Too-Straight Nose After Rhinoplasty

I have seen good results worsen after attempts at revision Rhinoplasty. Without a deformity or complication, I would learn to accept the results and see how you feel about it in a year. Many patients find more acceptance over time. Be cautious. Dr. G.

Hi Lily,

Speak with your rhinoplasty surgeon about your concerns.  There are some things that can be done to help you achieve your goals.  Judiciously injected filler may be the answer or revision surgery.  Good luck and be well.

Dr. P

Actually, the answer can in some cases be "yes!" But when it is virtually impossible for any surgeon, however experienced or capable, to guarantee exactly how every patient will swell, scar, and ultimately heal and settle into a final result, how can it be your doctor's fault that it is "too perfect?" Most of my colleagues' answers include useful information, and the most important is that none of us can comment or answer as accurately and honestly as your own surgeon. After a year of healing, your nose has reached it's "final" appearance post-op, so anyone who advises that you should wait and see is only deferring having to actually assess your concern.

What I "hear" as I read your question is that you do not like the fact that your nose somehow has an "operated" look, or that "people 'know'" you have undergone cosmetic rhinoplasty. Or is this your own self-awareness that you unconsciously "telegraph" to someone you might notice admiring your nose? As in--OMG, does he/she know I've had a nose job!?

The short answer to can changes be made to make your nose less "perfect" is: yes. In fact, you may get your wish--it could look absolutely terrible! The long answer is still relatively short: relax, and ask your surgeon about a temporary filler such as one of the HAs (Restylane, Juvederm, etc.), a longer-acting filler such as Radiesse, or even hydroxyapatite granules (this requires a small, local-anesthesia procedure). If you love these results, then a small cartilage graft can be placed for a "permanent" result. But beware; asking for a change can end up giving an unanticipated disaster that neither you or your surgeon will like, especially given your present "perfectly straight" nose.

Remember: the enemy of good enough is better!

There is a way to place a bump back onto your bridge if that is what you desire. Having a consultation where computer imaging (and morphing) is done would be very helpful. This would allow your surgeon to best determine what outcome you're looking to achieve.

A hump could be added back by grafting some of your own tissue such as cartilage or perichondrium (the natural covering found on cartilage). A temporary effect could be achieved with a soft tissue filler injection such as restylane or juvederm.

Another way to break up the straight line of a perfectly straight nose would be to create what is called a "supratip break". This is basically a subtle concave area on the bridge above the nasal tip. Computer imaging would allow you to see how your nose would look with this done as well.

Before you embark on another surgical procedure you may want to consider using a filler to simulate a nasal hump. IF you like this result, you could consider a long term result with a cartilage graft.