Revision rhinoplasty or nose rasping after rhinoplasty? Self-conscious on my side profile. (photo)

Question

Hi I am nearly on my 6th month post asian rhinoplasty with Rib cartilage, and I am unsatisfied with the results. It has really affect my mental health, I am so embarrassed and self-conscious on my side profile. My nose radix appear too high and the bridge aswell. considering I have a small face and being asian, it does not balance at all. I am thinking of nose rasping to shave off too much graft? would it be less expensive? if so how much will it cost in Perth, WA?

Donald Groves, MD · Answer

Hello and thank you for your question. After rhinoplasty (nasal surgery), the nose can become REALLY swollen, and this swelling can take a LONG TIME to resolve (up to 2 years to fully resolve). I would recommend that you continue to observe things for now. Steroid injections can help with the swelling in some areas. You are still only 6 months post-op, so ultimately you should still wait to see what your final results will be. What you are asking about is a full blown revision surgery, which is very invasive and still too early to even consider at this point. I constantly remind all my rhinoplasty patients how important it is to be patient after rhinoplasty surgery as it can take up to 2 years to see what the final nose will look like. I would not advise you to consider a revision operation prior to that time, especially if you are happy with the results achieved after all the swelling has completely resolved. 
If at that time you decide you still want to undergo a revision operation, it is no small feat. Though some surgeons would say they can achieve your goal via a closed technique, I would argue that the open approach is more effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look, particularly in a revision operation. To address the upper 1/3 and middle 1/3 of the dorsum, assuming they remain prominent after the swelling fully resolves, you are talking about taking down the bone (upper 1/3) and cartilage (middle 1/3), which cannot be done effectively with just rasping. 
Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision operations are much more difficult than primary operations. Regarding cost, every surgeon charges a different amount, and this varies by location- generally revision operations are more expensive than primary operations because of the added complexity of these cases. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible. 
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photo and description provided, especially since we do not know how things will look after all the swelling resolves. If at that time, you are interested in pursuing a revision procedure, I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps! 
Best Wishes, 
Dr. Donald Groves 
Plastic Surgeon

Revision rhinoplasty or nose rasping after rhinoplasty? Self-conscious on my side profile. (photo)

Answers (1)

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