Options for correcting sunken upper nasal bone in 2nd revision? (Photo)

Question

I got unlucky septo/rhinoplasty a year ago, in which my upper nasal walls collapsed inwards. My surgeon performed emergency revision at 6 mo and outfractured the bones with slight overcorrection. It’s been now 5 months since the revision. The other side is set nicely and straight, whereas the other one remains a bit sunken and nose looks twisted, up the bridge, just below the radix. What are my options? Outfracture the sunken side again? Cartilage craft? Fat graft? Under general/local?

Eric M. Joseph, MD · Answer

Many people who have small indentations or irregularities following rhinoplasty surgery may benefit from adding additional permanent volume to improve nasal symmetry. Depending on your examination, this may be something to consider rather than an additional surgical procedure. Hope this helps! Dr. Joseph

Peyman Solieman, MD · Answer

I'm sorry that you these complications from your rhinoplasty. Without seeing you in person or at least seeing pictures it is difficult to assess what would be the best course of treatment.  Achieving a completely straight nose is one of the most complex surgeries in revision rhinoplasty. In my experience, it may be that you need a spreader graft to help reposition the mid-vault as well as to support the nasal bone on the collapsed side. Occasionally, one can camouflage the defect with a cartilage graft if breathing is not compromised on the collapsed side. Still more, if it is only a cosmetic concern and you do not want to undergo another procedure at this time a temporary filler can help correct the aesthetic issues involved and buy some time for everything to settle down before a final procedure. By visiting a rhinoplasty revision specialist you can gain a better understanding of how your nasal structure can be altered for a more balanced appearance.

William Portuese, MD · Answer

Its important to wait at least a year to allow full healing to occur before embarking on another procedure. Since there's been significant changes to the normal anatomy, an in-person examination going to be required to make a determination about how to proceed with either  medial and/ or lateral osteotomy's and cartilage grafting techniques.

Richard Mark Winters, MD · Answer

Although patients are understandably hesitant to undergo further surgery, most significant cosmetic and functional rhinoplasty deformities are secondary to diagnosable and treatable structural abnormalities.... the mantra that ‘there is no simple solution to a complex problem’ is usually in play when I see patrients with tertiary rhinoplasty issues unsolved by their previous revision rhinoplasty.... that said, minor issues can be addressed more simply with more modest gains in mind.... I tend to avoid permanent fillers except in extraordinary cases as most of my revision rhinoplasty patients are young and I am not sure what they are to expect from these products in the distant future whereas I am comfortable with autologous tissues over timeGood luck...

Options for correcting sunken upper nasal bone in 2nd revision? (Photo)

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Options for correcting sunken upper nasal bone in 2nd revision? (Photo)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.