Revision rhinoplasty for the nasal tip
Unfortunately, this is impossible to tell without a personal examination (even photos don't tell the whole story). However, after a revision, the tip may change slighlty for 12-18 months. It is unlikely, however, that after 12 months an apparent asymmetry will resolve. Revision surgery may be able to correct this for you.
Hope this helps,
Dr. Sam Most
May take up to 2 years to see full results
It is difficult to advise this issue without an evaluation, but I can tell you that it may take up to two years for the swelling to reside for an open rhinoplasty, so I would suggest waiting a bit longer before making any conclusions.
Improving nasal tip with a rhinoplasty nose surgery procedure
Careful repositioning of the nasal tip cartilage, especially if you are unhappy after a previous procedure, is best done with an open rhinoplasty. Lesser treatments will not work.
Fixing a nasal tip with a revision rhinoplasty
Today, there are many techniques that surgeons can use to correct a rhinoplasty result. Unfortunately, there are no reliable, consistent, and safe techniques to permanently fix the nasal tip without surgery. Instead of injecting different medications into this delicate area, you may best be served by receiving a focused revision rhinoplasty procedure by an experienced surgeon.
Tip Revision Rhinoplasty For Asymmetry
After nearly one year of healing, it is unlikely that your tip is going to evolve much more from the current shape. It would be real important to review the operative notes from the original surgery to determine exactly what was done with the nasal tip. This would also give insight into what could be done to fix the asymmetry.
Without photos and a physical examination it would be hard to tell if an open or closed rhinoplasty approach is indicated. In my experience, there are few asymmetric deformities of the tip of the nose that are amenable to a closed revision rhinoplasty. In many cases, it is best to perform an open revision rhinoplasty to achieve the symmetry desired. This largely has to do with the need for structural grafting to recreate a more symmetric tip.
If it has been 11 months since your revision the asymmetry may not resolve enough to satisfy you and your surgeon. Surgical correction may not be as complicated as you fear. If it has not been a year since your last surgery, be patient.
How long since the revision?
If the revision was 11 months ago, then it is indeed unlikely that swelling is the cause of the deviation. If the revision was less than that, even if it's not going to get straighter it still needs time for the wound to mature before anything else is done to the nose.
Correcting an asymmetrical nose, particularly one that has had two procedures already, is a difficult task. Usually reopening the nose would be required. If the asymmetry is due to very minor shifts of cartilage, there are some minor in-office techniques (e.g., needle shave) that may be applicable. And fillers are a straightforward, albeit temporary solution, too.
Dr, Buckingham brings up an excellent point. You may need to assess the progress you have made with the previous procedures and balance the risk of any additional procedures with the potential benefits you may achieve.
Straighetening a crooked nose is often times like straightening out a crooked wire. Often times this is accomplished by a bend in the other direction rather than truly straightening the wire..
It is getting less and less likely that swelling is causing the deviation in your nasal tip. You can potentially add a small amount of filler like Restylane or Juvederm to even out the appearance, but it will need to be repeated every 9-12 months. o/w you would need revision surgery. Be careful though. Look at where you have come and appreciate the improvement rather than focusing on the minutia.