Can Revision Rhinoplasty Strengthen a Weak Nose and Resuspend Nasal Skin?

Question

My doctor broke and rasped my nasal bones, shaved down the septum too much and removed the distalend of the ULC.He also trimmed 4mm off the cephalic LLcartilage and sutured them together.My bridge and tip are now VERY thin (collapsed nasal valves),tip is upturned a little bit and the overall nose is too small and deprojected. I noticed that much of the skin that was supported by the big nose is now loose. Can a revision strengthen the weak bridge and tip as well resuspend the nasal skin?

Sam Naficy, MD, FACS · Answer

The features you describe can be corrected with structural grafting of the nose to improve both the appearance and function of the nose.

Thomas A. Lamperti, MD · Answer

Revision rhinoplasty can be performed to improve the support to the nose after a previous rhinoplasty. This is often done using cartilage grafting techniques. Enlarging the nose can help with the excess skin problem.

	It's not clear how long ago your surgery was. It can take quite a bit of time (at least 1-2 years in many cases) for the skin to redrape. Other variables are your skin thickness and age. Thinner skin shrink wraps faster than thick skin. Younger skin shrink wraps better than older skin.

Steven J. Pearlman, MD, FACS · Answer

Most often what we do in revision rhinoplasty is to restore or add structure and strength by using grafts of your own cartilage. This helps support the nasal soft tissue, including the skin and improve the nasal airway. You should seek a specialist in revision rhinoplasty to discuss your desires. It helps of you bring your operative report and old photos so your new doctor can see what happened and why.

Vincent P. Marin, MD, FACS · Answer

Without a photo it is very difficult to give you a specific answer, however, taking away too much cartilage from a larger nose can leave you with a small framework and too much skin.  It is always better to have a slightly larger, well shaped nose than a too small, unrefined nose. Thus, care must be taken in removing significant cartilage from even a large nose. Taking too much can leave you with the cosmetic issues you mentioned as well as breathing difficulties.

The treatment is a revision rhinoplasty with the use of additional cartilage to help rebuild the underlying structure and help restore form to the skin.  The cartilage can also help to rebuild the underlying airway and restore patency to your breathing.  See a surgeon with experience in this field as you do not want to have to undergo any more surgeries than absolutely necessary.

Best of luck

Vincent Marin, MD, FACS

Samir Shureih, MD · Answer

It depend on what needs to be done to the bridge. If you need a graft then the skin will redrape better. ou also need lots of work on the nasal valves collapse, with spreader grafts.

	Consult a reutable board certified plastic surgeon ( American Board of Plastic Surgery) and discuss the problems , how to solve them and what are the risks.

Can Revision Rhinoplasty Strengthen a Weak Nose and Resuspend Nasal Skin?

Answers (6)