My nose shape is awful at 7 months, are my goals still achievable? (Photo)

Question

I had a very poor rhinoplasty with a surgeon who left my nose looking piglike by overshortening my columella and lifting my tip up and rounded to the point of an almost pollybeak. It is also very asymmetrical. The image he showed me when we discussed the plan was not at all what I ended up with. My nose is 6 1/2 months healed and swelling is not enough to explain the deformities. I’ve drawn over the image to show what I wanted and would’ve been happy with. Is this still achievable?

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for providing these photos. I think the changes you desire are still very possible and it is possible to improve the base asymmetry as well. 3D imaging is a tool that is always incredibly useful so you can get a sense of what each change will do to your nose and overall appearance. I recommend scarless/closed rhinoplasty for all rhinoplasty regardless of whether primary or revision rhinoplasty.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Hong Ryul Jin, MD · Answer

I think your goal is reasonable. Making the tip sharper and correcting polybeak deformity while lowering the slightly upturned nose are achievable. It looks best that you wait till 1 year after surgery.

Steven M. Denenberg, MD · Answer

In the morph you made, you took down the incipient pollybeak nicely, and I see what you did with the columella and the junction of the upper lip and nose, but those changes are really tiny tweaks, and often a revision doesn't work well with tiny tweaks. The problem is, we always miss our optimal goal by some amount, and if we're only looking for changes that are tiny when measured with a ruler, if we miss by a little bit, well then maybe we didn't accomplish anything at all. Also, lowering the columella isn't a very highly predictable change to make, and pushing out the nose/lip junction is really almost impossible. If I were to morph your current nose, I would deproject the tip more (move the tip closer to your face), and elevate the tip more. If you looked at those changes and liked them, it would make you a better candidate for a revision. It would make it more likely that the revision would accomplish some changes that you saw as an improvement.
(Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. I’m sorry that you’re unhappy with your rhinoplasty results. It is recommended to wait at least one year after surgery before considering revision because your nose will continue to be in a phase of recovery during this time. Since six months have passed, you may consider dermal fillers to temporarily alter your nose’s appearance. If you’re still unsatisfied with your nose after recovery, revision rhinoplasty can lengthen your columella, define your nasal tip, and create a more symmetrical result overall.

It’s important to mention that each subsequent nose surgery becomes more complex due to the loss of structural support, scar tissue, and other factors. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to oversee your recovery, review your treatment history, and determine the best treatment plan for you.

Nima Shemirani, MD · Answer

Hi @hpers28. Thank you for sharing your photos. I'm sorry you are not happy with your results. It's possible to correct the issues you described with a revision rhinoplasty. I recommend seeing an expert revision rhinoplasty specialist for an in person examination. There are options for you that can be determined after examination.

Best of luck,

Dr. Nima

My nose shape is awful at 7 months, are my goals still achievable? (Photo)

Answers (9)

Answer: Rhinoplasty recovery: what you should know

Answer: Rhinoplasty recovery: what you should know

Answer: Revision Rhinoplasty

Answer: Revision Rhinoplasty

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.

My nose shape is awful at 7 months, are my goals still achievable? (Photo)

Answers (9)

Answer: Rhinoplasty recovery: what you should know

Answer: Rhinoplasty recovery: what you should know

Answer: Revision Rhinoplasty

Answer: Revision Rhinoplasty

Browse related questions

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.