Deviated tip after 1 year Rhinoplasty, what has gone wrong? (photos)

Question

had a Septoplasty 1 year ago, the hump was corrected and deviation too (apparently). He added some cartilage grafts on the sides of the nose on the tip.I'm happy the hump is not there anymore but my nose looks really deviated (more than before) and the tip is awful as columella has dropped a little bit too. Is this normal, what has gone wrong? surgeon has offered a revision but he said it would not really be worth it as the change would barely noticeable. is it really possible to correct it?

Clark Schierle, MD, PhD, FACS · Answer

I definitely think there is room for significant improvement in your symmetry with a revision surgery that will more aggressively reconstruct your dorsal septum and support it in a straighter position. You also have to understand that there is no such thing as the “perfect” nose. As rhinoplasty surgeons, we are able to improve the structure and function of the nose to address specific issues you have with how your nose looks and and how well you can breathe. Perfect symmetry does not exist in nature. Attempts to improve the symmetry of your nose should be aimed at achieving an improvement in your asymmetry to the point where it is no longer very noticeable. If you look carefully enough, you will always be able to find imperfections. The goal is a normal looking nose that is in harmony with the rest of your anatomy.

Afshin Parhiscar, MD · Answer

Dear lucystileOne of the main reasons primary and revision rhinoplasties are not satisfactory is not appreciating some of the issues involved. From your photos, it appears that you have relative hypoplasia of one cheek and piriform. This is normal as most of us have facial asymmetry. If the base of your nasal tip is lower and less projected, then unless that is corrected, it is difficult to build a stable and symmetric tip. Although an in person exam would be needed, I think you have piriform asymmetry and once corrected, your tip revision can be done to straighten your tip.

Manish H. Shah, MD, FACS · Answer

Hello lucystile,Thanks for your question.You started out deviated in your preop picture and at 14 months you continue to deviate.Even if you were straightened, it is not unusual for a septum to re-deviate.  Your nasal tip is higher so it shows your columella more easily on profile.There may be other aspects of your septum that still need treatment to straighten out further.You may need adjustment to the rotation of your current tip position and adjustment to the height of the columella to camouflage this area of concern.I would recommend that you speak with a surgeon who specializes in revision rhinoplasty, take more standardized photos, and simulate various outcomes for a revision rhinoplasty that would be acceptable to you.

Marcelo Ghersi, MD · Answer

Hello. You still have a significant deviation of the nose. Likely, in addition to bony deviation, the septum is deviated and was not completely straightened out. You should have a revision done by a surgeon who can deliver a major improvement.

Douglas J. Mackenzie, MD · Answer

Based on your photos you have several remaining cosmetic nasal issues.  There is no quick fix, only a secondary (revision) rhinoplasty will offer improvement.  It is true that nasal deviation is a tough problem, and some recurrence can happen, but yours still looks significant.  There are issues on your profile that should be considered for correction:  I think your tip is slightly over-rotated, your lip-columella junction could be better defined, and a chin implant would give better better balance.  See one or two surgeons comfortable with revision rhinoplasty for more thorough evaluation.

Deviated tip after 1 year Rhinoplasty, what has gone wrong? (photos)

Answers (5)

Answer: This is correctable

Answer: This is correctable

Answer: Needing rhinoplasty revision

Answer: Needing rhinoplasty revision

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Everything you need to know about Rhinoplasty

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Deviated tip after 1 year Rhinoplasty, what has gone wrong? (photos)

Answers (5)

Answer: This is correctable

Answer: This is correctable

Answer: Needing rhinoplasty revision

Answer: Needing rhinoplasty revision

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.