Is It Possible to Reduce Nose Bridge Height and Bring Tip Back Up After Rhinoplasty?

Hello,

Revision rhinoplasty is certainly more challenging than a primary operation. It should be performed by someone with expertise in Rhinoplasty. In your area, I would recommend Dr. James Ridgway in Seattle.

Best wishes,

-Dr. Asaria

Unfortunately the revision rate in Rhinoplasty ranges from 5% to 15% in the medial literature. The people publishing these articles are doing the most rhinplasties, so imagine the rate for doctors who only do this procedure occasionally. Grafts can be remove and nasal tips both raised and lowered to achieve a more attractive nose.Want your old nose back? You can't go backward, only forward and restore a more attractive noses.  When patients ask me to restore their old noses, they usually don't really mean that; they only liked their old nose better. I like using computer imaging to simulate potential changes in revision Rhinoplasty.

Removing onlay grafts and shield grafts (probably that's what was used to derogate your tip) are some of the easier things to do in revision cases. Lifting a tip up is also not particularly difficult.

Revision cases in which reversing aggressive tissue removal tend to be the most difficult kinds; especially if a deviation still persists.

If you find an experienced surgeon I'm sure you will obtain the change you are seeking.

All the best.

It is certainly possible to remove cartilage grafts placed in the nose and lift the tip by having revision rhinoplasty surgery. I would suggest you find a surgeon who offers computer imaging so you can see the possible changes that can be made by surgery. Also bring old photographs with you and describe what you liked and didn't like about your first nose.  I would recommend getting more than one opinion and see which surgeon best understands your surgical goals..

This revision requires a surgeon who has a great deal of experience to prevent an even worse nose after the revision. Talk to actual patients that the surgeon has done as well as photos.

It should be possible to remove the cartilage graft on your bridge to bring in back down.

Returning your tip to a more rotated position should be possible. How straight forward this will be depends on how your prior surgeon brought it down in the first place. Having your prior operative report available is helpful in this regard.

To find the right revision rhinoplasty surgeon for you I would recommend reviewing a potential surgeon's website and research the before and after rhinoplasty photos there to get an overall sense of whether you like that surgeon's aesthetic. It is also important to find a surgeon who is experienced with revision rhinoplasty surgery and who you trust and are able to communicate well with. In some cases this dialogue can start with having your potential surgeon review your photos via email so that you can get a preliminary assessment.

Is it possible to reduce the nose bridge height and bring the tip back up after rhinoplasty? 
It is unfortunate that you have to undergo rhinoplasty for the second time.  The old cartilage grafts can be removed to bring the nose back to its original position.  The tip can also be lifted up but that will depend upon what techniques were performed at the time of the rhinoplasty.  It is important to find a surgeon who has performed thousands of rhinoplasty and revision rhinoplasty surgeries.  It is also important to have excellent repoire with your surgeon on this second endeavor.  Have the surgery performed in a certified surgery center and be put to sleep by a board certified anesthesiologist. 

You can have the grafts removed or thinned and the tip elevated. It may look similar but it will never exactly be your old nose due to surgery and scar tissue. You need to think carefully about this. I am presuming that building up your nose with ear cartilage was a plan that you agreed to and were on board with for your first surgery. The desired result was achieved but you have changed your mind. This is not something that you can keep redoing without consequence. Once you have your old nose will you want a different modification?

It is troubling to get a nice result, yet from the patient perspective, find that the 'old' nose was the better look. Revision can remove the grafts and work backward to your old nose. With scar there are uncertainties as to just how close you can come, though computer imaging should be must to help to see where you are going before you get there.
Best of luck,
peterejohnsonmd

First,  I would discuss your concerns with your surgeon. Hopefully you can come to an agreement about how your nose was changed, what your like and what you don't.  Think carefully about secondary surgery for only a minor change, as reentering a surgical field can sometimes cause some scarring and unpredictable healing.

Fortunately, removing a graft and tip shape changes are common parts of secondary rhinoplasty and can usually be accomplished.  The tip rotational changes may be more difficult to undo, dending on what was done during the first operation. Seek the advice of your surgeon and some other respected opinion(s).

 

Good Luck!