I still have a bump and I am disappointed as I think my surgeon was too conservative. Do I Need a Revision Rhinoplasty? (photo)

Hello Doctors and thank you for your help. 8 months ago I had an open rhino:my Dr. shaved the bump,refined tip and put alloderm on the dorsum.The options my PS is giving me (at the 12th month) are: get a revision or get a filler(that I believe will make my nose look bigger).Which way should I go?Also I would like to ask: do you think a revision is necessary or after all ''my nose looks good''? Thanks

Doctor Answers 10

Do I need a revision rhinoplasty?

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With rhinoplasty, less can be more. Being conservative with surgery is better than being aggressive, as it is much easier to perform a touch up to produce the desired result than it is to reverse the effects of an overdone surgery. I would be cautious when attempting to do improve the appearance of a bump with fillers. There are some risks from attempting to modify the appearance of the nose using filler, which is also known as a non-surgical rhinoplasty.  The most serious side effect is necrosis, or death of the skin.

Filler may do the following:

1) Mildly lift a drooping tip    
2) Improve the appearance of irregularities
3) Augment the nasal dorsum.

Only a small amount of filler may be used and it must be injected slowly to limit the above risks.  I would see a surgeon that is comfortable with these injections.

Keep in mind that the filler will only be a temporary solution, and may not lead to the result you are hoping for. Regarding whether or not a revision is necessary, the choice is yours. It really depends on your goals. If you are trying to decrease the size of your nose further, then filler may not be the best option. If you are not satisfied with your surgeon's recommendations, a second opinion may be a good option. I hope this helps, and good luck.

Do you Need a Revision Rhinoplasty

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Dear Natural Me, I would wait the twelve month period for all of your swelling to completely dissipate and at that time assess your happiness with your result. At one year post surgery I would then further discuss your options with your surgeon. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Need for Revision Rhinoplasty?

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Only you can decide if a revision is necessary.  If you want additional reduction surgery would be necessary. I don't see an indication for fillers in the pictures you submitted.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty

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Your new nose looks very nice but I do see the residual small bump. In my opinion, if you want to revise it, I would just shave the small bump and be done.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Factors influencing someone to have revision rhinoplasty

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Dear NaturalMe

Thanks for the photographs.   To answer your last question:  Yes I agree with you that your nose "looks good", so it is entirely up to you.

  •  The decision to move forward with additional procedures is based on the same reasons you sought a rhinoplasty in the first place.
  • Weigh the risks of additional procedures with your desired outcome in a short list, then compare and discuss with your surgeon.
  • Best Wishes

Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon

Do I Need a Revision Rhinoplasty?

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Based upon your photos and comments the ultimate choice is yours. It seems you are bothered by the residual bump on the bridge. I would tend to prefer re-contouring the nasal bridge surgically since you probably want it reduced some. However fillers can camouflage the bump, although temporarily.  Doctors vary as to when the will venture back into an operated nose. In your case is reasonable to wait it out a full year if the surgeon feels there is still some degree of swelling present. The Alloderm can take that long to fully resorb.  Best of Luck  Dr Harrell

Bump Following Rhinoplasty Surgery

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Your nose definitely shows an improvement overall. That being said, you will continue to evolve as time goes on and might even see more improvement. I would be patient and wait another 6 months before considering a revision rhinoplasty procedure. Even a slight amount of residual swelling in the tissues can make a visible difference in the appearance of the nose. Keep in mind, this is a game of millimeters. 

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

Revision Rhinoplasty

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  Thank you for including photographs with your question.  The decision to pursue revision rhinoplasty is entirely dependent on your goals for the procedure.  The patients that tend to be the happiest after rhinoplasty are the ones who have specific complaints about features with which they are unhappy. 

  If you are only concerned with a small bump on the bridge of your nose your surgeon presented 2 acceptable options.  A small amount of filler can be added to the bridge on either side of the hump, and although this does add volume to your nose, it also creates a visually straight line of the bridge which tends to be more pleasing then a hump.  Fillers are only temporary and this will need to be repeated in the future.   Alternatively, a limited revision rhinoplasty could be performed to straighten the bridge of your nose. 

  If your goals are to improve the bridge and refine the tip of your nose, that can only be accomplished with surgery.  That being said, revision surgery to refine the tip of your nose is a lot to go through.  You can expect longer healing times, more swelling, and at least another year of waiting for your nose to take shape and form.  I typically only recommend revision rhinoplasty for patients that are very unhappy and have specific features that they would like addressed.  If you are unsure of your motivation for a revision surgery it is reasonable to wait. 


Hope this helps,

Christopher Kolstad, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 59 reviews

Revision Rhinoplasty

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The decision for revising any surgery will depend on how satisfied the patient is.

You are asking a group of experts that can find many faults, the question is there any thig that bothers you not what bothers some one else.

Samir Shureih, MD
Baltimore Plastic Surgeon

Do I need a revision rhinoplasty?

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Thank you for the question and the before and after pictures. Although the shape of your nose after surgery is good, I still see the bump that you mentation. Your surgeon did use alloderm for the dorsum which over time tend to slowly resorb and gets thinner. This may improve the shape of the dorsum. I agree with your surgeon; wait for another four months or even longer. If the bump persist then get a revision rhinoplasty. I don't think filler is a good long term option. Best wishes.

Moneer Jaibaji, MD
San Diego 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.