooked nose, especially after prior surgery, the most common way to straighten the nose is by using grafts of your own cartilage. The source for cartilage can be either your septum (if sufficient cartilage is left), the flat part of your ear (so the ear looks the same after) and sometimes rib cartilage. I also find that a new product called PDS flexible plate may be very helpful for getting a nose straight. Since this can be very complex surgery you should see an expert in revision rhinoplasty.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Septum Re-straightened and Supported

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Your nose is still extremely deviated and that is possibly what is contributing to your breathing difficulty.  Essentially you would need to be examined to see multiple views of your nose and come up with a surgical plan.  Based on the photo and your description I would suggest having your septum straightened and supported with a cartilage graft.  Cartilage can be taken from the nose, the rib or the ear depending on what is available.  Probably would need an open rhinoplasty, which is done with a small incision made on the bottom of the nose, which no one can see.  Again, it would be best to schedule an appointment to review in person.

Scott Chapin, MD, FACS
Philadelphia Plastic Surgeon
4.8 out of 5 stars 25 reviews

You may consider a Non-Surgical Rhinoplasty treatment to improve the crooked appearance of your nose.

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I read your concerns and reviewed your nasal photo which is limited:

Since you had 3 operations on your nose, I would not suggest a fourth without consulting several reputable revision rhinoplasty specialists. Further surgery would likely require cartilage grafting, and you may have to use ear or rib cartilage to attain a desired result.

You may see some improvement in the crooked appearance of your nose by adding volume to the indentation in your bridge on your right. My personal preference is to use Silikon-1000, an off-label filler for permanent results.

I hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.