Tip Rhinoplasty Nightmare, What Can I Do? (photo)

Just want experts opinion as to what went wrong with my rhinoplasty. I only had one, but am assuming I need a revison. Im only 2 months post op & I know swelling is normal, but the tip is SO assymetric. I hated my boxy nose & was going for a round tip. My doc said that my cartilage was crooked to & my skin was thin so this is the best its going to get? im devastated & cant believe I spent all that money for an ugly nose!. My doc says to keep warm compress on it 5x a day & squeeze bumps to help?

Doctor Answers 6

You may require revision rhinoplasty to improve your tip asymmetry.

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I read your concerns and reviewed your photos. I agree that you have thin skin which may be unforgiving for what lies beneath. I cannot know without examining you, but my hunch is that you could expect some degree of improvement with well-performed revision rhinoplasty techniques. Since you appear to have relatively little swelling, you may be a candidate for revision earlier than 1 year post-op.

The experience of your revision rhinoplasty surgeon is critical for achieving improvement. You may want to consult several reputable, busy revision rhinoplasty specialists to see what might be best for you.

All the best.

Dr. Joseph

West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

Bossae after tip rhinoplasty

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I agree with your assessment of your tip in that you do have tip irregularities called bossae that may improve some with time but likely will need a revision procedure. You also have collapse of your nasal al that will need to be addressed as well. That being said I would wait at least one year for everything to soften up and maximally improve and to allow a better outcome with revision surgery. If you have cartilage left in your septum than this can be more easily remedied. Good luck.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Tip issues post rhinoplasty

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easy answer

wait one year

consider revision

meet with several plastic surgeons

verify their experience with revision rhino

would be nice to know if you still have septal cartilage left

many revision cases benefit from grafting - would be great if you have some excess septal cartilage left, if not other locations may needed to be considered


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Rhinoplasty nightmare

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The main two problems I see from your pictures are,  the collapse of the lateral walls, and the position of the lower lateral cartilages on the tip creating a big asymmetry and bossae (rough edges).

In my opinion, while you are still only two months from your surgery, you will most likely need a revision. I would find a rhinoplasty specialist. In the right hands you can get an excellent result.

I would use septal, and or rib cartilage to reconstruct the tip, You need lateral crural strut grafts, and possibly an anterior septal graft at a minimum. Those terms can be found on Google, if you are not familiar with.


Tip rhinoplasty asymmetry

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It's hard to say without seeing more views of your nose and without knowing what was done during your prior rhinoplasty but you may benefit from structural grafting techniques to improve your tip dynamics.

This approach works especially well in nose like yours with strong cartilages and thin skin. It also appears that you have cephalically positioned lower lateral cartilages. Techniques such as lower lateral cartilage strut grafting with possible repositioning may be one way to help with your problem. My link below describes the technique in more detail.

You are a bit early in your recovery process so there will likely be further evolution of your nose as the healing process continues.

Tip Rhinoplasty Nightmare

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I understand your disappointment, but this can be corrected. Share your thoughts with your surgeon.   If you don't feel comfortable with his response consult with a surgeon experienced in revision rhinoplasty surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 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.