Can my nostrils be corrected and/or reshaped after disastrous alarplasty? (photo)

Question

In 1993 I had rhinoplasty in NYC to correct a hump on my nose, a droopy tip and reduce my nose width. The hump was removed, but the tipped remain droopy and the nostrils were cut and restitched so poorly that the left nostril extends further out than the right, the nostrils are shapeless and do not have a curvature, like two flaps - with no shape or cartilage. In 2004, I had surgery to raise the tip, but the doctors did not attempt to fix my nostrils. Is there is any possibility to fix my nose?

Terence Goh, MBBS, MRCS(Ed), FAMS (Plast Surg) · Answer

Dear moodbynature,I'm so sorry to hear about  the disappointment that you have with your procedure. Like the previous doctors who replied, a re-revision rhinoplasty is definitely challenging due to the altered anatomy and the presence of scar tissue. However, the good news is that it still can be done to improve your current situation. 1. Using suture techniques and tip cartilages, it is possible to improve the nasal tip projection. 2. There appears to be a depression over the left alar - this can be grafted with autologous tissue (from your own body) such as fat or cartilage.3. As for the alar, it appears that the alar interface to the cheek is too abrupt. However, this is assessed via a 2-dimensional photograph. An in-person consultation with a certified an experienced plastic surgeon would be required to understand what you are dissatisfied with so that your concerns can be addressed.I hope this answers your questions. Don't worry, it can be fixed.Regards,Dr. Terence Goh Plastic SurgeonAZATACA Plastic Surgery, Singapore

William Portuese, MD · Answer

The goal of an alar-plasty is simply to narrow wide nostrils, not reshape  them. The thick alar skin cannot be changed either. The alar notching present at the top of the left nostril can be improved with a composite skin graft harvested from the ear to attempt to make the nostrils themselves look more symmetrical. Revision rhinoplasty is a very difficult endeavor due to the fact there's already been previous alterations to the normal anatomy, thick skin, and scar tissue present. Choose your second surgeon wisely based on extensive experience.

Joseph M. Pober, MD, FACS - Account Suspended · Answer

My suggestion is to seek out multiple Board Certified Plastic Surgeons, I would have them all take a look at your nose and see who comes up with the best treatment plan for you. Also be mindful to look at all before and after pictures as well as stay in tune with the reviews of the Drs you seek out!Dr Joseph M Pober

Chester F. Griffiths, MD, FACS - Account Suspended · Answer

Hello Moodybynature and thank you for your question!
I recommend speaking with multiple board certified plastic surgeons about a revision alarplasty. RealSelf is a great tool to research which providers you would like to consult with either in your area or abroad. Revisions are difficult but the aesthetic of your nose will improve in the right hands. 
Best of luck,
Chester Griffiths, MD, FACS

Can my nostrils be corrected and/or reshaped after disastrous alarplasty? (photo)

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