Am I a good candidate for revision rhinoplasty? (photos)

Hi @a.anne! Thank you for sending your photos. I recommend seeing a revision rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. A rhinoplasty in my opinion is one of the most difficult procedures to perform. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of Luck, Dr. Nima!

Thank you for submitting your question and photos. Being that your initial surgery was two years ago and you’re unsatisfied with the results, you are likely a candidate for revision. Removing bumps through nasal rasping can be done during revision rhinoplasty. The tip can also be lifted and refined as necessary to create balance with the rest of your facial features while addressing the indentation you’re referring to.
Since each subsequent nose surgery becomes more complex due to the loss of structural support and scar tissue, the importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon with expertise in rhinoplasty techniques. They will be able to review your surgical history and aesthetic goals to determine the best approach.

You have that bump on the bridge, of course. When a bump comes down, that change often makes the nose *look* longer, as though the tip had drooped. So it's important to elevate the tip as well. Elevating the tip in a revision is a complex procedure, but in expert hands it's actually one of the more predictable changes to make, even in a revision.
How *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

I'd love for you to see some excellent morphs of what could possibly be done with your nose. It might make you feel better about the possibilities and help you plan your ideal goal.
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations.