Revision Rhinoplasty Advice?

I had Rhinoplasty 18 months ago. About 6 months later, I loved my new nose. Now, I'm worried as the left side of the nose halfway is much more raised than the right, a lot more like a bone raised. I can also feel a dip in the middle of the bridge, then it flares out to the tip. So now, the tip looks a lot wider. I remember feeling it after surgery and it was perfectly straight. I read that revisions are very difficult. I do trust my surgeon, but what could happen after the next surgery? Any advice?

Answers (6)

From your description, it sounds as if the middle third...

From your description, it sounds as if the middle third of the nose, called the middle vault, is starting to settle. Depending on your anatomy, looking at bone length and cartilage structure, spreader grafts may be needed to help this issue. Revision rhinoplasty is one of the more difficult procedures in facial plastic surgery. In my experience, there are only a few people in each city who perform consistenty good revision rhinoplasty. Many doctors who perform primary rhinoplasty, will not want to perform the secondary or revision rhinoplasty.

Rhinoplasties are difficult surgeries, revisions are even more difficult

Revision rhinoplasty is one of the hardest surgeries that a plastic surgeon can undertake. Scar contracture, graft alterations, underlying anatomy, missing tissue are just some of the challenges that a facial plastic surgeon has to face. Sometimes, the correction can be easily done. From a very superficial standpoint, without looking at your nose, your raised bony area can be filed down and that may be an easier thing to do.

The dip can be filled in with cartilage that has been morselized or diced down so that you can place it in the area of dipping. There are other products that can be used to fill in the area including fat. But I would really have to see you to fully comment on the revisional approaches that I might be considering.

Consulting a board certified Facial Plastic and Reconstructive Surgeon would be something that I would highly recommend. We specialize in the face and neck so we are ideally suited to help you in this area.

Speak to your surgeon

Without seeing your face and feeling your nose, it would be difficult to comment intelligently. You sound like you are describing an inverted-V deformity. Your surgeon can speak with you about your concerns and, with your assistance, come up with a reasonable plan to fix the problem. Revision rhinoplasty can typically be difficult but if it is well-planned can be executed effectively. Go back and speak to your surgeon.

Best of luck.

Return to your surgeon and see what he says.

Without seeing the nose it is difficult to say what would be needed. From what you say it sounds minor. If you are not satisfied with the answer of your surgeon seek a second opinion. 

The key point is that you trust your rhinoplasty surgeon...

Hi London,

The key point is that you trust your rhinoplasty surgeon.  Discuss  your concerns with your surgeon.  Revision surgeries, though usually more difficult than the initial surgery, are for the most part very successful.

Good luck and be well.

Dr. P

If you have trust in your surgeon and it seems that you...

If you have trust in your surgeon and it seems that you had a successful outcome initially, you should have him/her examine your nose and see what the problem may be. Revision surgery can be hard, but it should always be easier for the original surgeon to perform. Your problem may be easy to solve, but a proper examination by your surgeon is the best advice I can give you at this point. I hope that you are able to resolve your problem to your satisfaction.

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.

Ask a Provider

Get personalized answers from board-certified doctors.