Revision Rhinoplasty - how can I get my results closer to the rendering? (Photo)

Question

From the moment the cast was removed I suspected i wouldnt be thrilled with my result. After a year I spoke to ny surgeon about my concerns and he said he would do a revision for free to perfect the ridge of the nose, but he cant adress my other problems or doesnt see them as necessary. I dont wanna get a free revision knowing im gonna need another to get closer to what I wanted (is this incorrect logic?) I want a better result but now worry my expectations are unreasonable: I feel my nose doesn’t suit my profile: I wanted the negative curve on my nose removed I wanted the nostrils to be less prominent I wanted the tip rotation reduced I also feel like my nose is to short and sits high on my face I feel like my nose looks BARLEY different. Please note, I am aware the rendering includes a chin implant and liposuction (I didn’t get those)

Jeffrey H. Spiegel, MD · Answer

Hello - Yes, we can likely help with this. The answer will be to use a cartilage extension graft to lengthen your nose. The tip you had before and after are both more rotated upwards than the render you like. To get the nose down we'll need to add support.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. 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 with standardized lighting and standardized background. 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, or all patient selfie’s without real longterm in-office formal 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. Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website with standardized lighting and standardized backgrounds.

Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. 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. FACS
Harvard-trained board certified plastic surgeon

Revision Rhinoplasty - how can I get my results closer to the rendering? (Photo)

Answers (2)

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