Help! Do I need a rhinoplasty revision? (Photo)

Question

I had my rhinoplasty done a year ago by a board certified plastic surgeon. She used a rib graft to build a bridge. My nostrils are severely uneven and now my tip is dropping. I've now had several people say there's a blue/purple line across my nose where there is a gap between the graft and my tip. The bridge also looks uneven and my side profile is terrible - you can see the graft through my skin. During my post op, she said it's uneven because my tip hasn't dropped. What do I do?! :(

Manish H. Shah, MD, FACS · Answer

Hello,
Thanks for your question.
It looks like your surgeon was able to augment your bridge but was unable to project your nasal tip further to give it the appropriate aesthetic on profile. You will need another rhinoplasty surgery to correction this.
Another option is to carefully inject filler in to the tip of the nose to project it a bit. The problem with this approach is that the tip will become darker and you will need to repeat injections yearly with the associated risks of nonsurgical rhinoplasty. 
Your surgeon can make the necessary changes but may need more rib graft to fix things.
I hope this helped.
Dr. Shah

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a will benefit from a Revision in order to stabilize your entire tip complex, which is now drooping and a pollybeak deformity. With good surgical technique, you could have an outstanding result. I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag. If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag. Long-term results are much more meaningful than on table results or 1 week post-op results. 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

Best wishes and good luck.

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

Gianfranco Frojo, MD · Answer

I would go back to speak to your surgeon. There are definitely some issues present that can be addressed by your surgeon. If you are wanting to seek a second opinion, I would recommend finding a board-certified plastic surgeon (American Board of Plastic Surgery) who has also completed an aesthetic fellowship that is accredited by the Aesthetic Society.

Eric M. Joseph, MD · Answer

Based on your photos, your bridge and nasal tip asymmetries could be addressed with a permanent non-surgical nose job. Since your nasal tip does not protrude from your face as far as your bridge does, that is the reason for the line that is seen on front view and the droopiness on profile. The feasibility of a revision rhinoplasty would require an examination. Thank you for your question. Sincerely, Dr Joseph

Help! Do I need a rhinoplasty revision? (Photo)

Answers (4)