Preservation Rhinoplasty Revision

Hello and thank you for your question. I have done many revisions in this setting after prior preservation rhinoplasty. It is safe when good technique is used. Nasal tip deprojection is an extremely important aspect of your revision as well based on your description. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

In our opinion, when a rhinoplasty is under done, that is a better situation to be in, compared to somebody who has too much bone and cartilage removed. Perhaps the doctor that you met was not comfortable with Revision rhinoplasty surgery in general. If you could get a copy of your operative report, it might be helpful for your neck surgeon. Wishing you well moving forward. Sincerely Dr. Joseph

Unfortunately, what you describe is not uncommon. Deprojecting a nose seems to be something that many rhinoplasty surgeons have inadequate training for. But in expert hands, it's one of the more predictable changes to make, even in a revision. The woman whose before and after photos I posted with this answer had a very projecting nose pre-operatively.

Having a previous preservation rhinoplasty would not necessarily make the revision impossible. It might be more difficult than a "classic" revision, but a good examination before surgery would most likely give the surgeon the information he needs in order to make a good call about whether to proceed and what the realistic expectations are.

Preservation rhinoplasty is a newer approach to Rhinoplasty. In my opinion, its an incredible misnomer because its implies a minimally invasive technique and it really isn't. Most likely you can have a revision, but quite a lot more historical/ surgical detail is required and you definitely need to see a Surgeon who focuses on Rhinoplasty.