Need Revision. What Needs to Be Done? Can It Be Fixed?

Five year ago I had surgery to correct a deviated septum/breathing problem. I always had a large nose and had a bit of a hump as well. The main goal was to correct my breathing but the doctor also claimed he could "finesse" my nose to provide more definition and aesthetic improvement. He raised my tip.My main issue is now the tip. It appears twisted, with the right side much fuller and harder than the left. I don't want a tiny nose, but wish it could be more symmetrical. Can I be helped?

Doctor Answers 11

Revision rhinoplasty for tip issue

Rhinoplasty can be a challenge for the most experienced surgeon.  Further, the tissues can shift with time.  Of course one needs to take a full set of proper photos and examine you to make a reasonable conclusion.  As I look at your one photo, ti looks like there may be room for improvement.  Best to go to a couple of  surgeons with a large experience with re-do rhinoplasty surgery.  They will be best to ask about your goals and see if they are anatomically ans surgically possible. 

Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

Suggesting a change in the appearance of the nose when the complaint is functional is unethical.

First, I am disappointed that a surgeon would suggest a change in the appearance of your nose when your original complaint was functional. That's way of of line.

Now it looks as thought you need a revision, at least of the tip.  It is impossible to comment on the specifics without a close exam and a review of the previous op note.  Proceed with caution, a lot is at stake.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Need for Nasal Revision

The photograph is not clear, but the problems you describe can probably be improved. See an experienced revision rhinoplasty surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision Rhinoplasty to address the tip

An in-person consultation and examination would be essential.  However, based on your one photograph, it appears that you may benefit from a revision rhinoplasty to address your concerns.  It is likely that cartilage grafting would be needed.

Anurag Agarwal, MD
Naples Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Revision rhinoplasty

Based on the one view that you posted, there is some asymmetry of the tip. Revision rhinoplasty is an operation that requires careful, detailed pre-operative planning. This usually includes computer simulation so that you and your surgeon have the same expectations. I recommend that you see a Plastic Surgeon or Facial Plastic Surgeon with experience in redo rhinoplasty. Good luck.

Lawrence Iteld, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Nasal revision for tip asymmetry.

It is difficult to evaluate your nose from the photo. See a revision rhinoplasty surgeon for the best result. He can tell you if your goals are possible.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Revision Rhinoplasty of Nasal Tip

Hi JJ,

It appears that a well performed revision rhinoplasty can help you achieve your nasal cosmetic goals.  Choose your rhinoplasty surgeon most carefully. 

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Nasal tip scar tissue long after rhinoplasty

Dear Rhinoplasty patient from Hattiesburg, MS,
It is difficult to render a professional opinion without seeing all nose pictures or examining your nose. Based on this photo, there is significant excess tissue on the right side of the nasal tip, and columella deviation. Since it has been 5 years after your rhinoplasty, this indicates scar tissue accumulation on the right side of the tip. You are a good candidate for a revision rhinoplasty. A revision rhinoplasty specialist can help you to obtain your desired result. Good Luck

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 204 reviews

The asymmetry at the base of your nose and nostrils could be from a persistently deviated septum.

I read your concern and reviewed the photo you posted. I can't appreciate the tip asymmetry you mention, but it's clear that your columella is tilted, and your nostrils are uneven. Well-performed revision rhinoplasty surgery could lead to improvement in the appearance and function of your nose. You could consult several reputable rhinoplasty specialists to see what could be accomplished with revision rhinoplasty surgery. You could check for a list of board-certified specialists near you.

I hope this is helpful.

Regards from NJ

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Revision Rhinoplasty: Choose an Experienced Surgeon

With only one photo, it is difficult to give you a real sense of the complexity of the revision procedure.  Your photo suggests that there may be some significant damage to the tip cartilage on the left as well as a retraction of the columella (the center strut of the nose).  Both of these are challenging and should be tackled only by an experienced revision rhinoplasty surgeon. 

Joseph Campanelli, MD
Portland Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.