Unhappy with rhinoplasty revision results, how can this be fixed? 11 months post op (photos)

Question

I broke my already ugly nose back in 2006. Had a regular ENT do a septoplasty at that time. In 2020, I had a primary rhinoplasty done by a board-certified plastic surgeon. It turned out terrible. He said I had a complicated case because it was broken to begin with, and he offered to fix it for free. It was awful again. He did another revision - open - this past January 2022. My results are still not what I wanted and I hate it! I am so upset! What did he do wrong and how can it be fixed?

Gurkan Kayabasoglu, MD · Answer

Hi. First of all, we are sorry for your bad experience. If your surgeon was inexperienced, had two surgeries and your nose still looks like this, the problem is not in your nose but in your surgeon. Since it has been 11 months since your last revision surgery, it is time to have your last revision. But this time you need to choose a doctor who is successful and experienced in surgeries. Please review our results. Please check our Instagram account and RealSelf photos. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile. You can also book an online consultation and discuss your problems with me. With all respect.

Jonathan Kulbersh, MD · Answer

Thank you for submitting your question and providing photos. I’m sorry you’ve been unsatisfied with your previous rhinoplasty results. Once a year has passed since your most recent surgery, it is possible that revision rhinoplasty can help you achieve the results you’re looking for. During revision, the nose can be reshaped to create balance with your other facial features. This may include cartilage grafting and restructuring of the tip to create a refined, feminine result. 
It is imperative to note that each subsequent nose surgery becomes more complex due to the loss of structural support and scar tissue. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon with expertise in rhinoplasty techniques. They will be able to review your surgical history, assess your aesthetic concerns and goals, and provide a personalized treatment plan for you.

Steven M. Denenberg, MD · Answer

From these photos, what I see is that the bridge is still prominent, the bones (the upper 1/3 of the nose) are prominent and wide, and there are issues with the tip, and the nose is overall still strong in its forward projection away from the face. These are issues that are common to deal with during a revision. How *much* to lower the bridge, or narrow the nose, or what to do with the tip? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify most accurately just what's bothering you, and help you set a goal for a possible revision that's accurate for your tastes. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)
Now, while it's certainly true that past trauma can put a limit on the amount of improvement possible during an operation, it seems to me that you must evaluate whether your poor outcomes are the result of your situation, or the result of the surgeon not having adequate skill to address your nose's issues. Revision rhinoplasty is an incredibly difficult procedure, and not all surgeons approach it with the same skill.
Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. It also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations.

Kerem Sami Kaya, MD · Answer

According to the these photos, nasal dorsal elevation, which is called as nasal hump, is present. In addition, the nasal tip defining point is not exactly as desired and the nasal rotation seems a bit too much. I do not know your previous nasal structure, I cannot say what has changed or is still present. Have a nice day.Get well soon.

Thomas A. Mustoe, MD, FACS · Answer

Your nose can absolutely be improved with another revision but almost certainly would require cartilage grafting.  Your nose is short with irregularities but U am co code t that a surgeon experienced in revisions course help you.  The surgery ia more involved because of scar tissue from the previous surgery but in an experienced surgeons hands very doable.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Sorry you're experiencing trouble with your rhinoplasty outcome. Your nose can be improved. It  may require another open procedure to address the bridge and any irregularities at the tip area. I would wait at least 12 months before moving forward to ensure a vast percentage of the swelling has resolved so all undesirable aspects of your nose, if needed, can be improved. If your skin is thin in parts, temporalis fascia would help to camouflage the area. I would seek consultation with a facial plastic surgeon to learn more about what may be able to be done. Hope this helps!

Unhappy with rhinoplasty revision results, how can this be fixed? 11 months post op (photos)

Answers (6)

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