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Suggestions for Correcting Rhinoplasty Results

I discussed exactly what I wanted for a rhinoplasty result and even showed a picture. I asked that the nose not be tipped up, however, it now is. The nostrils are crooked and the doctor did a slight procedure to correct it, but made it worse. I wanted a straight nose on profile and it is not, and as I said, it's now tipped up with some of the tip cut off.

The physician said it's beautiful; of course, what else is he going to say. He eventually acknowledged that he made my nose worse. The doctor says he has no idea how to fix what he did and has refused to refer me to anyone that might help. Additionally, he did some lip surgery and made a choice to lengthen my lip without my approval. I have now lost my beautiful smile as the lip hangs over my lower teeth with my lips gently parted, and the lip covers half of the upper teeth on smile.

My nose is so ugly now I do have not been out socially for two years. I've spent almost $1000 trying to find someone who can help to do a revision. I am so devestated and very depressed. I've been in counseling for two years and can't get over this as I have to look at my face everyday and am humiliated how it looks. Any guidance or suggestions for correcting this? I have more photos if that will help.

Doctor Answers 12

There are options...

January 5th, 2009
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Dear Cathy,
Revision rhinoplasty is one of the most difficult aesthetic facial plastic surgical procedures, but can almost always be performed. By your description of your nose, it sounds like the only way to improve the appearance of your nose is another operation. It will likely require some degree of cartilage grafting and augmentation. I do not know where you live, but I could certainly recommend someone in your geographic area who would have the required expertise. You have nothing to lose by seeking a second opinion. It would be helpful for you to bring along a copy of all of your operative notes and pictures.
The psychological impact of all of this on you must be factored in. I think any surgeon would want to discuss a revision procedure with your psychologist/psychiatrist prior to proceeding, to make sure you are emotionally ready.

Anurag Agarwal, MD


Naples Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

January 5th, 2009

There are options...

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Dear Cathy,
Revision rhinoplasty is one of the most difficult aesthetic facial plastic surgical procedures, but can almost always be performed. By your description of your nose, it sounds like the only way to improve the appearance of your nose is another operation. It will likely require some degree of cartilage grafting and augmentation. I do not know where you live, but I could certainly recommend someone in your geographic area who would have the required expertise. You have nothing to lose by seeking a second opinion. It would be helpful for you to bring along a copy of all of your operative notes and pictures.
The psychological impact of all of this on you must be factored in. I think any surgeon would want to discuss a revision procedure with your psychologist/psychiatrist prior to proceeding, to make sure you are emotionally ready.


Naples Facial Plastic Surgeon

It is a long process.

January 5th, 2009
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I would suggest you get your money back from your physician! Make sure you get the appropriate psychological counselling about your nose to get a healthy perspective on the less than ideal outcome. Do some serious soul searching before you have anymore surgery. opefully you understood from the beginning that making a nose is not like building a house. There are no specs. Internal scarring can ruin perfect results. Surgeons also make mistakes. Also, patients having unrealistic expectations at the outset usually end as unhappy patients. Start looking for a revision specialist. In your area, Dr. Guyuron is well known. In Chicago, Dr. Toriumi is highly regarded. Good luck.

Dr. Shah

Manish H. Shah, MD, FACS
January 5th, 2009

It is a long process.

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I would suggest you get your money back from your physician! Make sure you get the appropriate psychological counselling about your nose to get a healthy perspective on the less than ideal outcome. Do some serious soul searching before you have anymore surgery. opefully you understood from the beginning that making a nose is not like building a house. There are no specs. Internal scarring can ruin perfect results. Surgeons also make mistakes. Also, patients having unrealistic expectations at the outset usually end as unhappy patients. Start looking for a revision specialist. In your area, Dr. Guyuron is well known. In Chicago, Dr. Toriumi is highly regarded. Good luck.

Dr. Shah

Manish H. Shah, MD, FACS

Upset with rhinoplasty, desires revision.

November 28th, 2015
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As a rhinoplasty surgeon, I am sorry to hear of your discontent.  Rhinoplasty is a complex operation and discontent is sometimes the outcome.  A thousand dollars is a lot to spend to find someone to help get your nose to a state that will make you happy but when you get the right result, it will be worth it.  I see you are in Ohio.  One of the best rhinoplasty surgeons worldwide, Baham Guyuron, MD (my mentor) is in Lyndhurst OH (Cleveland).  You may call him.
Adam Bryce Weinfeld, MD
November 28th, 2015

Upset with rhinoplasty, desires revision.

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As a rhinoplasty surgeon, I am sorry to hear of your discontent.  Rhinoplasty is a complex operation and discontent is sometimes the outcome.  A thousand dollars is a lot to spend to find someone to help get your nose to a state that will make you happy but when you get the right result, it will be worth it.  I see you are in Ohio.  One of the best rhinoplasty surgeons worldwide, Baham Guyuron, MD (my mentor) is in Lyndhurst OH (Cleveland).  You may call him.
Adam Bryce Weinfeld, MD

Unhappy with septorhinoplasty results

April 12th, 2010
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I don't think any one of us who are reading your question can be anything but upset with your predicament. Your nose is distorted especially from the view you are showing, the worm's eye view. If your doctor will not suggest someone, I would try one of the major teaching centers in plastic surgery like in Pittsburgh or Chicago where they may be of more help and have had more experience treating your problem. Good luck.

Steven Schuster, MD, FACS
April 12th, 2010

Unhappy with septorhinoplasty results

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I don't think any one of us who are reading your question can be anything but upset with your predicament. Your nose is distorted especially from the view you are showing, the worm's eye view. If your doctor will not suggest someone, I would try one of the major teaching centers in plastic surgery like in Pittsburgh or Chicago where they may be of more help and have had more experience treating your problem. Good luck.

Steven Schuster, MD, FACS

Rhinoplasty failure and depression

February 22nd, 2010
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Your disappointment and depression associated with a less than adequate result in rhinoplasty surgery is not unusual. When this depression causes you dysfunction in your life you need to seek counseling. You need to find a qualified facial plastic or plastic surgeon that has an extensive experience in revision rhinoplasty. Once you find that surgeon, it is imperative that the two of you develop realistic expectations to the extent your nose can be rehabilitated. Improvement and function may be the best you can achieve and your insight to the limitations any future surgery is very important for your future happiness and satisfaction. .

Lee Kleiman, MD

Lee Kleiman, MD
Annapolis Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

February 22nd, 2010

Rhinoplasty failure and depression

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your disappointment and depression associated with a less than adequate result in rhinoplasty surgery is not unusual. When this depression causes you dysfunction in your life you need to seek counseling. You need to find a qualified facial plastic or plastic surgeon that has an extensive experience in revision rhinoplasty. Once you find that surgeon, it is imperative that the two of you develop realistic expectations to the extent your nose can be rehabilitated. Improvement and function may be the best you can achieve and your insight to the limitations any future surgery is very important for your future happiness and satisfaction. .

Lee Kleiman, MD
Annapolis Facial Plastic Surgeon

Rhinoplasty Revision

April 10th, 2009
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If a patient has spent a thousand dollars in consultations trying to find somebody to do a revision, then the patient has visited many different surgeons and received many opinions. With so many similar opinions on a revision surgery, there is no need to find others as long as the consulted physicians are well-versed in revision rhinoplasty procedures. At this point, I strongly encourage you to continue counseling for your depression as this will help you transition back to your regular social activities and lifestyle.

William Portuese, MD
April 10th, 2009

Rhinoplasty Revision

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If a patient has spent a thousand dollars in consultations trying to find somebody to do a revision, then the patient has visited many different surgeons and received many opinions. With so many similar opinions on a revision surgery, there is no need to find others as long as the consulted physicians are well-versed in revision rhinoplasty procedures. At this point, I strongly encourage you to continue counseling for your depression as this will help you transition back to your regular social activities and lifestyle.

William Portuese, MD

Blepharoplasty using scalpel is better

February 25th, 2009
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New York City is a mecca for this type of surgery, and with literally hundreds of plastic surgeons here, I do not know of a single one who would prefer a laser to a scalpel for the procedure you mentioned.

Michaelangelo worked fine with a hammer and a chisel. Frankly, lasers "burn" and that's how they cut. If you look up, or Google the word "laser", it's an acronym for Light Activated something or other and the "R" stands for Radiation. Enough said?

Web reference: http://www.antell-md.com/newyorkplasticsurgeon/rhinoplasty_nyc.htm

Darrick E. Antell, MD
February 25th, 2009

Blepharoplasty using scalpel is better

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

New York City is a mecca for this type of surgery, and with literally hundreds of plastic surgeons here, I do not know of a single one who would prefer a laser to a scalpel for the procedure you mentioned.

Michaelangelo worked fine with a hammer and a chisel. Frankly, lasers "burn" and that's how they cut. If you look up, or Google the word "laser", it's an acronym for Light Activated something or other and the "R" stands for Radiation. Enough said?

Learn more: http://www.antell-md.com/newyorkplasticsurgeon/rhinoplasty_nyc.htm

Darrick E. Antell, MD

Unqualified surgeon

January 5th, 2009
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Cathy,

I'm going to go out on a limb here and guess that you went to an unqualified surgeon. Your case underscores the importance of board certification by the American Board of Medical Specialties (American Board of Plastic Surgery, American Board of Otolaryngologists). Of course, any surgeon can have a bad result, but surgeons that are board certified by these bodies would more than likely have the training and expertise to know how to correct untoward results and if not, would certainly know how, and be willing to, refer you to someone who does. You need to see a board certified plastic surgeon or otolaryngologist for some direction. Good luck!

Kenneth R. Francis, MD, FACS
January 5th, 2009

Unqualified surgeon

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Cathy,

I'm going to go out on a limb here and guess that you went to an unqualified surgeon. Your case underscores the importance of board certification by the American Board of Medical Specialties (American Board of Plastic Surgery, American Board of Otolaryngologists). Of course, any surgeon can have a bad result, but surgeons that are board certified by these bodies would more than likely have the training and expertise to know how to correct untoward results and if not, would certainly know how, and be willing to, refer you to someone who does. You need to see a board certified plastic surgeon or otolaryngologist for some direction. Good luck!

Kenneth R. Francis, MD, FACS

Unhappiness Two Years Following Rhinoplasty

January 5th, 2009
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Hi Cathy,

Sorry to hear about your dissatisfaction with your rhinoplasty and lip surgery two years ago. There are many excellent rhinoplastic surgeons who specialize in revision rhinoplasty. It sounds as if you will require an augmentation rhinoplasty revision which involves using your own cartilage to support your nose. Sometimes implants may be used to add to the dorsum of your nose if you lack your own cartilage.

It would be helpful to see more photos, particularly a front view without your head tilted back, and side profile views.

Before undergoing any revision surgery, your psychological state should be evaluated and improved. I understand that you have been working with a counselor over the past two years, but the fact that you are depressed, humiliated, and not interacting socially is most worrisome. Once your mental state is stable, there are revision rhinoplasty specialists who should be able to improve your nose. By lowering the tip of your nose, the appearance of your lip should improve.

Your experience again emphasizes how important it is to be sure that the patient and surgeon communicate enough before surgery so that surprises and or disappointment are minimized after surgery.

Good luck and be well.

Dr. P

Michael A. Persky, MD

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

January 5th, 2009

Unhappiness Two Years Following Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi Cathy,

Sorry to hear about your dissatisfaction with your rhinoplasty and lip surgery two years ago. There are many excellent rhinoplastic surgeons who specialize in revision rhinoplasty. It sounds as if you will require an augmentation rhinoplasty revision which involves using your own cartilage to support your nose. Sometimes implants may be used to add to the dorsum of your nose if you lack your own cartilage.

It would be helpful to see more photos, particularly a front view without your head tilted back, and side profile views.

Before undergoing any revision surgery, your psychological state should be evaluated and improved. I understand that you have been working with a counselor over the past two years, but the fact that you are depressed, humiliated, and not interacting socially is most worrisome. Once your mental state is stable, there are revision rhinoplasty specialists who should be able to improve your nose. By lowering the tip of your nose, the appearance of your lip should improve.

Your experience again emphasizes how important it is to be sure that the patient and surgeon communicate enough before surgery so that surprises and or disappointment are minimized after surgery.

Good luck and be well.

Dr. P

Michael A. Persky, MD

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Revision rhinoplasty

January 5th, 2009
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Hi, Cathy,

unfortunately, your story is not unheard of. On the brighter side, you can probably improve on your results greatly if you choose a good facial plastic surgeon who is experienced with revision rhinoplasty.

We deal with revision rhinoplasty on a regular basis. I will be happy to look over your photos and discuss your case further. If you are in Ohio, I can give you recommendations for a good surgeon close to your home.

In the meanwhile, I would encourage you to continue with counseling, as it will certainly be a useful adjunct before, during, and after surgery. You have been through a lot, and even with the best future surgery you will probably need some help adjusting.

Stella Desyatnikova, MD

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

January 5th, 2009

Revision rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hi, Cathy,

unfortunately, your story is not unheard of. On the brighter side, you can probably improve on your results greatly if you choose a good facial plastic surgeon who is experienced with revision rhinoplasty.

We deal with revision rhinoplasty on a regular basis. I will be happy to look over your photos and discuss your case further. If you are in Ohio, I can give you recommendations for a good surgeon close to your home.

In the meanwhile, I would encourage you to continue with counseling, as it will certainly be a useful adjunct before, during, and after surgery. You have been through a lot, and even with the best future surgery you will probably need some help adjusting.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.