Revision Rhinoplasty for Inverted V and Pollybeak, How Should this be Addressed? (photo)

Based on the pictures, how would you address my case? I have 14 months I got the 1st rhinoplasty and I'm really nervous about my 2nd procedure next month. the 1st was intended to reduce the overall size of my nose without changing my profile but after it I got polly-beak (probably because soft tissue and under-projected tip for lost of support) and what I see as a slight inverted V, which I think was present on my original nose but it is more noticeable after the osteotomies. Thank you.

Doctor Answers 8

Best Plan for Rhinoplasty Revision

Hi Yudy,   Thank you for your confidence in me.  Rhinoplasty is a procedure that is not only surgical, but requires an artistic vision for the shape of the nose that fits the individual's face.  Your questions and concerns are best answered in person following an in depth examination of your nose, and consultation including what bothers you, and what you would be satisfied with after surgery.   We can talk about inverted V's and polybeaks and spreader grafts, but it takes a combination of the artistic vision and surgical skill for success in rhinoplasty.   Your photos show that you are beautiful.  If it has been 5 months since your original surgery, you may wish to wait a full year before thinking about revision rhinoplasty.  Most importantly, choose your rhinoplasty surgeon most carefully.  Good luck and be well.   Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Revision for pollybeak

Based on your photos it appears that you would benefit from structural grafting to compensate for your thicker skin and correct the pollybeak

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Treatment of the nasal dorsum during revision rhinoplasty

Treatment of a the nasal dorsum can be achieved with nasal septal contouring  and possible spreader grafts to alleviate the dorsum problems you are experiencing.  A thorough discussion of your perceived improvement should be undertaken to determine the extent of cartilage shaping needed to achieve your desired result.  Rhinoplasty surgery can be a very gratifying procedure. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Evaluation for Rhinoplasty Revision

You have an inverted V deformity which can be corrected with spreader grafts. The pictures suggest you have short nasal bones, which could cause the inverted V, but this can be diagnosed with physical examination. You do have supra-tip fullness, a wide tip, and a hanging columella. This can all be improved with a revision rhinoplasty, but you must be patient post-operatively because your thick skin will prolong the healing process.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision Rhinoplasty - How to correct 'Pollybeak'

It looks like you would have benefited from narrowing of the nose from the frontal view. The profile was attractive as it was. At this point the tip needs to be better defined and projected and the 'V' could be improved as well. There are well known techniques for addressing each of these issues. You need an experienced nasal surgeon who understands your issues and has a plan both you and he can agree on. Best of Luck  Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

Goals should be clear for success in rhinoplasty

Your before pictures look pretty good, and it is hard to see what the goal was during your first procedure, though you now have fullness in the supra-tip, and a V on the bridge. The inverted V is caused by hump reduction, and collapse of the upper cartilages against the septum. We have a technique called a spreader graft which can correct the V. Look into the whys of the whole procedure though.

Best of luck, Peter Johnson, MD

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Addressing pollybeak deformity and inverted V

From the limited view your photos provide it does appear that improving your tip position would likely help with your supra-tip fullness. The inverted V appearance can also be address at the same time. An in person exam will allow for a better assessment of what needs to be done to improve your nasal aesthetics.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Revision Rhinoplasty for Inverted V and Pollybeak, How Should this be Addressed?

  IMHO, you should have a few in person consults if you're interested in a Revision Rhinoplasty.  The photos show a wide nasal bridge with possible open roof from the previous hump removal as well as increased subcutaneous thickening from scar tissue accumulation.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 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.