Septorhinoplasty 9 months ago,appears cosmetically worse than pre-surgery.How is this possible?Will I require a revision?(photo)

I had a septorhinoplasty 9months ago. Unfortunately my nose has come out looking cosmetically worse than pre surgery. I no longer have a pointed tip (which i loved about my old nose) and now have an indent on my right hand side. Almost appears as though it has collapsed inwards. Also, the supra-alar crease does not look symmetrical. Could anyone please explain how this indent could have happened? Would i require another "open" surgery to fix these concerns? Any advice would be much appreciated!

Doctor Answers 2


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It looks from the photos like you may have significant middle vault collapse and you will need a significant revision probably involving cartilage/rib grafts

Post Operative Rhinoplasty Concerns

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Thanks for your post. Pre-operatively you presented with a difficult case characterized by a crooked nose, thin skin and soft tissue envelope and asymmetries to the nostrils, alae and columellar structures. Unfortunately, the right indented region may represent collapse of the right upper lateral cartilage or underlying septum. This can be corrected with revision surgery utilizing cartilage spreader grafts and other techniques. Should you decide to have revision surgery, any asymmetries to the alar creases, nostrils or cartilages can be fixed at the same time. I would recommend an open approach surgery to optimize exposure and reconstructive options. I am sorry that you may need to consider additional rhinoplasty surgery. It may be best to wait a full year from your first surgery before you undergo any additional procedures. Hope this answer helps. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

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