After rhinoplasty, my nose looks too concave. I want to go back to surgery to get my profile straight. Is it feasible? (Photo)

Question

I had a rinoplasty done one year ago to enhance the tip of my nose. I was clear with my doctor when I said I wanted a straight nose and I don't like how concave noses look on man. Now I have a concave nose, it makes me feel like a have a baby nose. I've been living abroad after surgery and I don´t have the confidence to go back and show myself. In short, PROBLEM is my nose looks concave. After my bone was taken out, is it possible to replace it with other material and what are the risks.

Eric M. Joseph, MD · Answer

Depending on your examination, non-surgical revision rhinoplastic treatments with microdroplet silicone may be considered for achieving a straight nasal bridge on profile. Nasal widening of your bridge on front view may be achieved as well. Hope this is helpful for you.Thank you.Dr Joseph

Alejandro Nogueira, MD · Answer

If was to be your surgeon for your primary rhinoplasty this is how I'd rate and plan your case, based on the preoperative photo posted:-sligh dorsal excess: in need of very delicate, fine, thin and attentive resection of the dorsum, manually made with blade (cartilage) and rasp (bone) and not with chisel (used for massive hump resections); no more then 1-1,5 mm resection and in a straight fashion, parallel to the maxilla-broad dorsum and broad base: to be corrected with infracture osteotomies properly done and correctly located at the so-caled Joseph's angle (angle between maxilla and ascending maxillary apophysis-nasa bones complex)-poorly defined tip: the typical ethnic tip in need of Sheen's pentagonal tip grafting, a clear and close to absolute indication-short and poorly supported tip: in need of reinforcement of the medial cruras with a tutor graft or columellar strutUn fortunately and evidently... this was not the procedure in your nose; based on the photos this is what was done:-over resection of the dorsum and not in straight fashion, leading to a curvature like a slope (does not fit in a masculine face and rarely in feminine faces); this the so-called saddle nose deformity >>> this needs dorsal grafting of concha's cartilage to raise the dorsum-too high osteotomies leading to a double width of nose (funnel shape) >>> new steotomies, well done and correctly located are necessary-resection of the caudal septum + over resection of alar cartilages, leading to a over rotated tip, wide nasolabial angle and nostrils exposure (slight piggi nose deformity) >>> needs septal lengthening and tip grafting-additionally you need the strut at the columella (the lengthened septum can be used for that purpose) to reinforce its support and a tip graft to provide a well defined and beautiful tip (Sheen's technique)All the above with open approach rhinoplasty. Grafts for tip and dorsum are BEST harvested, always, from concha of ears. NEVER ever accept filler in a nose... disastrous...Yours is a very interesting and challenging case for the right surgeon, do seek the help of a real master in revision cases, complex issues and tip grafting.

Steven M. Denenberg, MD · Answer

You did an excellent job in Photoshop. It is possible, though not simple, to elevate your bridge as you drew.

Edward Farrior, MD · Answer

julioharrara,It indeed looks like the nasal dorsum has been over resected in an effort to create the illusion that the tip is more projected. This can be corrected with the augmentation of the nasal dorsum. Augmentation can be performed with cartilage from your nse , ear or rib. the source of the cartilage would depend on how much work was done n the septum with your first surgery. The revision would probable not require that the nose be broken again so it should not be as painful. Good luck and choose your revision surgeon wisely.

Steven Wallach, MD · Answer

You will likely need a dorsal augmentation wit cartilage to enhance your dorsum. Best to be seen in person.

William Portuese, MD · Answer

It is possible  to build up the bridge of the nose with the patient's own cartilage harvested from inside the nose. Look for a rhinoplasty specialist who performs this type of procedure often for  best results

Tae Ho Kim, MD · Answer

Because fillers are easy to inject and shape a nose, you may want to consider a hyaluronic acid filler to reshape the nose as you have drawn it.  You would need to do this most likely once a year if you use Voluma or Restylane Lyft.  Obviously, an operation would be a more permanent solution.  I would advise you to see a board certified plastic surgeon, who has a lot of experience with rhinoplasty and revision rhinoplasty.  Good luck!

Arian Mowlavi, MD, FACS (license on probation) · Answer

This can be corrected with placement of small amount of diced cartilage graft taken from your ears and/or spetum.

Dennis Barek, MD (retired) · Answer

Unfortunately, your original nose just needed tip projection, using a septal cartilage graft, and a correction of a hanging columella. I would not have lowered the bridge at all. But now that its done, the best recommendation I can give, is to harvest cartilage from your septum and use it to build up the bridge. If there is insufficient septal cartilage,  ear  cartilage can be used. I would not recommend any foreign materials.

After rhinoplasty, my nose looks too concave. I want to go back to surgery to get my profile straight. Is it feasible? (Photo)

Answers (9)

More Revision Rhinoplasty Questions

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Answers (9)

More Revision Rhinoplasty Questions

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