Seeking revision rhinoplasty for bulbous tip. Do I need a more experienced Dr. for major reconstruction w/rib graft? (Photos)

1st rhino thinned bridge, but overzealous alar base reduct pinched nostrils. 2nd rhino opened up nostrils, added a bit to tip w/ear cartilage. While it was a more desirable look, it was too conservative. I'd like more refined tip, which hasn't been done in priors, w/a bit more length, refining columella & the noticeable scars left from initial alar reduction & perhaps hide/remove the scar bump in tip of interior right nostril, where suture was tied off. I also have a slight deviation. Thanks!

Doctor Answers 3

Experienced revision rhinoplasty surgeon

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 Since this will be your tertiary rhinoplasty, it is very important to seek out a very experienced rhinoplasty surgeon for best results. Placement of a rib graft in the nose will only make the nose bigger  which means you are adding bulk to the nose, which may be counterproductive. To reduce the width of the bulbous tip require suture techniques and possibly a conservative cartilage removal applied to the lower lateral cartilages of the nasal tip. The thickness of the skin over the tip of the nose will determine how much improvement can be obtained. It's also important to obtain old operative reports from the first 2 surgeries, so that the new revision surgeon can get in idea of what was accomplished previously.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rib graft

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Without an examination, it is difficult to say whether or not you will need a rib graft. That being said, your nose is not bad and the areas that concern you can be easily improved.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 123 reviews

Rib at 3rd rhinoplasty?

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It is hard to say that you would definitely need rib at a third rhinoplasty.  But I think it is safe to say that you should have a surgeon who is familiar with complex rhinoplasties and uses rib in some of his cases.  So the safest answer is yes.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 62 reviews

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