Is There Really Any Help for This Upturned Revision?

I had revision on the tip to improve an already upturned tip from a previous rhinoplasty 16 years ago. This is 3 weeks post-op. I feel it has been more shortened and upturned. Dr. says it will drop more. I feel hopeless. Will the tip continue to drop or am I destined for grafts to lengthen the nose. So depressed.

Doctor Answers 3

Upturned a 3 weeks

3 weeks is still very early to judge result of rhinoplasty - I would wait at least 3 months before judging the length of the nose

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Nose still upturned after revision rhinoplasty

There certainly can be quite a bit of significant tissue swelling that will cause your nose to be more rotated right after surgery. After only 3 weeks, it would be difficult to say how much you would expect it to drop. A lot depends on the techniques used to stabilize your nose during your reivision surgery.

Regardless, you would want to wait at least one year before entertaining another revision. Counter-rotating the over-rotated nose can be extremely difficult, especially when scar contracture is involved. Although one can use cartilage grafts to reposition the tip position, your skin envelope has to follow. If the skin envelope isn't maximally "loose" that will end up being the self-limiting factor to how much counter-rotation can be acheived.

If you want, visit the web reference below and then look at patient 26.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Rhinoplasty Result

Although it is only 3 weeks after your revision procedure, I agree that your nasal tip is significantly over-rotated in the setting of a rather short nose.  It is possible that your tip will drop to some degree, but it is uncertain how much.  Right now, the best course of action is to wait because a revision is not feasible for about a year.  However, should you decide at that time to pursue a tertiary Rhinoplasty, you will need a nasal lengthening procedure, likely with rib cartilage.  Seek out a Rhinoplasty Surgeon who specializes in complicated revisions.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

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