Can I restore my damaged nose to a normal and natural, in my opinion, state? (Photos)

Question

I had septorhinoplasty in 2020. The surgeon only promised to remove the hump on the bridge, but the results turned out to be very unpleasant.Also, my breathing problems got worse. I would like to know your opinion - how realistic is it to give my nose a natural and harmonious state (I tried to demonstrate it a little in photoshop -restore the bridge, lower the tip and nostrils, change the excessive projection)? I will be very grateful for your answer.

Man Koon Suh, MD · Answer

Thank you for your question. Lowering the tip height and reducing nostril showing is a feasible and realistic goal. For this, lower lateral cartilage realignment and alar rim graft should be performed, which is not a complicated surgery.The correction method of supratip sinking may not be determined based on these pictures. If the septal support is sufficiently preserved, it is possible with a simple cartilage onlay graft on the sunken area, but if there is a case of septal collapse, structural reconstruction using rib cartilage would be required.

Jonathan Kulbersh, MD · Answer

Thank you for your question and the photos you provided. Breathing issues can be corrected during revision rhinoplasty once the cause is determined. This may require straightening the septum, shrinking turbinates, opening nasal passages, or correcting a collapsed nose. During this procedure, the nasal bridge can also be built up and the tip defined to achieve the desired result. 
Each subsequent nose surgery becomes more complex due to the loss of structural support and scar tissue. Because of this, the importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon with expertise in rhinoplasty techniques. They will be able to review your surgical history, assess your concerns, and determine the best course of action to help you reach your aesthetic goals.

Walter Joseph, MD · Answer

Hi Morgiana! I think it is very realistic to improve the appearance of your nose to a more "natural" state that is proportioned and balanced to your face a bit better. This would likely require an open approach (incision across the columella) and cartilage grafting. Depending on how much cartilage your previous surgeon took from your septum at the time of your initial surgery, you may need ADDITIONAL cartilage (either from a cadaver or from your own rib).

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning! Sorry that you're experiencing trouble with your rhinoplasty procedure. Yes, a revision procedure can address the issues you're concerned about. Fixing the breathing would be a priority as well. This would involve careful inspection of the septum and internal valves to see what damage may have been created (if any). If no septum is left, rib cartilage would be a great option for support and structure. With thin skin, camouflage is often needed in the form of perichondrium or temporalis fascia to prevent excess show of irregularities and to create smoothing - especially at the tip. Seek consultation with another surgeon to learn more about what may be best. Hope this helps!

Can I restore my damaged nose to a normal and natural, in my opinion, state? (Photos)

Answers (4)

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