First rhinoplasty 2008 to correct dorsal hump. Disasterous results: roof collapse and bridge bump. Second rhinoplasty 2009 revision surgery results: rebuilt collapsed roof using available nose cartilidge; surgery time 3 hours.Now 2010 and 14 months post revision. Nose tip round and bulbous. Before 1st surgery, satisfied w/ tip. Want tip narrowed as before. Want nose nostrils narrower. Can a 3rd procedure achieve final results?
Can Third Rhinoplasty Procedure Succeed to Achieve Final Results?
Doctor Answers 8
Revision rhinoplasty is among the most complicated, and unfortunately common, procedures. I've operated to fix problems for people who are having their 7th or 8th rhinoplasty.
The key is in the diagnosis. The facial plastic surgeon you see should have experience in revision rhinoplasty and be able to evaluate you before surgery to identify what's causing the problem. Recovery (decrease in swelling, etc) may be somewhat slower after two previous surgeries, but with the right person (and a little luck) you should be able to receive excellent results. good luck!
Another revision rhinoplasty is possible
it is difficult to comment without seeing your photos - tip narrowing after multiple revisions is sometimes limited due to scar tissue and skin thickness
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Undergoing a third rhinoplasty for desired results
It is important to make sure you wait at least one year prior to embarking on a revision rhinoplasty. A
third procedure can indeed help improve the results from the rhinoplasty, but it is important to have crystal clear
expectations before moving forward between the patient and the surgeon. Make sure your surgeon is very well
versed and experienced with revision rhinoplasty and has performed thousands of
rhinoplasties and revision rhinoplasty procedures.
Third Revision Rhinoplasty
In the hands of an experienced revision rhinoplasty surgeon you can probably improve your appearance. Experienced surgeons will be straight-forward in establishing reasonable expectations. Previous pictures and operative reports will be helpful when you schedule your consultations.
A conservative approach is alwasy indicated in these cases
With you having had 2 prior procedures, the approach to take is a conservative one, focusing on the worst features and correcting them, while being sure to do no harm.
Sounds like the focus would be on some tip refinement to reduce some of the bulbousness (by removing likely a combination of scar tissue and possibly cartilage), and alar base reductions (narrowing of the nostrils).
One thing is sure- you need to go to a surgeon who has both confidence and experience in these tertiary procedures.
Rhinoplasty # 4? Maybe Yes. Maybe No
Sorry it has not gone well.
You must have some very thorough opinions from surgeons who are used to re-operating on noses. Be sure to bring all medical records and photos. If the surgeon has all the info, you get a more informed opinion.
To save time, you might send your current photos and at least get an idea if the surgeon feels he or she is up to the task. Not easy, but it has been done.
Robert Kotler, MD, FACS
Revisions can be tough, and certainly the more that are done the harder it gets. If you contemplate a third and are not going back to you previous surgeon, obtain the medical records to bring to the next doctor.