Is Revision Rhinoplasty Feasible for Me? (photo)

Had open rhinoplasty 15 yrs ago and have always been disappointed with the results. The surgeon didn't address my request for less projection, did not touch the tip/nostrils at all, only refining the bridge. I'd like: less projection, less bulbous tip (if poss. sharper tip), higher columella. I've also recently noticed a slight asymmetry which has started to develop between my nostrils which I'd like corrected. Based on my photos, is this feasible for me with a revision?

Doctor Answers 6

Correction of Hanging Columella and Bulbous Tip with Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for the excellent question and photos. In my opinion, you could certainly benefit from a revision rhinoplasty to address your concerns. The columella could be raised by suturing it to your septum with 1-2 permanent sutures, what's called a tongue-in-groove technique. This can also help set your tip projection. The tip can be refined by a combination of suture techniques, including individual dome-binding sutures and horizontal flattening sutures. Interdomal sutures to bring your tip cartilages closer together may also be helpful. Small cartilage grafts (taken from your septum) could also be used to to support your existing tip cartilages, if needed.

I would favor an open approach for your surgery, as the tradeoff of a tiny, very inconspicuous incision between the nostrils gives me much better access to the tip cartilages. You should definitely consult with a few surgeons who specialize in revision rhinoplasty. Computer imaging may be helpful during your consultation to help ensure that you and your surgeon are on the same page in terms of aesthetic goals.


Dr. Mehta

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 52 reviews

Revision rhinoplasty for bottom heavy nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 A revision rhinoplasty is acceptable to undergo to make  the refinements you have requested. Revision rhinoplasty in this nose would accomplish: decreasing the projection of the tip, tucking in the columellar show, narrowing the tip, And reducing the the fullness  in the supratip area. Please see the link below for similar noses we have trimmed back the excess columellar show.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Is Revision Rhinoplasty Feasible

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I strongly suggest that you consider a revision rhinoplasty to narrow the base of your nose, raise the columella, and reduce the fullness above your tip. I would need to examine you before recommending a decrease in the tip projection. The appearance of your nose can be significantly improved.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty to improve tip

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It's hard to say without an exam but you could certainly consider revision rhinoplasty to address the concerns you have with your nose. I can see that your columella is quite prominent. This can be moved upward somwhat to help create better balance.

At the same time you could create a more refined tip and deproject it somwhat.

You can read more about hanging columella repair at my web reference link below. From there you can also read about tip tip refinement, etc.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello, and sorry to hear you are not happy with the result of your initial surgery. An exam would be necessary to provide you with the best possible advice. But looking at your photos, it does appear you would benefit from revision rhinoplasty.  I would recommend seeking the advice of an experienced revision rhinoplasty specialist. They may use computer imaging software to morph photos of you and give you an idea of how the final result of surgery may appear. I hope this helps, and I wish you the best of luck.

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Though it is difficult to say without being able to examine you in person, from your photos it does appear that you would benefit from a revision rhinoplasty. Because your initial surgery took place so long ago, newer and more advanced techniques have developed that can provide you with a pleasing aesthetic result. I recommend scheduling a rhinoplasty consultation with an experienced facial plastic surgeon.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 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.