Still swollen two years post revision rhinoplasty - how can I make my nose smaller? (Photos)

Question

Had first procedure in 2022. Sides and tip noticeably larger after two years, so had revision with ear cartridge. Two years later, tip is still larger and right side of nose has noticeable lump (visually and to the touch). Surgeon now wants to use filler to give the illusion of a slimmer nose. I don’t want an illusion - I want a nose that is smaller than the one I started with. I am just at a loss for what to do after spending 30k at this point.

Guray Yesiladali, MD, FEBOPRAS · Answer

Your frustration is completely valid &mdash; especially after undergoing two surgeries, investing significant time and money, and still not achieving your goal of a smaller, more refined nose.
Based on your description:
The use of ear cartilage in your revision likely added structural support, but may have also contributed to bulkiness, especially if thick skin or scarring is present.
The palpable lump on the right side could represent residual cartilage, graft shifting, or scar tissue.
While filler can camouflage irregularities or asymmetry temporarily, it cannot shrink or refine &mdash; and using it to “slim” the nose is a visual trick, not an actual solution.
If your goal is a nose that is truly smaller and more refined, not just masked:
Another surgical revision may be necessary &mdash; but this time with careful reduction of previous grafts, potential soft tissue thinning (if appropriate), and strategic reshaping of the nasal framework.
This kind of case requires very advanced revision rhinoplasty expertise, particularly with thick-skinned patients or post-graft irregularities.
You’ve already invested a lot &mdash; financially and emotionally &mdash; so the next step should be a consultation with a surgeon who has extensive experience in complex, structure-heavy revision rhinoplasty, not just cosmetic touch-ups.
I hope this helps you feel less stuck and more empowered about your options moving forward.
&mdash; Güray Yeşiladalı, MD

Steven M. Denenberg, MD · Answer

But at this point, after two operations and a graft, the surgeon really would need to examine you in person in order to tell what can be accomplished and whether it would make enough improvement to make you happy. He would have to examine the nose, and the inside, and *feel* it so he has an idea of what cartilages are where and what size they are. That's usually how we decide on a good plan.

Don't have filler -- you'll hate it. I've never understood the idea of making a nose bigger (with filler) in order to make the nose *look* smaller. I don't believe it.

You might have to commit to a visit out of town to find an expert who can help you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Still swollen two years post revision rhinoplasty - how can I make my nose smaller? (Photos)

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Still swollen two years post revision rhinoplasty - how can I make my nose smaller? (Photos)

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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.