I had a closed rhinoplasty procedure 14 months ago and have developed a polybeak deformity. My surgeon expressed that he wants to do a revision surgery (for free). I'm looking for opinions as to what is causing this deformity. Has my tip dropped bc its lacking support or does it only look droopy bc of the elevated bridge? Is the bulb of my nose still round bc my thick skin heals that way & if so is it safe to to take it in more? Is this a case where simply lowering my bridge will fix all this?
Answer: Revision rhinoplasty for multiple problems. You need a revision rhinoplasty to correct insufficient tip projection, probably excess scar or cartilage above the tip, insufficient rim cartilage, etc. An in person examination will determine exactly what other issues including the dent need to be repaired. See a very experienced revision rhinoplasty specialist can show you many examples of his work with natural results in noses like yours.
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Answer: Revision rhinoplasty for multiple problems. You need a revision rhinoplasty to correct insufficient tip projection, probably excess scar or cartilage above the tip, insufficient rim cartilage, etc. An in person examination will determine exactly what other issues including the dent need to be repaired. See a very experienced revision rhinoplasty specialist can show you many examples of his work with natural results in noses like yours.
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January 28, 2017
Answer: Pollybeak deformity It's impossible to say for sure which factors are at play, however, it is certainly possible and safe to improve your nose with additional surgery. The most important thing, by far, is your relationship with your surgeon. If you trust them and their abilities then go for it. Otherwise, seek out a revision rhinoplasty specialist even if it means you will have to pay. Good luck!
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January 28, 2017
Answer: Pollybeak deformity It's impossible to say for sure which factors are at play, however, it is certainly possible and safe to improve your nose with additional surgery. The most important thing, by far, is your relationship with your surgeon. If you trust them and their abilities then go for it. Otherwise, seek out a revision rhinoplasty specialist even if it means you will have to pay. Good luck!
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Answer: A nonsurgical revision rhinoplasty may be appropriate. Dear Tinelillian in Santa Barbara, California: It is hard to say whether or not the tip rounded and dropped a little bit because of lack of support or due to the fact that, in some people with thick skin, as the tip narrows spontaneously in the healing period the skin thickens up. A very experienced surgeon should be able to tell the difference and it is possible that by injecting some cortisone or steroid that it can help solve the problem, because if the skin has become thicker that is the antidote to that problem in many cases. The time to do it is now, because 14 months after surgery has been enough time for the skin to “ripen” and for the result to be visible. Whether or not lowering your bridge will help is hard to say without feeling the bridge. Consult with a surgeon who has long experience, is highly specialized and focused on rhinoplasty, and has a huge photo gallery so you can find results of patients who had problems similar to yours. Be sure to bring a written list of questions. Bring all of your photographs and operative reports from your prior surgeon. Bring a friend or family member to also listen and observed. his will make it a much more productive consultation. Before you go, look at a lot of websites, read the reviews, read books, and learn as much as you can. You want to do it right the second time and, hopefully, you maybe will have improvement without surgery. Best wishes, Robert Kotler, MD, FACS Over 4,500 nasal procedures performed
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Answer: A nonsurgical revision rhinoplasty may be appropriate. Dear Tinelillian in Santa Barbara, California: It is hard to say whether or not the tip rounded and dropped a little bit because of lack of support or due to the fact that, in some people with thick skin, as the tip narrows spontaneously in the healing period the skin thickens up. A very experienced surgeon should be able to tell the difference and it is possible that by injecting some cortisone or steroid that it can help solve the problem, because if the skin has become thicker that is the antidote to that problem in many cases. The time to do it is now, because 14 months after surgery has been enough time for the skin to “ripen” and for the result to be visible. Whether or not lowering your bridge will help is hard to say without feeling the bridge. Consult with a surgeon who has long experience, is highly specialized and focused on rhinoplasty, and has a huge photo gallery so you can find results of patients who had problems similar to yours. Be sure to bring a written list of questions. Bring all of your photographs and operative reports from your prior surgeon. Bring a friend or family member to also listen and observed. his will make it a much more productive consultation. Before you go, look at a lot of websites, read the reviews, read books, and learn as much as you can. You want to do it right the second time and, hopefully, you maybe will have improvement without surgery. Best wishes, Robert Kotler, MD, FACS Over 4,500 nasal procedures performed
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January 31, 2017
Answer: Poor results You are indeed a candidate for revision, it is unclear what may exist inside, what are the unrelying reasons for your problems or which anatomical parts are ok or which need restoration or replacement, and this uncertainty of preop diagnosis (in your particular case) is due to the combination of a very thick skin (does not allow visualization of inner situation) and the massive amount of fibrosis (not a good sign). You need a very well expenrienced and very self confident revision rhinoplasty reputed specialist with a wide range of technical resources, and a lot of improvisation and creativity skill since the final diagnosis, planning and strategy decision-making will not occur until intraoperatively he may visualize the real situation underneath the skin.So far seems the tip needs a lot of work, grafting, rebuild, etc, and also the alae show some issues; the dorsum is too broad. Do research well.
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January 31, 2017
Answer: Poor results You are indeed a candidate for revision, it is unclear what may exist inside, what are the unrelying reasons for your problems or which anatomical parts are ok or which need restoration or replacement, and this uncertainty of preop diagnosis (in your particular case) is due to the combination of a very thick skin (does not allow visualization of inner situation) and the massive amount of fibrosis (not a good sign). You need a very well expenrienced and very self confident revision rhinoplasty reputed specialist with a wide range of technical resources, and a lot of improvisation and creativity skill since the final diagnosis, planning and strategy decision-making will not occur until intraoperatively he may visualize the real situation underneath the skin.So far seems the tip needs a lot of work, grafting, rebuild, etc, and also the alae show some issues; the dorsum is too broad. Do research well.
Helpful
January 28, 2017
Answer: Poly-beak deformity: from thick skin, scar tissue, elevated. She, drooping cartilage, or all? A poly-beak deformity can be caused by all of the above reasons. A thorough examination is required to make a determination about what the cause is. When you have identified the cause, then a plan for correction can occur. A revision rhinoplasty is more difficult than a primary rhinoplasty due to scar tissue and thick skin present and alterations of the normal anatomy. If the issue is excess thick skin, steroid shots should be beneficial. If there is residual cartilage present in the lower portion of the nasal dorsum, a touch up revision procedure can be performed.
Helpful
January 28, 2017
Answer: Poly-beak deformity: from thick skin, scar tissue, elevated. She, drooping cartilage, or all? A poly-beak deformity can be caused by all of the above reasons. A thorough examination is required to make a determination about what the cause is. When you have identified the cause, then a plan for correction can occur. A revision rhinoplasty is more difficult than a primary rhinoplasty due to scar tissue and thick skin present and alterations of the normal anatomy. If the issue is excess thick skin, steroid shots should be beneficial. If there is residual cartilage present in the lower portion of the nasal dorsum, a touch up revision procedure can be performed.
Helpful