Revision Rhinoplasty is Not Risky in the Hands of an Experienced Rhinoplasty Surgeon
The good news is that all of your issues can be fixed. Revision rhinoplasty is a difficult procedure. Most important, is finding an experienced rhinoplasty surgeon with special expertise and revision rhinoplasty. While it is possible to do this via a closed approach, the incision underneath her nose is pretty obvious from the side and should be fixed as a part of any procedure done. If you're going to have to open the incision in order to fix it, an open approach would not be unreasonable. My recommendation would be to find a surgeon you're comfortable with, one that has a lot of experience with revision rhinoplasty, one with good pre and postoperative revision rhinoplasty photos, and let them decide which approach is best. Good luck.
Is revision rhinoplasty too much of a risk? Would a closed rhinoplasty be possible?
Hello laurenlaz87,Thanks for your question. From what I see, it appears that you have post-surgical alar retraction. While this could be fixed with closed rhinoplasty, I would recommend careful open revision rhinoplasty with extended spreader graft placement to derotate the tip cartilage elements into a lower position. At the same time, more tip focused enhancements can be performed to finesse the tip and give it a better shape. It also appears that you have malposition of the lower lateral cartilages that worsened when your tip was narrowed. As the sutures are placed to narrow your tip the structures pull upward and retract the rims of your nose. A carefully performed open tip rhinoplasty can fix this. I would suggest you see a revision rhinoplasty specialist and have computer simulations performed so that you and the surgeon are on the same page.Good luck,Dr. Shah
Nasal Deformity after Rhinoplasty
You appear to have a hanging columella which gives your nostrils an unnatural shape from the side and base view.
This condition can be corrected with a minor revision procedure. Options to lengthen one's nose are available too, but require more extensive and complex rhinoplasty revision techniques. I would not recommend fillers and doubt that fillers would help.
The best solution clearly depends on your aesthetic goals and desired outcomes. I would consult with a Facial Plastic Surgeon and discuss your options after examination. I share your concerns about your columella and lack of tip definition, but these can be improved in the hands of an experienced plastic surgeon. Please try to remain positive and focus on the best solution. Hope this response helps.