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

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.

Doctor Answers 8

More work on the tip of your nose would make a big difference

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.

Omaha Facial Plastic Surgeon
4.8 out of 5 stars 41 reviews

Unhappy with Nasal Tip After Rhinoplasty? Will Secondary Revision Cost?

           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

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Most plastic surgeons do not charge for a revision of a rhinoplasty.

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.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

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Nasal tip asymmetry after surgery

If you are not happy with your result then consult with your plastic surgeon.  Express your concerns.  It appears that you had a conservative trim of the lower lateral cartilage.  This has left you with some bulkiness of the nasal tip as well as asymmetry.  

Jeffrey Zwiren, MD
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Revision Rhinoplasty Fees

10-15% of primary rhinoplasty patients are estimated to undergo revision, so you're not alone. If you go to the same surgeon and have a good relationship with him/her, you will likely get a heavy discount on the surgeon's fee. There usually is some fee associated with anesthesia and/or perhaps facility, so its NOT free.

If, however, you've lost all confidence and go to a new surgeon to start the whole process over, you can expect you'll be responsible for all the fees, and typically revision rhinoplasties cost more than primary rhinoplasty fees. 

For starters, I'd encourage you to stick with your surgeon. Explain what you are unhappy with, undergo a digital photo imaging session so you can have a meaningful discussion about what you'd like your nose to look like, and maintain realistic expectations.  From what I see from your photos, you should be able to get a nice improvement from a revision rhinoplasty.  

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
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Revision Rhinoplasty for the asymmetric over projected nose.

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.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
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Revision rhinoplasty to improve the look and symmetry of the nasal tip

Thank you for your post.  After reviewing the photos you've provided, I think you have a valid point regarding your nasal tip.  Revision rhinoplasty can help refine your nasal tip, make it more symmetric, and improve the harmony of the nasal tip with the rest of your nose and facial features.  The cost of the procedure will vary depending upon the training and experience of your revision rhinoplasty surgeon and the geographic location. I think your goals are quite reasonable though, and I believe your nose could be improved by any experienced revision rhinoplasty surgeon. It would be helpful for your revision surgeon if you could obtain the operative report from your first surgery.  You may require cartilage grafting to the nasal tip.  If you had a septoplasty performed with your first procedure, you may require cartilage grafts obtained from the ear. 

Dara Liotta, MD
New York Facial Plastic Surgeon
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Revision rhinoplasty

Dear jcr7jf,

  1. I can understand why you are unhappy and these issues can be solved with a revision rhinoplasty
  2. 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
  3. The cost would depend on how much work would need to be done and who you go see
  4. 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


Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 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.