Revision rhinoplasty was botched or is this as good as he says? (Photo)

Question

Had revision rhinoplasty 4-5mo ago for a pinched tip & breathing issues. Now I have a S or C curve, asymmetric points on the tip, cartilage @45° angle at the tip, and irregular nostril openings bc one side healed w a depressed scar & other healed by 2nd intent. I'm not happy but he's happy w results. He also says depressed scar side is lower that L & nose curve is due to muscle asymmetry when smiling- but not smiling in these pics. Any thoughts on what can/should be done or not? Thank you.

Lexie Wang, MD · Answer

Hi dog momma. First of all, you are definitely still healing if you are only 4-5mo out of surgery. The nose has a lot of ways it can still change. That being said, a lot of your complaints are relatively minor. I would see if other people like friends/family/colleagues notice it. I personally do not think this is worth the risk of undergoing yet another revision rhinoplasty for several reasons: (1) each time you open the nose, you're at risk for ischemia, which your tip already looks like it is experiencing; (2) each time you operate on the nose, you increase the risk for irregularities/asymmetric healing and so it might even get worse than how it is now. Of course only you can make that decision whether the risks are worth it but to me, I see very little subtle things that you are worried about that are not the worth the risk of those two above. Good luck!

Jennifer Goodrich, MD · Answer

Revisions are never easy. I do appreciate the curvature of the dorsum you mention, but always important to take it in context of what it looked like before and after initial surgery. Especially in revisions, it can take even longer for everything to heal/settle down. I would recommend continuing to follow up as scheduled and re-assess when you are 1 year out from this most recent surgery. You may be surprised how your nose will continue to change over the next 7-8 mo. Hang in there!

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