Nose still crooked and having trouble breathing 6 months after septorhinoplasty revision. What went wrong? (photos)

Hello @Exquisite718655, thank you for your question. After 12 months it is possible to evaluate what may have happened in the process. It can be associated with several factors related to the surgical technique used. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Thank you for your question and sharing your photographs.

I'm sorry that you are still experiencing problems following your surgeries.

The external appearance suggests that the support was insufficient to control the shape. This can easily happen after injury in particular if there was a previous intervention.

Stronger support is usually achieved using rib cartilage grafting. This can be your own or donor cartilage.

Ear cartilage is generally too soft to support the nasal tip adequately.

I would suggest to you to discuss your concerns with your surgeon in the first instance.

Hello, and thank you for the question. It appears that your profile (side view) is much improved from your second procedure. On the front view, you do still appear to have a slight curvature of your nose, however you are only 6 months out from surgery. There is undoubtedly still a significant amount of swelling remaining in your nose. As this improves, the shape of your nose may improve as well. Your surgeon may be able to recommend some conservative measures to help things along including massaging, taping at night, or steroid injections. It is important to remember that revision rhinoplasty is extremely difficult, especially after the nose has had 2 significant traumas and 1 prior surgery. It may not be possible to fully straighten your nose out. I would recommend you follow up with your surgeon for further evaluation.

Sorry to hear that your issues were not addressed. Traumatic and crooked noses can be very difficult to get perfectly straight. I am not sure who performed your prior surgeries, but IMHO, noses like this should be managed by a double board certified ENT/Facial Plastic Surgeon who has plenty of experience correcting breathing issues. Even still, very strong techniques are required to keep your nose straight. You tip is still under projected and you still have a dorsal convexity. I imagine your nose would require a full septal reconstruction at this point. Hope this helps. Message me with any further questions.

Unfortunately, cartilage has memory. Revision should not be considered for at least another six months. An extensive open septorhinoplasty with outfracture of the left nasal bone and possible use of spreader grafts could improve both function and appearance but this would require internal silastic septal splints which are uncomfortable. After rhinoplasty the nose is hypervascular for up to a year, so operating too soon would do more harm than good. Even then, one gets diminishing returns for each revision, so think hard and long about whether you can live with the results.