Collapsed tip, significant asymmetry, inverted V with no dorsal contour or bridge - Is revision a bad idea? (Photos)

It is true a comprehensive and high difficulty revision (8/10 complexity scale) like yours is a risk... that can be minimized by choosing a reliable, experienced and talented surgeon with passion for long procedures on great challenges.

You have, indeed, open roof and inverted V deformities, there were no efficient osteotomies (infractures) and hence you have open roof and the middle vault has collapsed in V fashion; this is a must-treat (fractures, spreader grafts, etc).

There are many irregularities at the tip, alar cartilages, nasal valve, alar retraction, etc, a full revision and likely a restoration / replacement of some elements with your autologous grafting might be needed.

Can't comment on the profile and bridge due to lack of images.

Based on your photos, since you appear to have freckles, that is consistent with relatively thin nasal skin. We can also see a wide, and asymmetrical nasal tip appearance, with collapse on the left side when you breathe in. In general, issues like this, where there are both functional and cosmetic concerns, may require revision rhinoplasty surgery. Please consider meeting with several reputable rhinoplasty specialists. I hope this helps. Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. Extended spreader grafts can be placed to treat the inverted V deformity. With good surgical technique, you could have an outstanding result. 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