Can I do a revision for supratip graft or should I just live with a depressed nose?

Question

I have had several rhinoplasties. I recently had one in which a supratip graft was removed (the one before it placed it there, two different surgeons). Given the pictures, is there any way to get a surgeon to help me out with a supratip graft or should I just live with a depressed nose? I've tried filler before and it hasn't worked longer than a few weeks.

Evan Ransom, MD, FACS · Answer

Thank you for the question and the photo. It would be helpful to see a full set of standard photos before making a medical recommendation. That said, small imperfections in the dorsal contour can be treated pretty easily with filler. The thing that concerns me in your case, however, is that you have had "several" surgeries. This means that the blood supply to the skin will be less predictable and possibly less robust; this is a setup for potential skin necrosis from vascular occlusion. Revision surgery may be a better option, but it is difficult to recommend this without an examination and review of prior records. Soft tissue augmentation for small irregularities can be accomplished with temporalis fascia (from behind the ear) or cartilage (from the ear or septum). Please visit with an experienced rhinoplasty surgeon before making your decision. Take care!

Jonathan Kulbersh, MD · Answer

I recommend getting a consultation to go over your concerns and your desired results. Revision rhinoplasty is a technically challenging procedure and I would suggest that you seek a surgeon that has a good track record for natural results. There a few select of these surgeons in each major city.  I would look at their reputations, board certifications, and before and after pictures.  
I hope this helps.

Nima Shemirani, MD · Answer

I would consider a more permanent filler such as Bellafill or even liquid siliconeWhen placed in small amounts (like the supratip area), it should not cause any long term issues or consequencesIf you could avoid another surgery, that would be idealWhen you are ready, please visit a revision rhinoplasty specialist who can address your concerns
Best, Dr. Nima

Toby Mayer, MD · Answer

Revision rhinoplasty or not?  A graft can be placed in the supratip and the slight hump can be filed down. This  should be done by a very experienced revision rhinoplasty surgeon. The one thing you don’t want to do is take any backward steps which would make this worse.   See several experienced surgeons and have look at their results.

Jill Hessler, MD · Answer

Revision rhinoplasty is a more complex surgery than primary rhinoplasty.  I would recommend you have a consultation with a board certified specialist focusing on rhinoplasty to review your previous surgical procedures and discuss your current concerns.

Can I do a revision for supratip graft or should I just live with a depressed nose?

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Can I do a revision for supratip graft or should I just live with a depressed nose?

Answers (10)

Answer: Revision rhinoplasty or not?

Answer: Revision rhinoplasty or not?

Answer: Revision Rhinoplasty

Answer: Revision Rhinoplasty

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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.