I had nose reshaping done in Thailand in Nov 2010.Apparently from the medical report,the doctor did not diagnose or corrected my deviated septum so the nose appears in an S-curve frontal view.What are other nasal issues I need to be aware of and make sure are addressed during the revision.I am not sure if I can find a doctor here in Thailand who is highly experienced and skillful enough on western nose revision and may have to go to the US for this.The surgical report and pictures are attached.
Revision Rhinoplasty Advice Needed? (photo)
Doctor Answers 7
Revision rhinoplasty for wide, droopy and slightly asymmetric nose
There are multiple issues. According to the pictures shown, the nasal bones appear to be crooked and off center for which osteotomies will need to be performed. Bone and cartilage in that area will need to be removed to eliminate the hump and spreader grafts will need to be placed in the lower third of the nose to adjust the crooked nasal septum just above the tip.
There are several problems besides the nasal deviation that should be addressed with a revision rhinoplasty. You have a residual cartilaginous hump, narrowing if the mid portion of the nose which probably is causing breathing obstruction, an irregularity of the dorsal nasal bones and a bifid and asymmetrical tip.
Your photographs indicate that you would benefit from a revision rhinoplasty. The areas that need to be addressed are the following:
1. Nasal hump correction - it appears you have a Polly-beak deformity
2.Nasal tip needs to be rebuilt probably with a combination of cartilage grafts and fat augmentation
3.Correction of the deviated nasal septum
4. Correction of the upper lateral cartilages separation from the nasal bones
The surgery was performed over a year ago, so you may safely undergo a revision, but you need an experienced plastic surgeon to perform the procedure.
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Revision rhinoplasty should be delayed until you are at least a year out from your previous surgery. An in-office exam is essential.
How to address revision rhinoplasty concerns
You do have several contour deformities of your bridge that would need to be addressed. Your coluemlla also appears retracted and you have a persistent bump on your bridge. The main issue that needs to be addressed with a revision is to ensure the ultimate stability of your nose to make sure that your results persist.
I would recommend using an open approach (it sounds like your initial surgery was done using a closed approach) to best address your tip asymmetry. A septoplasty can be done at the same time as the revision rhinoplasty to improve your nasal airway and to provide cartilage for the necessary grafts.
The post operative views show multiple problems
1: The nasal tipis destroyed. Probably need reconstruction with grafts
2: nasal Hump correction
3: correction of seperated upper lateral cartilage from the bone
Good luck in Thailand
Revision Rhinoplasty Advice Needed?
Yes it certainly looks like you would benefit from a revision rhinoplasty. There are many things that need to be done, like revising the hump , tip reconstruction and possible osteotomies. You can send your pics throught the link website below and I can image them for you.