Should I get revision rhinoplasty? (Photo)

Question

I had rhinoplasty about 1.5 years ago and while I was initially happy with the results I felt like it changed and now have a divot on the side of my nose that was pushed over to straighten it. I also have a theory that this notch might be causing chronic redness / telangiectasia across my nose. I showed my doctor and he tried some filler but I didn't like it. Should I consider revision or just live with it? Could revision mess it up even more?

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. Since your initial surgery was over a year ago and dermal fillers haven’t addressed your concerns, revision rhinoplasty can be considered to change the appearance of your nose. During this procedure, the cartilage in the nose can be straightened, reducing the appearance of the divot you’re referring to. 
Keep in mind 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 concerns and surgical history to determine the best course of action for you.

Man Koon Suh, MD · Answer

Thank you for your question. Although filler can be a simple way to correct notching, they are not recommended as they are not permanent. The fundamental correction is a cartilage graft using ear or septal cartilage. However, it is unclear whether this will improve telangiectasia.

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

Hi there! Great question. A revision certainly can improve the area, but there's always a risk of creating another problem. I see the area you're referring to. Often times, camouflage grafting works well by using temporalis fascia. At the same time, if any bone needs to be treated, that could be addressed, too. As for the telangiectasias, that is quite possible. Trying something like IPL may be a good start. Hope that helps!

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