Considering a revision rhinoplasty for 2nd time. My nose has no shape to it. Thoughts? (photos)

Question

first rhinoplasty in 06' age 28, was very happy with results. By 13' the tip had enlarged and looked very wide when smiling. Had revision by same surgeon in 14' at age 36. He shaved center down, lifted tip, and brought sides of nostrils inward. I have not been happy since and considering a revision with a different surgeon. I like the look of a nose that is thinner in the middle. My nose has no shape to it and just straight all the way down. There is also a bump on one side so it looks uneven.

Nima Shemirani, MD · Answer

Hi @raelynn36. I recommend seeing a revision rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. Rib harvesting is sometimes necessary in revisions if the septum and supporting cartilage of the nose have been weakened. This will give more strength and support to the nose. Best of luck, Dr. Nima!

Tanveer Janjua, MD · Answer

Unfortunately you have thick skin which makes it very difficult to get the fine shape you want. You are better off just getting the left sided hump shaved and leave the rest alone.Regards Dr J

Thomas Trevisani, MD · Answer

From limited photos- it appears that your nose can be improved with Revision Rhinoplasty-Preferably performed through a closed technique. It would helpful to see pre-op photos- as well as reading the op-report. Keep in mind that Revision Rhinoplasty is a challenging procedure that needs to be performed by an experienced, skilled and talented Surgeon.

Tarek V. Copty, MD, FACS · Answer

Dear Raelynn, 
I would suggest that you seek consultations with some experts in the field of revision rhinoplasty to discuss your objectives and goals. In reviewing your photographs it does appear that refining and reshaping your nose with revision surgery will help feminize your facial aesthetics. During your consultation have imaging performed to show you realistic proposed results of what surgery can provide. The imaging should take into consideration your nasal anatomy and previous procedures. This can help you make an informed decision. 
Best regards,
Tarek V. Copty, MD FACS

William Portuese, MD · Answer

When performing rhinoplasty for the third time, it's very important to have specific goals in mind on exactly what you're trying to accomplish. The bump on the side of the nose can certainly be shaved down.  It is Very important to have realistic expectations, especially when there's thick skin present in the tip of the nose. A thorough internal and external examination is going be required to make  a determination about how best to proceed with a very difficult procedure

Michael Elam, MD (retired) · Answer

Dear Raelynn, You do appear to have a dorsal hump that can be addressed and your nose can be refined to a more feminine appearance. It is important to have very realistic goals when having a tertiary rhinoplasty as your nasal anatomy has been altered and you have scar tissue formation. Discuss your desired nose with your surgeon and he/she can tell you if these changes can be accomplished with revision surgery. For further information see the link and video attached. Best regards, Michael V. Elam, M.D.

Considering a revision rhinoplasty for 2nd time. My nose has no shape to it. Thoughts? (photos)

Answers (6)

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