Crooked, uneven, and hard bump from side profile. Is it worth risk of revision rhinoplasty? Same doctor? (Photos)

I'd have a very serious and sincere conversation with your surgeon, in good tone and begging him to be equally sincere with you. Ask him if he feels capacitated and motivated to go beyond with your result; he did a good work on you, can it be improved? No doubts, there is a huge margin for that. Is it a poor result with plenty of technical fails? Not at all. It is a grey zone result, not calamitous, not brilliant, just better and hence good for you.

I'll tell you what I'd do; first and above all I'd talk with myself, to ask to me (you): is this result good enought to live my life? are the costs and challenges of a revision worthy for me? can I overcome the fear to put my face again in human hands? do I accept the risk of another non brilliant result or even a worsening?

If you conclude that you wish to get the revision, then ONLY a surgeon confident that he can reach at least 9/10 has to bear the responsibility, and his talent and skills have to be proven to you.

Goals for such revision, to my knowledge and capacitation I'd focus on:
-strong and well planned alar rim grafting to push the nostrils down to level closer with the columella
-lateral crura grafting, tutoring, even replacement to align the tip and improve symmetry
-polish the dorsum, you have a little "polly beak" or supratip prominence, very likely you may also need spacer grafts in that area
-improve the overall result of the tip shape, location and lenght, a slight deprojection, reduce the bulbosity, tip grafting, etc

These are the items you can discuss with your current surgeon, prompt him whethe he feels capacitated for this; should he express or transmit any doubts or vague words... then you'd better seek the help of a experienced revision surgeon.

Based on your photos, you are a great candidate for revision rhinoplasty. Your tip is still wide and you have a residual bump. If your not sure about your first surgeon, seek out a couple more rhinoplasty experts to see what you think. Then you can make an educated decision.

Hello! Thank you for your question.
As far as I can understand from your question recommended to seek a second opinion from a surgeon specializing in revision rhinoplasty. If your current surgeon is dismissive of your concerns ("it's not worth it"), you may benefit from consulting a different highly experienced surgeon who validates your concerns and offers a concrete plan.Given the nature of the irregularities, a Revision Rhinoplasty will likely be necessary once the nose has fully matured (around 12-18 months post-op). A comprehensive consultation with a revision specialist is the next appropriate step.
It would be better face to face consultation.
Best Regards!

Based on your photos, you appear to have a persistently wide nasal appearance in the lower 1/3 of your nose, and this is associated with a hanging columella, excess nostril show, and a polly beak. Please consider meeting with another reputable rhinoplasty specialist to discuss the ramifications of revision rhinoplasty for a less distracting, less operated looking, more symmetrical and more feminine nasal appearance.

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, correction of alar retraction, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon