After a failed septorhinoplasty, what should my next step be? (Photo)

Question

A year ago I had a septorhinoplasty done by an ENT, it was fully covered by OHIP. I had broken my nose as a child and it caused a lot of trauma to my nose . After the surgery my nose didn't heal well , the dorsal bump on my nose wasn't reduced at all and I now suffer from chronic pressure aswell as frontal headaches and still have breathing obstruction . My surgeon refuses to give me answers and take responsibility , what should I do now and what will it cost me ?

Sam Rizk, MD · Answer

Thanks for your question, Ally.
Ok, so the good news is that you’re from Ontario, and a septorhinoplasty is covered by OHIP because it’s a functional treatment. In many cases, a rhinoplasty will need to be paid out of pocket or through personal insurance. Although, with a septorhinoplasty, and specifically in your case, there are enough problems associated with the original procedure that you shouldn’t have any problems there.
  That being said, the most important part of this type of surgery is for your breathing to be up to par. You should start looking into consultations for another procedure, and to discuss your options with another board-certified facial plastic surgeon and get a second, third, or fourth opinion in order to weigh your options accordingly.

Steven M. Denenberg, MD · Answer

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_ally940.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.I looked at your previous posts, too, and boy, as you say, there's just soooooo little change, that I just don't see that a rhinoplasty was performed. Even if the surgeon was way too conservative in lowering that bump, you'd expect there to be more change than this, and more swelling in the photos taken early on after surgery.At least here in the U.S., it's not legal for a surgeon to keep the operation report from you. You might get a copy and see what it says. But really, it doesn't matter what it says; what matters is what your nose looks like now, and that, based on your reporting, you shouldn't allow that surgeon to operate on you again.In the morph, I lowered that bump, but I also elevated the tip, and then brought the entire nose back closer to your face. When a bump is taken off of the nose, it can make the nose *appear* to be longer, as if the tip drooped, so it's important to elevate the tip somewhat. Then, moving the nose closer to the face just overall makes it smaller.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and how to tell whether your previous surgeon should be performing your revision. You should only have surgery if you are able to make yourself very confident in your surgeon's skills. Read that page very carefully. Most plastic surgeons are quite poor at this operation, and I believe my advice will go a long way toward keeping you safe.
I'd love to hear what you think of the morph. Did it seem to address your main concerns?
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

Toby Mayer, MD · Answer

Revision rhinoplasty for unsatisfactory results. The best course of action for this is to see several very experienced revision rhinoplasty surgeons who can show you many examples of his results with noses like yours with natural results.

Mohsen Tavoussi, MD, DO · Answer

Insurance do not cover cosmetic surgery and may have considered the hump removal as such. Your symptoms may be due to several factors which may include recurrent deviation, internal scars or sinusitis to name a few. You need to have a consultation with a facial plastic surgeon who can address both your functional and cosmetic concerns. Best

Sheikh Saadat Ullah Waleem, MD · Answer

Hi
Your definitely need a revision surgery. In my humble opinion it shud better b done by an ENT surgeon as he wud b able to deal with the functional aspects as well as any sinus problem since u hv mentioned those in yr query.
Good luck

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your problem and I would get your records and pre op photos and go on complimentary consultations with experts in the area and be evaluated Dr Corbin

Michael Elam, MD (retired) · Answer

Dear ally, I am sorry to hear that you have had issues with your previous surgery. If you want to have both function and aesthetics addressed I would suggest  that you seek complimentary consultations with some experts in the field of septorhinoplasty surgery. I would also suggest that during the consultation you have imaging performed to show you the proposed changes to your nose. Once the desired nose is agreed upon the surgeon will then discuss in detail the techniques which will be used to attain those results. An intra-nasal examination will be performed to provide a proper diagnosis for your current breathing concerns. Depending on the diagnosis the surgeon will discuss what functional issues need addressing as well. A fee for the procedure will also be given at this time. Review the surgeons before and after photographs to ensure natural looking results. Please see many examples of before and after septorhinoplasty results in the link and video below.  Best regards, Michael V. Elam, M.D.

Richard W. Fleming, MD (retired) · Answer

Unfortunately you will probably need to have revision surgery to improve the appearance and function of your nose. See an experienced revision specialist who will evaluate your nose, discuss options, and give you the cost which will depend on what you need.

Gregory Park, MD - Account Suspended · Answer

Consultations with plastic surgeons in your local area will provide you with expert opinions to improve your breathing and shape of your nose. Thank you for sharing your question and concerns. Best wishes.

After a failed septorhinoplasty, what should my next step be? (Photo)

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