Revision rhinoplasty candidate
A revision rhinoplasty can accomplish building up the collapsed mid-vault with spreader grafts, and narrowing the nasal bones with low lateral osteotomies. This will help significantly with the inverted V deformity. Important to know how much cartilage is left on the inside of the nose for grafting purposes. For more information and many examples, please see the link and the video below
Revision Rhinoplasty - Good News
It would be helpful to know when your surgery took place, but judging from the photos, you do appear to be a good candidate for a revision rhinoplasty. Do not worry: your nose can be improved. With many of my revision-rhinoplasty patients, their fear that their current condition is permanent is the very first thing that I like to address, because the psychological aspect of having had work done elsewhere for an improvement -- and then having a large disappointment -- can be quite upsetting. Depending on what structures you still have intact, I might possibly use your own cartilage to reconstruct, but this would be dependent on an examination. No matter what, please do your research carefully, and choose a board-certified plastic surgeon with years of experience who specializes in revision rhinoplasty.
Revision rhinoplasty restores structure and can improve symmetry
We often use grafts of your own cartilage to restore structure in revision rhinoplasty. We even use these grafts in many primary rhinoplasties. It is impossible to determine what you will need to create a more harmonious profile without examining your nose inside and out. I also need to touch your nose and septum to see what has lost structure and what structure remains.
Revision Rhinoplasty? Yes
Thanks for sharing your post and photos. You do appear to have some post operative structure issues relating to your middle vault cartilages and lateral nasal side walls. Fortunately, a thoughtful and well designed revision rhinoplasty procedure via an open approach can address these concerns and others that you may wish to correct regarding your tip. I would favor structural correction with cartilage spreader grafts, along with other appropriate techniques which can be done on your behalf. It may be best to wait one year from your first procedure before undergoing this revision for the optimal result. I recommend discussing your case in person with a reputable revision rhinoplasty surgeon when you are ready to proceed. Best Regards.
Depending on your examination, a nonsurgical revision rhinoplasty may be considered for indentations along your nasal bridge.
You appear to have thin skin which may lead to irregularities after rhinoplasty surgery. Depending on your examination, microdroplet Silikon-1000 injections may be considered for adding volume to your nose and improving your nasal appearance. Hope this helps. Dr Joseph
It looks like you need a revision. The middle third of your nose may have been over treated. It looks like you might need a graft to camouflage the depression.
Inverted V deformity, mid-vault collapse, common post-surgical deformity after rhinoplasty
Rest assured, it can be fixed. An inverted V deformity can have multiple causes and can be fixed with spreader grafts, on-lay grafts and sidewall augmentation. If there are any functional difficulties, breathing problems, then spreader grafts are the ideal solution because they will correct the breathing and the cosmetic concerns. This will require additional surgery and significant cost. If there are no other cosmetic abnormalities on-lay grafts are simpler but are not anatomically correct and are not my choice because I like to reconstruct the structural integrity of the nose. You need to wait at least a year from your previous before revision to assure that no other problems present themselves in the mean time. Good luck.
An educated patient is always n advantage but you are reading a bit too much about techniques utilized in revision rhinoplasty.... it appears that you have had a closed rhinoplasty with somewhat irregularly resected dorsal structures... it does appear 'fixable'although you only have to bat .300 to make it to the cooperstown, a rhinoplasty expert who has a 95% success rate will still leave 5% of their patients unhappy... The decision to undergo a revision rhinoplasty needs to be considered carefully..Unfortunately, unsatisfactory results and secondary deformities from primary rhinoplasty are all too common.... like many other advances in science, technology, etc. the techniques and approach to rhinoplasty have become significantly refined over the last 20 years..... much of what is done now by qualified rhinoplasty specialists is much more 'constructive' than the 'destructive' methods of the past.... still many patients have suboptimal surgeries that result in asymmetry, over-resection of supporting structures and ultimate collapse over time. You need a thorough evaluation and a well thought out plan....you will need to gain the confidence that your surgeon has the skills and aesthetic judgment to fix your problem....17/20 'experts' are either fibbing or don't know any better....you will need to see several doctors to become convinced...find out who OR nurses and doctors go to and who their family/friends go to.... do your homework and be sure that your revision rhinoplasty surgeon has: 1. many years of rhinoplasty practice experience
2. judgment and techniques that have evolved over time
3. a practice focused on rhinoplasty
4. a willingness to do difficult, secondary and reconstructive cases
5. an interest in teaching others how to evaluate and do rhinoplasty properly
6. a willingness to share rhinoplasty resume, photos and patient experiences with prospective patients good luck...
Changes to the nose after rhinoplasty
It sounds as if you have a lot of concerns after having your rhinoplasty done. Some are very surgery specific and others don't make sense. You need to speak to your surgeon first, then get a consult with a surgeon that specializes in revision rhinoplasty.