Possible revision? I'm noticing dents, asymmetry & an unnatural result (Photos)

Question

I had a rhinoplasty 7 months ago, the first 4-5 months I was very pleased. My nose was more swollen at the time and the contour appeared softer and more natural . Now I am noticing dents, asymmetry, and an unnatural result. I don’t know if I should go back to my surgeon or seek out a revision specialist. Every month I am noticing more flaws and am less happy. I also think I may have a mid vault collapse and over resected dorsum. Am I in need of a revision? Included 3 Month post op and current.

Nima Shemirani, MD · Answer

Hi @jh1022. I am sorry you are not happy with your rhinoplasty results. I recommend seeing an expert revision rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. Best of luck, Dr. Nima.

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.  Although an exam in person is ideal, from your photographs alone it appears that you may have a residual dorsal hump, specifically at the keystone.  The mid-profile collapse may be there too, but further reduction at the keystone may provide enough of an improvement.  I would not recommend a revision rhinoplasty until 1 to 1 /2 years postop, when all the swelling has come down.

The next step for you is to find the right aesthetic plastic surgeon.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Eric M. Joseph, MD · Answer

Many people with thin skin have postop indentations that may be more obvious than in those with thicker skin types. Revision surgery may be necessary, but your skin will remain thin. Sometimes we use microdroplet Silikon-1000 to fill indentations postop to reduce stigmata of surgery. Hope this helps. Dr Joseph

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! Thanks for the questions. At 7 months, there's still time for improvement. I advise my patients to wait at least 12 months before considering a revision. This allows for all imperfections (if any) to "show-through" and allow for complete correction. At this point, I would revisit with your surgeon to discuss your concerns. If you need to seek another opinion, it can only help to fortify your ultimate decision. Those who perform high-level rhinoplasty and revisions would be good starting points. Hope this helps!

Possible revision? I'm noticing dents, asymmetry & an unnatural result (Photos)

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