Flat nose from front view and unhappy with the result. (photos)

Question

I had rhinoplasty surgery for about 2 months ago and I'm not happy for the result. Doctor took away too much of the bridge and he fiksed the rip of my nose (im happy with the tip). is there any risk that I take second rhinoplasty, Without destroying the tip of my nose and the rest?? I just want higher bridge to make mye nose look normal, not like Michael Jackson nose. I want my nose to look natural from front view and side view. Please help me!

Thomas Trevisani, MD · Answer

Overall, it appears you have had a great improvement. It is far too early to be worried or concerned about revision. Give it a year and revisit the issue. After a year, if there are areas of concern- they can be addressed.

Robert Morin, MD, FACS · Answer

One of the best ways to treat an over resected nasal dorsum is to build up that part of the nose using a DCF or diced cartilage and fascia graft. First, cartilage is harvested from the septum, ear or rib. It is then diced finely into a paste-like consistency. The diced cartilage is then wrapped in facia (a tough soft tissue material harvested from the side of the head.) This DCF graft is then placed into a carefully dissected pocket on the dorsum of the nose. The result is usually a smooth, straight, natural appearing dorsum with symmetric and aesthetically pleasing dorsal aesthetic lines.

Steven Wallach, MD · Answer

It does look like your nose was over-treated.  You need to wait about a year and then you can consider a revision which will likely require dorsal onlay.

Michael Yerukhim, MD · Answer

Thank you for your question, and I'm sorry you're having a difficult time.

Your dorsum does look too low on profile views. This can certainly be improved with grafts, and a multitude is available. However you need to wait for the healing process to take place, so that changes that will inevitably happen over the next year can be taken into account during surgery planning.

If you're happy with your tip, then endonasal (aka closed rhinoplasty) approach may be a good approach for your eventual revision. In a closed approach, the incisions are hidden inside the nose, and the tip does not have to be disturbed. An in person evaluation and examination will be necessary to fully diagnose the deficiencies and the new anatomy of your nose, as well as what surgical maneuvers will be possible and necessary.

Seek an experienced revision rhinoplasty surgeon.

Best of Luck!

William Portuese, MD · Answer

Since it has only been two months since your primary rhinoplasty, it's important to wait at least one year before electing to undergo a revision. This will allow the healing process to be complete. It is also important to know how much cartilage is left on the inside of the nose for potential grafting purposes. The bridge of the nose can be built up  with the patient's own cartilage harvested from inside the nose.

Robert E. Zaworski, MD (retired) · Answer

Since you are only 2 months post op, it is a little too soon for nasal revision.  It takes several months to see the final result.  Follow up with your surgeon on a routine basis so he can monitor your progress and recommend any revision that is needed.

Flat nose from front view and unhappy with the result. (photos)

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