What caused this issue? Is revision rhinoplasty a good idea and would it work? (photo)

Your tip cartilages have shifted and likely you have residual deviation of septum. A formal revision with repositioning and modification of tip cartilages and septum should be successful. Consult with a surgeon experienced in revision rhinoplasty.

Hi @Honest319146! Thank you for sending your photos. You would be a great candidate for a revision rhinoplasty to decrease projection and realign your nasal tip. It appears that your lower lateral cartilages have shifted over time. A rhinoplasty in my opinion is one of the most difficult procedures to perform. The skill, artistry, and technique of the surgeon will determine your outcome. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of luck, Dr. Nima!

Hello and thank you for your question. While perfect symmetry would be unattainable, it does appear you might be a good candidate for revision rhinoplasty to adjust some of the changes you describe. Keep in mind that revision rhinoplasty is even more complex than the original procedure in many cases. I encourage you to schedule a consultation with an experienced, board-certified facial plastic surgeon who has the skill, expertise, and precision to achieve the best possible result for you.

Revision rhinoplasty will certainly be able to reshape and create more definition to your nose. The decision to undergo rhinoplasty is a strictly personal one, as only you can weigh the pros and cons of the recovery and financial aspects relative to how much the nasal appearance bothers you.

your dorsum has been 'skinnied' down to the post where over-resected upper lateral cartilages have laid bare your dorsal septum... lack of support has it curving toward your left... poorly supported and under projected tip is similarly skewed to the left

this can be addressed through a revision rhinoplasty with structural grafting

good luck

Thank you for your post and picture. More information would be needed to give you a definite answer. When did the slanting begin? It is possible that over time, your lower-lateral cartilages have shifted. Regardless, if the appearance of your nose bothers you terribly, then it might be worth considering a revision rhinoplasty to realign your tip and to decrease projection. Keep in mind that no two sides of a nose will ever be perfectly symmetrical, and you might have to accept some slight asymmetry/slanting depending on what was done in your original rhinoplasty. When you seek surgeons for your revision, please do your research and focus on board certified plastic surgeons with decades of experience in revision rhinoplasty.