I Am 26 Yrs Old Wanting a 4th Rhinoplasty Surgery for Revision. Is 4 Too Many? Please Help Me. (photo)

1st@22yrs: infection ate cartilage leaving dent in dorsum. Dr. then “stimulated” it by jamming needle in/out causing excess scar tissue &L. nostril to contract/deform. 1mos post-op he did revision & put excess cartilage on 1 side of dent & nothing on other 1/2, creating bump w/ illusion of even deeper dent. I have significant scar tissue & also tissue removed from root of my nose. 3rd surgery 2 yrs later didn’t change much. Im terrified if I have 4th: may have necrosis/inc scarring/contraction/collapse

Doctor Answers 7

4th rhinoplasty?

You have had a lot of surgery.  So ones natural inclinication may be to say enough is enough.  However in looking at your photos, there does appear to be room for improvment/correction.

with that said.  i would urge you to seek someone expereinced in revision rhinoplasty.

your case in complex enough that you need to be seen in person to evaulate if ther is the potential for true improvement with yet another procedure.

i would be happy to see you if you care to visit austin.  its not too far from nola

Austin Plastic Surgeon
4.9 out of 5 stars 57 reviews

I Am 26 Yrs Old Wanting a 4th Rhinoplasty Surgery for Revision. Is 4 Too Many? Please Help Me.

Over the internet in your specific situation is very hard to address the issues. Best to seek in person consults. But I would only treat the skin issue. Good luck 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

4th Rhinoplasty

   The dent can be improved by filler or with grafting.  I am not sure why there have been so many problems with your nose, but I am sure it can be improved.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Revision rhinoplasty

In general, the more your nose is operated on, the more difficult each surgery will be. I would recommend seeking an in-person consult with an experienced and board certified revision rhinoplasty specialist. He/she will be able to assess your nose in person and provide you with advice on how you may make an improvement. I hope this helps, and I wish you the best of luck. 

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

Fourth Rhinoplasty?

You have had lots of nose procedures and at some point you need to consider that certain goals can and can not be reached without damaging the underlying structure of the nose. There are things about your nose that could be improved, but I would not go near an in-experienced nasal surgeon. This is not for rookies. You need a surgeon who specializes in revision Rhinoplasty surgery and knows how to fix the nose with their eyes closed.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 49 reviews

Revision Rhinoplasty


You have had several rhinoplasty procedures and the question which you face is are the improvements you want achievable by a fourth procedure? In the hands of a skilled revision rhinoplasty surgeon it is my belief by your photographs that there is room for improvement. A direct examination would be necessary for a true evaluation. I am not sure when you had your third procedure done however it is imperative you wait at least a full year for any revision surgery. Your original surgeon revising your nose one month post op is not recommended. Make sure you see a skilled revision rhinoplasty surgeon who has expertise and a lot of experience in the field of revision rhinoplasty.

Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Multiple revision rhinoplasties

You are right to be wary of more surgery. The procedure becomes more difficult and outcome less predictable with repeated surgery.

However, your photos explain why you are still thinking of further suregry. I would suggest a 'cheat' - to have a small filler injection to hide the dent. I'd choose a 'reversible' filler such as hyaluronic acid.

If this did not work, you can always have another rhinoplasty to put a bigger piece of cartilage graft, but the outcome will be uncertaqin to some extent.

Anindya Lahiri, FRCS (Plast)
Birmingham Plastic Surgeon
4.8 out of 5 stars 32 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.