Why did my nose start changing again after rhinoplasty?

I had rhinoplasty, and my nose started to "droop down" a little and became a lot larger in size and in shape over the past 3 years. Why is that? Is there a way to have rhinoplasty to stop this from happening?

Doctor Answers 11

The nose continues to change with time

Whether you've had a rhinoplasty or not, the nose changes as a result of the aging process.  The nose will generally start to droop ever so slightly just as every other part of your body starts to do the same.  With that being said, a nose that has gone through surgery will also change with time but sometimes more significantly.  However, by using good techniques and judiciously removing small amounts of cartilage/tissues only if necessary, there is less likelihood that the nose will change in structure significantly at a later time.  It is difficult to say anything specific as there are no pictures in your case.  In the end, it is important to go to a surgeon who understands the long term effects/changes of a rhinoplasty.  


Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

The nose continues to change with time

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Whether you've had a rhinoplasty or not, the nose changes as a result of the aging process.  The nose will generally start to droop ever so slightly just as every other part of your body starts to do the same.  With that being said, a nose that has gone through surgery will also change with time but sometimes more significantly.  However, by using good techniques and judiciously removing small amounts of cartilage/tissues only if necessary, there is less likelihood that the nose will change in structure significantly at a later time.  It is difficult to say anything specific as there are no pictures in your case.  In the end, it is important to go to a surgeon who understands the long term effects/changes of a rhinoplasty.  


Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Why did my nose start changing again after rhinoplasty?

Dear waterlily2015,

Thank you for your clinical post. Depending on the type of primary rhinoplasty that was performed if increase nasal tip support to minimize drooping and nasal tip reduction was performed inadequate cartilaginous support can over time result in the nasal tip beginning to droop again. There is a natural gravitational and musculature tensile force on the tip when one animates and smiles and the use of structural grafting can help minimize plunging tips, but the absence of the structural support can result in recurrent drooping after primary reduction rhinoplasty. It is far less common for the nose to increase in size after reduction rhinoplasty surgery unless a primary process such as Rosacea or pilosebaceous hyperplasia, which is increase in the pilosebaceous glands of the subcutaneous tissue of the nose, is present.

Generally, these patients will have very oily skin with large pores and soft tissue reduction may be required. Additionally, if you have lost a lot of facial weight and the cheekbones have lost some of their native fat then the nose can appear relatively large and proportionate to the deflated cheeks. Regardless of the etiology if you have concerns several years following a primary rhinoplasty with a plunging tip or the size of the tip of your nose seeking out the consultation of your initial rhinoplasty physician if you feel confident in their abilities or other rhinoplasty physicians would be important to seek out what other options may exist. Secondary rhinoplasty is fraught with risks and is usually less predictable than the primary surgery, so seeking out a proper experienced rhinoplasty surgeon is essential.

I have been performing rhinoplasty surgery for over 20 years and was fortunate to be trained in both plastic surgery and ear, nose, throat otolaryngology. The use of computer imaging pre-operatively can help me convey to patients the type of outcomes that can usually be achieved. The use of open structure rhinoplasty techniques usually allows modern rhinoplasty surgeons to achieve more predictable long-term results than we could achieve in the past.

I hope this information has been of some assistance and best of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

Why did my nose start changing again after rhinoplasty?

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Dear waterlily2015,

Thank you for your clinical post. Depending on the type of primary rhinoplasty that was performed if increase nasal tip support to minimize drooping and nasal tip reduction was performed inadequate cartilaginous support can over time result in the nasal tip beginning to droop again. There is a natural gravitational and musculature tensile force on the tip when one animates and smiles and the use of structural grafting can help minimize plunging tips, but the absence of the structural support can result in recurrent drooping after primary reduction rhinoplasty. It is far less common for the nose to increase in size after reduction rhinoplasty surgery unless a primary process such as Rosacea or pilosebaceous hyperplasia, which is increase in the pilosebaceous glands of the subcutaneous tissue of the nose, is present.

Generally, these patients will have very oily skin with large pores and soft tissue reduction may be required. Additionally, if you have lost a lot of facial weight and the cheekbones have lost some of their native fat then the nose can appear relatively large and proportionate to the deflated cheeks. Regardless of the etiology if you have concerns several years following a primary rhinoplasty with a plunging tip or the size of the tip of your nose seeking out the consultation of your initial rhinoplasty physician if you feel confident in their abilities or other rhinoplasty physicians would be important to seek out what other options may exist. Secondary rhinoplasty is fraught with risks and is usually less predictable than the primary surgery, so seeking out a proper experienced rhinoplasty surgeon is essential.

I have been performing rhinoplasty surgery for over 20 years and was fortunate to be trained in both plastic surgery and ear, nose, throat otolaryngology. The use of computer imaging pre-operatively can help me convey to patients the type of outcomes that can usually be achieved. The use of open structure rhinoplasty techniques usually allows modern rhinoplasty surgeons to achieve more predictable long-term results than we could achieve in the past.

I hope this information has been of some assistance and best of luck.

For more information, please review the link below.

R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Yorkville, Toronto

Drooping tip gradually over 3 years after rhinoplasty.

Generally, if adequate support is not built into the tip support framework, healing and gravity will work to draw the tip down over time.  This process can occur months and years following rhinoplasty.

Mario J. Imola, MD, DDS, FRCSC, FACS.

Drooping tip gradually over 3 years after rhinoplasty.

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Generally, if adequate support is not built into the tip support framework, healing and gravity will work to draw the tip down over time.  This process can occur months and years following rhinoplasty.

Mario J. Imola, MD, DDS, FRCSC, FACS.

Rhinoplasty revision, some advices:

Thanks for sharing your concerns with us. 

After having analyzed all the info and photos provided to us, i recommend to perform a Secondary Rhinoplasty (not a tip revision) this means (basically) treat the nasal bones and the nasal cartilages.
Therefore i would perform a narrowing of the nasal base (nose osteotomy) and alar and triangular cartilage shaping.

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 291 reviews

Rhinoplasty revision, some advices:

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for sharing your concerns with us. 

After having analyzed all the info and photos provided to us, i recommend to perform a Secondary Rhinoplasty (not a tip revision) this means (basically) treat the nasal bones and the nasal cartilages.
Therefore i would perform a narrowing of the nasal base (nose osteotomy) and alar and triangular cartilage shaping.

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 291 reviews

Nasal changes

The nose changes through one's lifetime.  Hard to say without an exam and a review of your photos. Best of luck.

Nasal changes

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The nose changes through one's lifetime.  Hard to say without an exam and a review of your photos. Best of luck.

Plastic surgery does not prevent future changes

Plastic surgery is one time event. It fixes but does not change future changes. Life goes on. Bodies keep on changing. So does the nose.

Plastic surgery does not prevent future changes

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Plastic surgery is one time event. It fixes but does not change future changes. Life goes on. Bodies keep on changing. So does the nose.

Changing nose

The nose can continue to change throughout our lives.  Usually the changes are subtle and do not affect away her nose looks and any significant way.  However sometimes the nose can drop or become longer or wider looking with time.  A revision surgery can certainly change that and most likely will not continue to enlarge or become wider after a second surgery.

Regards

Dr. J

Changing nose

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
The nose can continue to change throughout our lives.  Usually the changes are subtle and do not affect away her nose looks and any significant way.  However sometimes the nose can drop or become longer or wider looking with time.  A revision surgery can certainly change that and most likely will not continue to enlarge or become wider after a second surgery.

Regards

Dr. J

Rhinoplasty healing

Rhinoplasty results depend on technique and how you heal. Generally, it is possible that noses can drop over time and appear larger. There are certain techniques available that can minimize this.

Richard A. Zoumalan, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Rhinoplasty healing

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Rhinoplasty results depend on technique and how you heal. Generally, it is possible that noses can drop over time and appear larger. There are certain techniques available that can minimize this.

Richard A. Zoumalan, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 27 reviews

Changes in rhinoplasty with time

Difficult to evaluate without images; however, the common cause for this "problem" is the loss of tip support. If the tip then starts to lose projection it will look "squatter" and broader-essentially "bigger".  Conversely the tip with good support will help to maintain the integrity of the lower cartilage position of the tip and be more elegant. Changes very often can happen even over many years and the tip and "supratip" areas are the most vulnerable to these. This is why The best long term results are achieved by accurate assessmnt, restoration, and maintenance of very solid tip support. 

Ludwig A. Allegra, MD
Seattle Facial Plastic Surgeon
4.0 out of 5 stars 16 reviews

Changes in rhinoplasty with time

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Difficult to evaluate without images; however, the common cause for this "problem" is the loss of tip support. If the tip then starts to lose projection it will look "squatter" and broader-essentially "bigger".  Conversely the tip with good support will help to maintain the integrity of the lower cartilage position of the tip and be more elegant. Changes very often can happen even over many years and the tip and "supratip" areas are the most vulnerable to these. This is why The best long term results are achieved by accurate assessmnt, restoration, and maintenance of very solid tip support. 

Ludwig A. Allegra, MD
Seattle Facial Plastic Surgeon
4.0 out of 5 stars 16 reviews

Changes in the nasal appearance after rhinoplasty are due to resolution of swelling.

Any changes in appearance after liposuction are due to resolution of swelling. There will not be anatomic changes unrelated to swelling within the tissues. It would be interesting to see some photographs.

Changes in the nasal appearance after rhinoplasty are due to resolution of swelling.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Any changes in appearance after liposuction are due to resolution of swelling. There will not be anatomic changes unrelated to swelling within the tissues. It would be interesting to see some photographs.

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.