Problems Became Worse After Revision Rhinoplasty

I had Revision Rhinoplasty on May 4th. It seems that the problems that were meant to be corrected are now only exaggerated. My septum is still leaning SEVERELY to the right and the tip of my nose is still round and hard on the left side, which shows when my head is turning slightly to the left. But it's smooth when my head is turned to the right. I had a closed rhinoplasty and the incision was made on the right side of my nose. Is this likely to correct itself? Please don't say in time.

Doctor Answers 3

Revision Rhinoplasties require more time to heal vs. Primary Rhinoplasties

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Revision rhinoplasty is probably one of the more challenging procedures we perform, and it requires a skilled surgeon who not only understands your anatomy, but understands what was previously done and what your goals are. In general, I find that patients need more time to heal and see the final result after revisions, up to a year or more. This is the reality, and any attempt to perform another procedure on you prior to that would not be a wise choice in my opinion. That being said, I have not seen any photos of you or personally examined you, so it is difficult to know what your options are.

My adivice would be to stay in close contact with your surgeon-- part of our jobs is to help our patients in situations just like these, to offer reassurance, and to get you comfortably through the healing process. If after a year, you are still unhappy, seek out a plastic surgeon in your area with rhinoplasty experience who can accurately assess what needs to be done.

Good luck,

Dr. S

Healing is a biologic process that is not 100% predictable

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Without photos and knowing the details of your injury and intraoperative details, it is impossible to say.

Scar tissue and swelling bulds up and settle down over a period of months to years. You may not want to hear in time, but that is the reality of heaing.

The only way to definitively straighten a nose is to rigidly fix it to counter the effects of healing and scar contraction. This would likely take grafts from either the ear or ribs or skull or hip bone. It can be a major procedure and there is no guarantee that it will be absolutely straight.

Realistic expectations following revision "rhinoplasty"

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A few points:

First, "in general" one must be careful about timing with respect to doing revision rhinoplasties. In your case, IF you were to have yet another procedure, this would be considered a "tertiary" rhinoplasty. The problem is that your nose is still healing, and in fact the tissues are VERY ACTIVELY going through the healing process assuming that May 4th was several weeks ago - 2009. So except for minor revisions, most surgeons would not consider performing your tertiary rhinoplasty (if needed) for many months.

Secondly, a "septorhinoplasty" is the procedure which corrects both the septum and the nose. If you truly just had a "revision rhinoplasty" and your septum previously had been crooked, then a "rhinoplasty" (without septoplasty) would NOT have straightened the septum. To best answer your query, a surgeon would really need to know more details than you are providing.

Thirdly, and finally, the RealSelf forum is a wonderful tool, but the nuances you are describing with respect to your nose probably cannot be accurately answered by anyone unless they actually examine you. I would strongly advise actually seeing someone "in person" so that you can review your concerns, and so that they can review details of your two surgeries and make appropriate recommendations.

David W. Stepnick, MD
Cleveland Facial Plastic Surgeon

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.