2 rhinoplasties reverting to old nose. What can I do about this? (Photo)

Question

I had my first rhinoplasty 3 years ago. After surgery it was ok. But eventually within 2 months the hump was back and my side profile was not good. The same surgeon did a revision one year later and it was amazing. Here I am 1 year and 3 months after my revision rhinoplasty and once again my nose changed back to a better version of my old nose. It definitly is no where near as bad as it was but it is 100% NOT like it was after surgery or within the first 3 months. Normally noses get better. Help

Eric M. Joseph, MD · Answer

Based on what I'm seeing, it seems as though the tip of your nose has drooped after surgery, and this gives the appearance of a convexity along the bridge of your nose. Sometimes a droopy nasal tip can occur if there is not adequate cartilaginous tip support placed during revision rhinoplasty surgery. In that regard, a review of your operative report and an examination would be helpful. Wishing you well moving forward. Sincerely, Dr Joseph

Jeffrey H. Spiegel, MD · Answer

Yes, you've had bad luck. The soft tissue envelope of your nose is not behaving and we need to compensate for that by adjusting the underlying cartilage and bone.  This is correctable.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. This is why longterm results matter and you really need to carefully and critically evaluate your surgeon’s long-term results on their website. Based on your photographs, you are a great candidate for revision rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. With good surgical technique, you could have an outstanding result. 
Here is some general advice when considering surgeon selection for your next revision.  I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results. 
I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

William Portuese, MD · Answer

Since you're looking to perform a third rhinoplasty, you should seek out a rhinoplasty specialist with extensive experience, producing natural long-term results. You're also going to require an in-person consultation to figure out what is causing the problem, residual cartilage, or thick skin. Each one are treated differently. If it is simply thick skin, that's treated with a series of steroid shots over several months. If there's if there is residual cartilage, that needs to be surgically addressed.

2 rhinoplasties reverting to old nose. What can I do about this? (Photo)

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Answer: Two rhinoplasty is reverting to the old nose

Answer: Two rhinoplasty is reverting to the old nose

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Everything you need to know about Revision Rhinoplasty

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2 rhinoplasties reverting to old nose. What can I do about this? (Photo)

Answers (4)

Answer: Two rhinoplasty is reverting to the old nose

Answer: Two rhinoplasty is reverting to the old nose

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.