Continued swelling and lopsidedness. I had a revision rhinoplasty two years ago - do I need another? (Photos)

I would recommend a revision rhinoplasty. There are some irregularities of the bones and cartilages that cannot be fixed any other way. You need to be very cautious in selecting a very experienced revision rhinoplasty surgeon. Revision rhinoplasty is a subspecialty of aesthetic surgery alone.

Hello and thank you for your question. Based on your photographs, a revision may be helpful here. This can be designed to tension your nose and improve the symmetry of your Mid vault and tip refinement as well. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hi there,
Thank you for sharing your detailed experience — I truly admire your patience and commitment throughout such a long and difficult healing process.
From what you’ve described and based on the timeline, persistent swelling and asymmetry two years after revision rhinoplasty is no longer considered part of the normal healing phase. While minor residual swelling can last longer in some patients — especially with thick skin or large grafts — a firm lump at the graft site, visible asymmetry, and ongoing structural issues (like lopsidedness or dorsal irregularity) may point to something more than just swelling.
The area where rib cartilage meets the nasal bone can sometimes create contour irregularities or movement over time if the graft was not securely integrated or if scar tissue has developed unevenly. In some cases, these issues can be addressed with localized steroid injections, though you’re right to be cautious — in thin-skinned areas or with aggressive dosing, steroid can cause skin atrophy. However, when done conservatively by an experienced surgeon, it can be helpful for persistent swelling or scar tissue.
If the shape, support, or symmetry of your nose is still bothersome and continues to affect your quality of life or confidence, a second revision may be appropriate — ideally with a surgeon who specializes in complex or tertiary rhinoplasty cases. These procedures are delicate, but with the right approach and careful structural work, excellent results are still possible.
You’ve been through a lot — and your concerns are valid. Trust your instincts, and don’t hesitate to seek a second opinion from a surgeon experienced in rib graft revisions and structural rhinoplasty.
Wishing you clarity and confidence in your next steps,Dr. Mustafa AydınolPlastic, Reconstructive & Aesthetic Surgeon