Multiple surgeries - Is there any way to restore my old nose? (Photos)

Question

I had my dorsal hump taken off when I was 17 but was left with a hanging columella. I was butchered by a dr in 2020 who left a bossae on the tip on my nose and made the whole thing look totally different. I didn’t know by asking to make it smaller that he would give me a new nose that was in fact smaller but botched. In 2022 i had a revision and suffered a nasal valve collapse/obstruction. The doctor cauterized the turbinates last week but my nose feels even worse. It’s super uncomfortable 24/7 and feels like there’s crap in there. I also can’t breathe well. On top of that i just hate it and would give anything to go back to my old nose without the hump. Is there any hope in building it with rib or other tissue and make it how it once was. I can’t even look in the mirror anymore and every day is very difficult. i need an ENT that’s also a plastic surgeon.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include placement of a dorsal onlay graft with diced cartilage wrapped in fascia, nasal tip deprojection, tip de-rotation , among other maneuvers. With good surgical technique, you could have an outstanding result. 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

Steven M. Denenberg, MD · Answer

After two previous rhinoplasties, it can be very difficult to work inside the nose, and we can't get everything we want. So, the goal is not to create a nose that is as close to perfect as we can get, and it's not to restore something close to the original nose.

Rather, the goal is to achieve a nose that looks much better than the *current* nose, to get a nose that doesn't bother you because it's too this or too that, and doesn't draw attention because it's too this or too that -- to get a nose that looks as natural as possible, given where we are right now.

The main thing that catches *my* eye about these photos is that the tip looks strong, out of proportion to the bridge. Compared to the height of the bridge, the tip sticks out further, and its width makes it noticeable. To my tastes, the tip is also a bit low, making the nose look longer than perhaps ideal, longer than perhaps what you might like.

So I would approach this nose by elevating the tip, "de-projecting" the tip (bringing it closer to the face), and trying to narrow it. That way, the tip wouldn't stand out beyond the bridge except a "normal" amount, and it wouldn't be prominent because it sits low, and hopefully it could be narrowed a bit, too, even after the previous surgery. Further, a smaller, shorter nose shows its imperfections less because it doesn't stand out from the face saying "look at me!"

I think a rib graft on your nose would be awful. It would make your nose look much bigger, accentuating any remaining imperfections. Your bridge is strong enough right now; I'd adjust the tip to match the bridge. I think that some excellent morphs showing exactly the changes I'm recommending would convince you of that. Or maybe, the posted photos aren't good enough for me to see some other problems, but that's my 2 cents based on these pics.

Finesse changes of the shape of the tip are unlikely now, but I don't see that they're necessary.

Finally, it's pretty rare that turbinate work harms the airway long term. You could have some big crusts hanging on to the turbinates this short of a time after surgery; when they fall off, the airway will improve.

Kyle Kimura, MD · Answer

I'm so sorry that you've had this experience after your rhinoplasty. Unfortunately things become more and more challenging after each subsequent revision surgery and I think your best option is to find a plastic surgeon that specializes in revision rhinoplasty, as these can be exceedingly difficult. 
I do think there are certainly options to address your issues and agree that rib cartilage is almost certainly going to be involved to some extent. Again, my recommendation is to find a plastic surgeon in your area, or someone you are willing to travel to meet with, that specializes in revision rhinoplasty and visit in person to really go over your concerns and make sure your goals align with theirs. 
I really hope this helps and best of luck,Kyle Kimura, MD

Multiple surgeries - Is there any way to restore my old nose? (Photos)

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Multiple surgeries - Is there any way to restore my old nose? (Photos)

Answers (3)

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Everything you need to know about Revision Rhinoplasty

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