Unhappy with Nasal Tip After Rhinoplasty? Will Secondary Revision Cost? (photo)

Question

I had rhinoplasty in 2012 and was dissatisfied with the nasal tip. I noticed a few months after surgery the deformed tip, spoke with the surgeon and he said it was still healing. Well, it's a year and a half later and I am still unhappy with the results. From the front of the face you can see where the nose looks slightly crooked. The tip slants to the right of the face, making it somehow look larger from the side view on the left. I have attached pictures if you want to look.

Steven M. Denenberg, MD · Answer

Hi. The problem is not so much the asymmetry. It's that inadequate work was done on the tip of your nose. The tip of your nose is drooping down, and it projects strongly forward off of your face. See my "Web reference" link for a morph showing what your nose could look like with a revision rhinoplasty. In the morph, I brought your nose back toward your face, raised the tip, so it doesn't look so long, and I also tucked up the columella, which is the little piece of skin that separates the left nostril from the right nostril.

	Small asymmetries are difficult to correct, but often, when a nose is deprojected, which means brought back closer to the face, some of the asymmetries go away, because asymmetries are frequently more noticeable when the nose projects strongly.

	In selecting a surgeon, you need to see before and after photos of his work in revision rhinoplasty, and especially work on the tip of the nose. Tip work is the hardest part of the rhinoplasty operation to teach and to learn, and many doctors don't do it well enough.

	The good news for you is that, in capable hands, deprojecting and elevating the tip of the nose are two of the most predictable parts of a revision operation.

Kenneth Hughes, MD · Answer

Your tip can be refined and deprojected.   The columella droop can be improved as well as the tip asymmetry.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

	Kenneth Hughes, MD Los Angeles, CA

Vincent N. Zubowicz, MD · Answer

I personally do not charge a revisional professional fee after rhinoplasty. This is an issue however that you need to discuss with your plastic surgeon. You look to be a good candidate for revisional surgery.

Toby Mayer, MD · Answer

Revision Rhinoplasty for the asymmetric over projected nose involves removing excess cartilage and grafting cartilage where you need it. I need to see better pictures to give you a more definitive answer and cost projection. Make sure you see a very experienced rhinoplasty revision surgeon for the best results.

Nima Shemirani, MD · Answer

Dear jcr7jf,

	
		I can understand why you are unhappy and these issues can be solved with a revision rhinoplasty
	
		It would take some cartilage grafting to straighten the nose, and special care to bring that tip in to match the bridge of the nose
	
		The cost would depend on how much work would need to be done and who you go see
	
		You can look on realself to get an idea of how much it would cost depending on which area you live in


	Best regards,

	Nima Shemirani

Unhappy with Nasal Tip After Rhinoplasty? Will Secondary Revision Cost? (photo)

Answers (8)