How Long Should One Wait to Get a Revision Rhinoplasty Reduction and Removal of Spreader Grafts? (photo)

I had an initial rhinoplasty a year ago for slightly deviated septum (naturally deviated) and to my dismay, surgeon used spreader grafts and made my nose much wider and even longer with flared nostrils and bulbous tip. How long should I wait to get revision to reduce the overall size of nose? I just want my original nose size back with or without the prior deviation. There were no other issues but thought surgery for straighter nose be cosmetic improvement. Before & after photo to scale attached

Doctor Answers 4

How Long Should One Wait to Get a Revision Rhinoplasty Reduction and Removal of Spreader Grafts?

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If you are a year after your surgery, I think the result can be improved. Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Nose Too Wide After Spreader Grafts

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Although you've probably taken this into consideration, the removal of the spreader grafts might make your breathing worse -- so that potential trade-off needs to be factored into your decision. Your surgeon would have a better idea that any of us as to how much their removal would effect your breathing.  Other things to consider is that even at a year out, the nose will probably continue to get narrower, and at the end of 2 or 3 years, you might think the width is just fine.  With the photos you provided, it's difficult to make a good analysis of your appearance, but one thing that makes your nose look longer in the "after" photo is that your head is tilted downward more than in the "before".  I know it's a hassle, but if you could provide more photos, taken from the same angles as your "before" photos and with the same lighting (and preferably the same camera), then we could make a better assessment and therefore give better advice.  Thanks.

Rhinoplasty revision

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It is very difficult to comment on your results without a full complement of pictures ( lateral ,3/4 and base view) which are in focus. You can certainly have a revision after one year . I would speak to your surgeon to discuss your  concerns so that you will have any better idea as to what can be changed. Imaging is not a guarantee but is often helpful. The main point is to have a thorough discussion of the options and goals of surgery.

David F. LaPatka, MD
Santa Barbara Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Wait at least a year to have a revision operation.

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Hello Pepper123,

Thanks for your question.  Looking at your pictures, I can see that the spreader grafts have widened your nose and rotated your tip down some.  I'm not really sure why your alar base has widened but you only show one view.  I typically recommend waiting at least one year after an initial surgery to undergo revision surgery.  By that time the nose has softened and internal scar has settled down enough to redissect the tissue planes safely.  To reverse your changes is essentially impossible, but the spreader grafts can be removed and some of the tip changes can be addressed to bring them closer to preop.  However, because of vascular changes, changes in fatty content, and scar, your nose won't ever go back to it's original shape. 

Good luck,

Dr. Shah

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