How Difficult is Rhinoplasty Revision for Tip?

I had a Rhinoplasty where a slight bump on the bridge of my nose was shaved down and the extra cartilage that was removed was shaped and inserted into the tip of my nose to fill out very small natural depressions. The result left the tip of my nose feeling hard/unnatural and looking a bit bulbous. I'd like to have the cartilage removed completely (replaced with Radiesse). How difficult will this be, can it be done with local anesthetic, and what cost should I expect? Also what will recovery be like? Thanks!!!

Doctor Answers 7

Tip revision

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Tip revision surgery is rarely easy and It is difficult to answer your questions without seeing your photos or examining you – it would be very helpful to post images showing your areas of concern


Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Revision rhinoplasty for nasal tip

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It is very bad idea to remove cartilage from the nose and replace it with Radiesse. Do not undergo this lightly. Injectables into the nose have been fraught with multiple complications including areas of necrosis at the nose tip. Do not have the surgery just to make the nose feel softer. If there are irregularities or bumps, this can certainly be addressed through revision rhinoplasty surgery of the tip, which in and of itself is a very difficult and complex operation. This is also done under general anesthesia, not local anesthesia, and recovery from this will take a full year to see the beneficial effect of the revision tip plasty.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews


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It is not vert difficult to do this. I will approach my old surgeon and inform him or your concerns. He will be able to shave some of the extra cartilage or replace it with a smaller one. It does not make sense to remove it and then use rafiese.

Radiesse is not a replacement for cartilage

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I would need to see photos of your nose and more information about what is done. Your plan to remove cartilage and replace with Radiesse could injure your nose to point where it might be repairable using standard rhinoplasty techniques. Start with the surgeon that operated on you. If you are not happy with the answers then consider second opinions. Experiencing problems after a rhinoplasty is common and very frustrating for the patient. I wish you good luck with your quest to have your problem corrected.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Noses need to settle and soften for up to two years after revision rhinoplasty

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Scar tissue can persist for up to two years as the tip of the nose softens after revision rhinoplasty. Sometimes grafts use can remain firm but as long as the nose looks good, it is less important. I suggest you see a revision specialist before considering any further surgery on your nose. Fillers, including Radiesse do not work well in the tip of the nose. The are better for small dents and to balance the profile.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews


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Secondary rhinoplasty are more difficult than primary rhinoplasty.

Cartillage grafts should be used sparingly and with expertise, because the will show evantually.

To remove the cartillage is not easy. Radiesse is Not the best alternative. It is not permanent and require expertise each time it is injected.

See A board Certified Plastic Surgeon for your revision

Samir Shureih, MD
Baltimore Plastic Surgeon

Nasal Tip Revision

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You ask many questions, but don't mention how long ago you had the primary operation. After dicussing this with your surgeon, wait up to one year for swelling to resolve. If the revision is limited to the tip, local anesthesia is reasonable. The tip cartilages can be removed, but I do not recommend Radiesse which will require supplemental injections every 12-18 months. During surgery the tip cartilages can be reduced or modified.

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

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.