Revision Rhinoplasty Using One Nostril Only?

I've had my first rhinoplasty over 6 months ago. During the healing process my tip downturned so I went for a revision. My doctor performed the revision rhinoplasty using one nostril only. Why was that? Was it to avoid extra scarring on the other nostril? Or because there was no necessity to use both of them for the surgery? I had a small bump on the end of the nasal bone and a downturned tip. Thanks

Doctor Answers 4

Revision rhinoplasty using one nostril

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     I suspect that during the healing process after your first surgery, you've lost some some tip support and dorsal septal height which are structurally crucial to the external shape of your nose. This can happen when the septal cartilage is weakened from excessive over-resection during surgery or trauma or both. The cartilage may also reabsorb due to unrecognized septal hematoma or an infection.  It may take several months or even years until these structural changes can become evident.

   Sometimes, surgeons can use small incisions strategically placed inside your nose, in order to perform minor adjustments or revisions after initial surgery and this could be done through one nostril. However, the deformity that you describe usually requires a bit more extensive approach and may require reconstruction with  additional cartilage material harvested from either ear or rib. Sometimes there is enough residual septal cartilage left in order to perform the repair. 

Tacoma Facial Plastic Surgeon

Revision through one nostril

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With what are describing it sounds like you needed (and hopefully received) a columellar strut graft - this can be placed through an incision on just one side.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Revision rhinoplasty

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Dear W_DC,

This question would be best answered by your surgeon.  My guess is that he felt that the asymmetry was best treated by revising one side.  It sounds like he is on "your team" and wants to make you happy.  If you have any questions about a procedure, I am sure your surgeon would be happy to answer them.

As plastic surgeons, our priorities lie in making our patients happy and feel like they are being taken care of.  So, if you have questions, or are unhappy, let him know.  Coming from a surgeon's point of view, we would rather hear about it, than not know about it.


Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Revision Rhinoplasty

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It is difficult to say what exact procedure you had done by the description. If I were to guess I would state that your physician must have felt that the deformity that you had was treatable through a small unilateral incision. I would go back to your surgeon and discuss your concerns and hopefully he/she can answer those questions for you. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 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.