2 years since revision rhinoplasty - Could I have open roof or inverted V deformity? (photo)

Question

I am trying to understand why my nose looks like this after 2 rhinoplasty’s from the same surgeon. Is this an open roof deformity or an inverted V deformity? I My surgeon claims it is scar tissue and selling and will not help more. I feel botched and don’t know how to fix this. Would he give me my money back if it is a deformity? it’s been 3 years since my original and 2 years since my revision

Steven M. Denenberg, MD · Answer

On your right side, it has aspects of an open roof, but on the left, it looks as though something's just wrong with the position of the bone. Although, yes, it could be scar tissue as well. It does not look like something you should have to live with.

But beyond that, no offense, it doesn't look like an exceptional result. The tip looks wide, and the bottom of the tip droopy. If you have another operation, it would be good to address *all* areas of the nose that you don't think are great, rather than just one. These things we see in the one photo should all be significantly improvable.

How *much* to change the bones, or modify the tip, and what would all that look like in the other views of the nose as well? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs -- especially the tip work, and the fact thats it's a third operation -- require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. Though, in your case, I think the answer is obvious.

Gianfranco Frojo, MD · Answer

I would have a very honest conversation with your surgeon about what your outcome. I would bring in  your concerns on printed out photos so you can readily show what you are seeing. If you are not able to have a similar opinion of your outcome with your surgeon....I sometimes recommend finding another American Board of Plastic Surgery Certified Plastic Surgeon. I would recommend finding one with experience in rhinoplasty. A second opinion can sometimes provide a fresh perspective on the situation and provide new advice that may be beneficial This is a challenging thing to answer over the internet without a physical exam and in person discussion.

Philip S. Schoenfeld, MD, FACS · Answer

I am not certain that this is a true inverted V deformity but there are certainly some dorsal irregularities which can certainly be corrected.  I would suggest asking your surgeon if they might be able to correct this for you.  If you have lost confidence in your surgeon then you may need to move on.   I can't speak to whether or not you will get your money back 2 years after surgery.

2 years since revision rhinoplasty - Could I have open roof or inverted V deformity? (photo)

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Everything you need to know about Revision Rhinoplasty

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2 years since revision rhinoplasty - Could I have open roof or inverted V deformity? (photo)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.