What Exactly Would my Revision Rhino Require? Is It Straightforward? What Are the Costs?

Question

Wanted refinement of wide tip & slight narrowing. Changes were slight enough that many people havnt noticed (which i wanted) but I was more attractive before. old nose had natural cute flick to it, i didnt want profile changed. Now my flick has gone, my nostrils are more retracted and look even bigger and i feel my columella hangs especially when i smile. at 23 it's made me look older, & lack of tip projection looks 'nose-jobby', i feel. would second op make the nose more natural and feminine?

Thomas A. Lamperti, MD · Answer

The changes to your columella and ala can be addressed with revision surgery. Also, your tip projection can be improved as well. This would likely help with some of the nostril enlargement you're noticing as well as creating a supratip break. It's not clear how long ago your initial surgery was, but you'd want to wait about a year before having a revision procedure.

	Additional photographic views would help provide a fuller assessment. Revision tip work is relatively more complicated, but not impossible to do.

	Surgery costs vary widely depending on the region of the country, surgeon experience and surgery length. About $7000 plus operating room and anesthesia fees would be an average cost.

Sam Naficy, MD, FACS · Answer

Based on your photos it appears that you have slight hanging of the columella and alar retraction - both of which can be corrected with revision rhinoplasty

Guido P. Gutter, MD · Answer

Your surgeon achieved what you wanted: Refinement of the tip and narrowing of the nose in a subtle way. But "subtle" tell-tale signs of a rhinoplasty are often :Loss of tip projection and slight retraction of the nostrils.

	As Dr.Schwartz mentioned grafting can improve this. Predictable and subtle "refinement" in a secondary Rhinoplasty is best done by an experienced Surgeon devoting a majority of his practice in (secondary) Rhinoplasty. I am sure there are some very good surgeon in your area: Jack Sheen,MD used to be one.

	Every time you have surgery on your nose the results are less predicatble, the resolution of swelling longer etc.

	Do your homework, find a surgeon very experienced and think the revision to be the last procedure on your nose (in other words: Go for a home run!).

	Good luck

Michael L. Schwartz, MD · Answer

you hav lost some of the shadowing that you had before as well as some of the projection. You can improve the rim retraction and projection with grafting and not have to have a full revision procedure.

Richard W. Fleming, MD (retired) · Answer

Your nostril retraction and the hanging columella can be corrected and tip projection increased with a limited revision rhinoplasty. It iis not clear in the pictures you submitted, but it appears that there is narrowing in the mid-portion of your nose (the hour glass look) - do you have any breathing problems? An examination and/or more pictures would be helpful. My website provides instructions on how to take pictures for nasal evaluation. Make sure you select a surgeon very experienced in revision rhinoplasty.

What Exactly Would my Revision Rhino Require? Is It Straightforward? What Are the Costs?

Answers (5)