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

Question

Had revision over 1.5yr ago. Wanted widened. It was thinned . U can see the osteotomy diagonal line. I know the upper bone part is difficult to move again but this middle area, is that difficult to pop back out? Did not want it thinned/higher. I figure (pray) this area is thinner bone and more accessible so relatively speaking easy to pop out?Asst trying to say bridge and tip are thinner because I lost weight. I know what my nose looked and felt like and you can feel (and one one side see the indents from the cuts made to move the mid vault inward. It is frustrating because the adamance is actually starting to be insulting. Another dr said they could do some fascia grafting but I think I would like the sides popped out as well as the grafting to the upper sides. Can see and feel the indents and the tip was thinned as well. So main question, are those approximate side areas circled easy to pop back out? And how would it be done and how long does that take, cost? I dont have another $24,750. Thank you.

Jeffrey H. Spiegel, MD · Answer

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.

Eric M. Joseph, MD · Answer

It is difficult to evaluate your up close photos, and I doubt that the yellow line corresponds to where your osteotomy was performed. If you are desiring a wider nasal appearance, with filling in of nasal indentations, depending on your examination, microdroplet Silikon-1000 injections maybe considered. I hope this helps. Sincerely, Dr Joseph

Andrew Miller, MD · Answer

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.

Guray Yesiladali, MD, FEBOPRAS · Answer

Your frustration is completely valid&mdash;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&mdash;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&mdash;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.
&mdash; Güray Yeşiladalı, MD

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

Answers (4)

Answer: Midvault Indentations After Revision Rhinoplasty – Can They Be Corrected?

Answer: Midvault Indentations After Revision Rhinoplasty – Can They Be Corrected?

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

Answers (4)

Answer: Midvault Indentations After Revision Rhinoplasty – Can They Be Corrected?

Answer: Midvault Indentations After Revision Rhinoplasty – Can They Be Corrected?

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.