Revision rhinoplasty 18 months ago. Possible to move these parts back out? (photo)

Yes, this can be done. We would need to use cartilage grafting to resupport the sidewalls, and then other tissue to smooth out irregularities. However, this should be quite achievable.

It's difficult to tell exactly from the one view that is supplied, but yes, indented areas can be "popped out." The middle third can be made a bit wider at the same time. Probably ear cartilage would be carefully shaped into spreader and onlay grafts to accomplish this. Be sure to see a few rhinoplasty experts for consultation.

Your frustration is completely valid—especially when you feel your aesthetic goals weren’t met and your concerns aren’t being acknowledged. It’s clear from your description that you’re experiencing midvault narrowing and visible/feelable indentations, likely from over-aggressive osteotomies or cartilage resection during your revision.
To your main question:
Can the midvault be “popped out” or widened again?Yes, in many cases it can be surgically expanded using spreader grafts or onlay grafts—typically harvested from septal, ear (conchal), or rib cartilage depending on what’s available. These grafts can restore width and structure to the upper lateral cartilage region, correcting the collapse and improving both form and airway if affected.
Is this area accessible / easier than upper nasal bones?Generally yes. While the nasal bones higher up are rigid and more difficult to re-break after previous osteotomies, the cartilaginous midvault is more flexible and accessible for structural grafting. However, the degree of existing scar tissue and prior surgical changes will influence complexity.
Fascia grafting may be helpful for camouflaging subtle contour irregularities, but as you correctly pointed out, it won’t rebuild structural width. In your case, a combination of spreader or batten grafts with soft tissue grafting may be more appropriate.
Timing and costHealing time is similar to revision rhinoplasty—initial swelling improves in weeks, but final results take up to a year. In terms of cost, if a full revision is needed (especially with rib grafting), it may still be substantial, but some experienced surgeons offer focused midvault correction as a less extensive procedure.
Given that you already invested significantly, it’s worth seeking a second or third opinion from a surgeon experienced in complex structural rhinoplasty, especially one who understands revision anatomy and respects your observations.
I hope this gives you a clearer and empowering perspective on next steps.
— Güray Yeşiladalı, MD