What is the safest way to remedy after a failed REVISION rhinoplasty?

Question

I had a revision rhinoplasty in late 2019. I merely asked for a minimal improvement for my side profile and breathing as I didn't have a major issue with the look of my nose. The doctor did a full reconstruction (grafts everywhere) with resulted in an extremely large, asymmetrical nose that changed the look of my entire face. He did a "touch up" procedure in 2023 to fix a large,glaring lump, but my results are still bad. What is my best approach to fix this?

Andrew Miller, MD · Answer

Unfortunately, it looks like some more work is needed to smooth out the irregularities. A well performed revision should make a nice improvement, but it has to be done by someone with extensive experience. If you don't want surgery, then fillers and maybe silicone may be able to make a nice improvement.

Eric M. Joseph, MD · Answer

You appear to have several indentations and irregularities, likely because you have thin nasal skin. If you are looking to avoid further surgery, depending on your examination, microdroplet Silikon-1000 maybe considered for achieving a smoother nasal appearance, however, this would not lead to a narrower nasal appearance. I hope this helps and I wish you well moving forward. Sincerely, Dr Joseph

Steven M. Denenberg, MD · Answer

When a surgeon misses your goals for your rhinoplasty by such a large margin, twice, there is a communication or conceptual problem there, and giving him a third opportunity is not reasonable -- there would be little chance for success. From this one photo, it does appear that improvements are possible. But you should also know that a third-time revision is quite difficult technically, and the great majority of plastic surgeons would not be able to approach the operation with expertise. So I wouldn't give up, but you need to re-vamp your method for choosing a surgeon, and definitely not use a surgeon based only on his verbal assurances or a referral from someone else or a board certification.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision with placement of morselized bone dorsal onlay graft or a fascial dorsal onlay graft to help improve the contour of your nose. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

What is the safest way to remedy after a failed REVISION rhinoplasty?

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Answers (4)

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