Is a 2nd rhinoplasty going to help or make it worse? (photos)

I had a rhinoplasty in 2006 to remove a bump on the bridge of my nose. I did not have surgery on the tip. Over the years my left nostril has collapsed and a hard nodule has formed at the tip. This has caused my nose to look deformed. I had a consult with one surgeon that told me the collapse of my nostril could not be repaired. He also said fixing the nodule at the tip would guarantee visible scarring because the skin is so thin. This has led me to believe getting it repaired is a lost cause.

Doctor Answers 6

Although Redo Rhinoplasty is a more complex procedure- Improvements are possible.

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Hello, thank you for your question and images.

Although I am limited by not examining the area, on the surface what you are describing is reasonably correctable.  I would suggest that you find, and have a consultation with an experienced rhinoplasty surgeon that is comfortable performing secondary, or redo procedures. 

If your surgeon appreciates your goals, and feels comfortable with performing the secondary procedure based on prior experiences of the same nature, then you may find a different response.

Good luck!

Sergio P Maggi, MD, FACS

Austin Plastic Surgery Center

Revision Rhinoplasty

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Hello! I would disagree that collapse after rhinoplasty cannot be repaired. While it may not be easy, it usually can be improved. Seek consultations with several experienced rhinoplasty specialists and take your time in selecting your next surgeon. Good luck!

Catherine Winslow, MD
Indianapolis Facial Plastic Surgeon
4.7 out of 5 stars 42 reviews

I very much doubt your consult surgeon is correct

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From these photos, you seem to be a good candidate for a revision rhinoplasty, because the goal would involve changes that are not subtle. In general, it's hard to do a tiny tweak in a revision, and if the changes desired are larger, getting a meaningful improvement is more predictable, but only in truly expert hands.

The "nodule" is probably just a folding of your left tip cartilage. Besides fixing that, your bridge could probably be narrowed, and the tip narrowed and elevated. See the Web reference link for a demonstration of those changes.

Remember that you absolutely must see a revision doctor's before and after photos before selecting a surgeon. Revision rhinoplasty is a difficult undertaking, and the great majority of rhinoplasty plastic surgeons cannot handle it.

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Revision rhinoplasty candidate

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 A revision rhinoplasty procedure can be contemplated as long as patients have realistic expectations upon what they're trying to accomplish. The dorsal hump can be shaved down, the bridge narrowed, and the alar collapse repaired with cartilage graft. It would be helpful to have the operative report  to understand what was accomplished with the initial procedure, and important to know whether or not there is any cartilage left on the inside of the nose for grafting purposes.  Thin skin in the nose  can be difficult to deal with, so look for a very experienced rhinoplasty surgeon for best results

Is a 2nd rhinoplasty going to help or make it worse?

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Hello Djmstar198319,

Anytime you are considering a revision rhinoplasty it is important to realize that the healing is a little less predictable because of scarring.  Having said that, there are several techniques that can be used to help open up the area of collapse.  Even with thin skin, there are methods that help to camouflage to some extent the irregularities.  As long as you have realistic expectations and have specific goals you'd like accomplished (helping the area of collapse and the nodule), I think you would be likely to be pleased with what can be accomplished. 

I would recommend you consult with a facial plastic surgeon for an evaluation of your nose and to determine if your goals are possible based on your anatomy and previous surgery.

I hope this helps and good luck. 

Second rhinoplasty will it make it worse.

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From looking at your photos and reading your description what I think you have is called a "tip bossea" and is a result of cartilage and skin contracture after a rhinoplasty. This is a very common consequence of rhinoplasty years later and one of the major reasons people have revision rhinoplasty. It can be repaired by a skilled rhinoplasty surgeon without visible scarring and give you a beautiful well functioning nose. Interview several doctors who have expertise in revision rhinoplasty. I am sure you can be helped. 

Eugene L. Alford, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

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.