Can the Patient Choose an Open or Closed Revision Rhinoplasty?

I had rhinoplasty 38 years ago and hated it. started radiesse 3 years ago, still hate it. it wasn't till i started the radiesse did i realize the extent of how twisted it was. i thought it was just the tip but the doc injected the side bridge to straighten it out. tho' i would love to have it completely redone and perfected i am afraid i will be bad luck with the best doc. can i request a little tweaking on the tip without it being carved out, pinched and nose job looking?

Doctor Answers 9

Revision Rhinoplasty

The best way to achieve the results you seek is to have a thorough and detailed consultation.  The issues you describe (pinching, carved out, unnatural appearance) can all be avoided in the hands of the right surgeon.  Make sure that he/she is up to date with the latest advanced techniques to avoid the issues you fear.

Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Revision rhinoplasty (perfect nose)

Revision rhinoplasty can sometimes be incredibly difficult and unpredictable, or sometimes surprisingly simple with outstanding results.  This is what makes the procedure addictive for facial plastic surgeons.  Having an experienced surgeon with whom you are comfortable is arguably the most critical factor for you.  Do not be surprised however if you visit 5 different surgeons, and get 3-4 different recommendations- they each make recommendations based on what they know will produce the best results in their own hands.  Thus, the approach (open vs closed) is not as important as you may think.  Also, the fear of scarring from the open approach also seems to be magnified- it heals beautifully and is virtually invisible unless you are inches away looking up at the nose.  You are also fortunate to have one of the most experienced rhinoplasty surgeons near your location- I recommend consulting with Rollin Daniel, MD in Newport Beach.

Christopher R. Hove, MD
Paoli Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Revision rhinoplasty nose job

Your nose has been through quite a lot and I believe you must proceed with caution to avoid a too-operated look. Certainly the surgeon should take your preferences into account and I am glad to hear that at this point you want a little and not alot done. Still ultimately the doctor must do what he or she believes is the best operation or treatment. So it is always a conversation and a joint decision between the doctor and patient. Revision rhinoplasty is the most difficult of all cosmetic procedures so the doctor must operate within his abilities doing what is reliable and safe to improve the nose. Hope this helps and good luck.

Michael Godin, MD
Richmond Facial Plastic Surgeon
3.6 out of 5 stars 7 reviews

Open vs Closed Rhinoplasty

Pick the doctor, not the technique.Select an experienced surgeon who will will evaluate your nose and discuss alternative treatments so your expectations are clearly defined. Minimal changes can be made if that is your goal.   You are right - it must look natural. Choose carefully because there is a risk of severe complications with  revision rhinoplasty in noses previously injected with Radiesse.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty

It's not the approach that counts but the end result. If your doctor feels comfortable with closed techniques and thinks he/she can deliver the result you desire this way then go ahead. If he/she feels that an open approach would provide a better chance of getting you the nose you want then accept it or seek surgeons who only do closed procedures.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Can the Patient Choose an Open or Closed Revision Rhinoplasty?

Yes, patient can ask for the closed rhinoplasty but it depends on the surgeon if he feels comfortable with this technique. Also, the more complicated the problems are, the more likely you will have a better result with open technique as it is possible to do certain maneuvers that are hard to do with closed technique specially if the tip needs to be worked on. I also noted that your nasal base is rather wide. Don't know if you are smiling or not.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Open vs. Closed rhinoplasty

You can choose what type of surgery you want done on your nose but a thorough discussion with a surgeon experienced in revision rhinoplasty is in your best interest. Cartilage grafting can help to achieve a more natural contour to your nose and avoid the operated look. It is essential that you also discuss any breathing problems that may have resulted from your previous rhinoplasty.

Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Choosing open versus closed rhinoplasty

You can certainly request what you want done to your nose. You don't have to have areas of your nose changed if you dont' want to.

That being said I wouldn't push your doctor to use an operative approach that they wouldn't otherwise recommend in your case. To address the tip pinching you have currently, revision surgery can be done. Cartilage grafting can be used to improve the tip contours aesthetics.

Visit with an experienced revision rhinoplasty surgeon to see what options you have.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Nasal revision

You can request anything you want weather it will be feasible to accomplish what you request is a different matter. As an aside Radiesse in the nose may be problematic when a secondary rhinoplasty is performed.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

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.