Revision rhinoplasty: too upturned tip & retracted columella, can it be brought down without rib graft?

Question

I am only 3 months post op from my first rhinoplasty (the plan was to remove the slight bump and reduce round bulbous tip) but I am gutted with the unnatural result. My nose is now too short and upturned, and columella has disappeared. I want my nose longer again, can the tip be brought back down without use of rib graft? My surgeon said my current cartilage was bad and almost translucent to work with. Do I have any hope of getting the length and columella back? Struggling to find UKsurgeon

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Thank you for your questions and photos. I'm sorry that you're experiencing trouble with your outcome. At 3 months, there certainly is time for the tip to drop some and swelling to settle. I often tell patients we need to wait 8-12 months before considering a revision as much will change. If you do desire a revision, you can make improvements to the rotation, length, columella, and tip. If your septal cartilage is gone, rib is the best choice because strong material is needed to hold the nose in a new position (ear won't really work). Donor rib is an option but can be expensive and is not for every patient. I would continue follow-up with your current surgeon if you're comfortable. Otherwise, seeking consultation with other surgeons may be a good choice. Hope this helps you!

Revision rhinoplasty: too upturned tip & retracted columella, can it be brought down without rib graft?

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