When Can I Get Nose Lengthening Procedure After 4th Rhinoplasty?

My doc told me that my nose cannot be lengthening using rib graphs and he just performed Alar rim graph and alar base reduction. This is my 4th Rhinoplasty. There is significant swelling which does not look normal. The nostrils look big.

This swelling concerns me. I would like to get my nose lengthened slightly using rib graphs and refine my tip. When can I get the nose lengthening done and how long will the present swelling take to reduce?

Doctor Answers 6

Timing of 5th Rhinoplasty Procedure

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The pictures you submit lead me to believe you just had the 4th surgery. Wait for resolution of current swelling, which will probably be several months to a year, before considering another revision. With the help of your expert revision surgeon, you will be able to evaluate your present result. If you're not patient, the outcome can be disastrous.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Fourth Rhinoplasty

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Although 4 rhinoplasties seem like a lot, it all depends on what was done in each of them. Many patients will have little done between the first, second or third. This should be taken into consideration by the surgeon. I also believe that some revisions can be done as soon as 3 months after the previous procedure. Typically, most surgeons would say to wait one year.

As far as lengthening your nose and tip refinement, that needs to be determined in a consultation. If you have an ethnic nose you may need to have your tip defatted. Lengthening the nose can also be performed from the top down as opposed to the lengthening it from the tip.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 286 reviews

The enemy of good is better (surgeons understand this).

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At this point in time you risk the problem of ending up having Michael Jackon's Nose (RIP). IF you put repeatedly operated and scarred skin on stretch or tension with a lengthening graft (not graph), it is likely that the skin will ulcerate. This will result in exposure and probable loss of the graft.

Currently you have a good result and despite your desire to seek a better outcome, my advice to you is to refrain from any additional surgery before you get in irreparable trouble: " The enemy of good is better".

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Secondary Rhinoplasty

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The swelling has not resolved yet, and will take a long time for the swelling to go away because of the scarring. So, give it time to heal and the swelling to subside, DO NOT THINK OF ANOTHER RHINOPLASTY.

With every surgery you run the risk of destroying your nose permanently.

Samir Shureih, MD
Baltimore Plastic Surgeon

Multiple revision rhinoplasties

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With each surgical revision of your nose, the results become increasingly unpredictable especially if you are trying to make additional refinements to the tip or lengthening the nose. My advice would be to wait for all swelling to resolve before you consider additional rhinoplasty surgery of at least one year. It may be possible to do additional surgery but that would depend on healing factors and the current status of your nose and skin. Besides if you wait you might be satisfied with the two year results from your current surgery.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

3 rhinoplasties is enough!

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You need to stop having rhinoplasties.  At this point, after 3 surgeries by hopefully well-qualified surgeons, you are as good as it gets for you in most all cases.  Give the swelling a year to go down and try to adapt to your nose. There are just times to stop and this is probably one of them! 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.