Rhinoplasty failure… but why & what now? My nose looks the same as before (Photos)

Based on your photos, you appear to be a candidate for revision rhinoplasty since your tip still appears droopy. The tip should be able to be made smaller as well. Be sure to see a couple of different rhinoplasty experts with your preop photos and op note to see what can be done. Computer imaging can be done at the same time.

We have met many patients over the last 25 years who have come to our office looking ridiculously close to how they started, even though they were over a year after rhinoplasty surgery. The best way to answer your question would be to procure a copy of your operative report and before and after photos. This data may be reviewed by another reputable rhinoplasty specialist to see what may have happened. As I mentioned in the title of this post, an under-operated nose may lead to a more predictable outcome than a nose that has been made to small. Simply put, removing a persistent dorsal hump along with tip narrowing and tip rotation should be something attainable in the right hands. I hope this is helpful and I appreciate your question. Sincerely, Dr. Joseph

Hello and thank you for your question. Based on your photographs, will benefit from a Revision Rhinoplasty. Careful selection of a revision surgeon is needed to here. I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up. Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag. If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, that can also be a red flag. Long-term results are much more meaningful than on table results or 1 week post-op results. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon