Bad Nose Job
Doctor Answers 85
"Doc, you didn't operate on Michael Jackson, did you?"
Rhinoplasty is considered to be the most difficult of all cosmetic surgical procedures. Even the best surgeons have revision rates of 3-5%. Bad nose job results are usually due to many factors, the most important of which is choosing your surgeon carefully. I am continually amazed that many patients are more careful, and spend more time picking out the color and model of their new car than they are in selecting the surgeon who will operate on their nose.
As we know, the nose is smack dab in the middle of our face, and cannot be covered by clothing when things go wrong.
- You need to discuss with your surgeon what bothers you about your nose during the initial consultation.
- Your surgeon needs to make the proper diagnostic evaluation in order to correct what bothers you.
- You need to be assured that your expectations are realistic.
- Look at before and after pictures.
- Ask to be scheduled when other post-operative patients are in the office so that you can see and speak with them.
- Look at the before and after photos.
Once the surgery has occured, one needs to wait 6-12 months before correcting the bad result. If you still have confidence in your surgeon then schedule a revision surgery. You may want to get one or two other opinions from respected rhinoplasty surgeons (in the Chicago area, Dean Toriumi, M.D. is among the finest in the world).
Fillers may temporarily help particular problems, but truly bad results will need surgical correction.
Remember that the best chance for sucess is the first time, so choose carefully.
Talk to your doctor about your bad nose job...
Talk to your doctor about your bad nose job concerns
Rhinoplasty is generally acknowledged as one of the most difficult of all facial plastic surgery procedures. The reasons for this are multiple, and include the complexity of the three-dimensional structure of the nose, nasal physiology, in addition to the required technical skills and an aesthetic eye. Final results in rhinoplasty really should not be judged until one year has passed; in some cases, things may continue to change even after that. If you have had a rhinoplasty and are unhappy with the results, it is important to communicate this with your surgeon. It may be that time will remedy the situation, or (in rare cases) interval measures may be required. Either way, this communication is important. If a revision is required (after 1 year), it is important to choose a surgeon who is experienced in revision rhinoplasty surgery. The Internet has made it easier to identify potential surgeons, but always meet with a few and ask for examples of results and perhaps speak to a few former patients.
Further treatment for bad nose jobs It's important...
Further treatment for bad nose jobs
It’s important to recognize that full healing and shaping of the nose can take over a year. At that time, if someone is unhappy with the result they can consider a revision rhinoplasty.
Revision rhinoplasty is typically much more complicated than a primary rhinoplasty, and it’s very important to select an experienced surgeon who performs a great deal of rhinoplasty procedures.
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It depends on when your Rhinoplasty was done
A bad nose job really depends on how long ago it was done. Right after surgery, your nose usually doesn't look very good. The swelling and the bruising usually distorts the area so that it really won't look like it should for weeks to months. This especially occurs in the tip area. Sometimes, after your rhinoplasty, results that are not going to turn out as promising can be determined. Usually they are very obvious things like a deviated nose still appearing deviated after the procedure. Or the bump over your nasal bridge is obviously still apparent.
One thing to know is that the tip area takes the most time to refine itself. The swelling in this area takes patience for it to go down. Your doctor will consider steroid injections and oral steroids to help this in some cases but using steroids can be a risky thing to do especially if it is not injected deep enough.
Don't worry though. There are a lot of great surgeons out there that can improve almost any situation in the nose from a prior rhinoplasty. It might take some work but there are options to improve the situation.
A Revision Can Help!
Very sorry to hear of your bad result from Rhinoplasty.
A revision surgery can help. Find a surgeon known for excellent nasal work, possibly a surgeon known for rhinoplasty revision.
Don't lose hope.
Bad nose jobs and revision rhinoplasty
Today there are a number of reasons for bad nose jobs; the most likely is an inexperienced surgeon who doesn't know what he/she doesn't know. Revision rhinoplasty attempts to correct the underlying problem, which is either over resection or underresection of tissues, or both.
The goal in revision rhinoplasty is to restore a natural looking nose that fits the face, using the person's own tissues. Sometimes the nose has to be completely rebuilt in revision rhinoplasty, achieving both form (nasal aesthetics) and function (breathing). You must speak with your doctor about the procedure and wait at least a year in most cases. If you're not comfortable with a second surgery with your current physician, choose a surgeon who specializes in revision rhinoplasty. Review costs after you've visited with different surgeons so you won't be biased on cost alone.
Dealing With A Poor Rhinoplasty Outcome
Firstly, I sympathize with your situation and am sorry that you have to go through this experience. However, I think there is one part of your inquiry that really stands out in my mind. You give the impression that you have researched the topic of rhinoplasty and have not seen 'any good nose work' along the way. Unless you only researched a limited geographic area, I would seriously question how realistic you are about achieving a reasonable outcome.
Although rhinoplasty and revision rhinoplasty are quite complex, there are a number of well-trained, experienced surgeons across the country that should give you hope. It wouldn't take more than an internet search for revision rhinoplasty to discover a handful of them. In the meantime, try and be patient and positive. Give it upwards of a full year to heal completely then methodically go about choosing a trusted revision rhinoplasty expert to see if they can help you. Good luck.
How to talk to your Dr. about a bad nose job...
We all hate to hear about the large number of bad nose jobs out there. It is a very common reason plastic surgeons get sued.
I think that part of a good nose job entails educating patients about the possible consequences of surgery. Despite good surgery, some noses go bad! However, some patients get bad surgery.
I tell patients to wait a year at least after surgery to let healing complete. A re-analysis of the nose from the outside and inside is necessary after that point to figure out what went wrong.
Reoperative rhinoplasty is much harder than primary rhinoplasty. I recommend that patients seeking revision find a surgeon who specializes in corrective/revision rhinoplasty. This increases your chances of improving the outcomes.
Considering revision rhinoplasty
If you think you had a bad rhinoplasty and you are thinking about a revision, there are several things to consider.
1. You need to let things heal first, and it takes about a year. No respectable rhinoplasty surgeon will touch your nose until about a year after your surgery. Doing it before then will severely compromise your chances of having a good outcome.
2. It is not your fault. Unfortunately, there are too many surgeons out there who do rhinoplasty, and who should not be doing it. It is an extremely complex operation, and it requires a great deal of theoretical knowledge, practical experience, and artistic hands. Unfortunately, some of them sound convincing enough to talk many patients into having it done -- that is why there are so many unhappy rhinoplasty patients out there.
3. Fortunately, there is plenty of wonderful rhinoplasty surgeons. Do your research, review their websites, go to several consultations (I would go to at least three), and look at their before and after photos. In particular, look for the photos of patients who had problems similar to yours: overdone primary rhinoplasty, same ethnic characteristics, skin thickness, same gender and age.
4. Do not rush into a revision.
What to do about a bad nose job
In plastic surgery, just as any other medical procedures, there is a potential for less than an ideal outcome. When it comes to cosmetic procedures, patients experience a higher degree of anxiety associated poor outcomes.
It's important to know that the early outcome of rhinoplasty surgery, does not necessarily equate to late results. Swelling and minor asymmetries typically improve after one year. Most surgeons therefore, recommend waiting for one year before considering revision surgery.
So if your surgery is less than one year ago, then be patient and wait. Talk to your surgeon or ask for a second opinion. Try to take a step back and don't allow worries about your nose to take over your life.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.