Unhappy with my nose, 3 years post-op. Doctor won't tell me what he did wrong, how do I fix this and what do I do now? (Photos)

I had my rhino 3 years ago for my bulbous tip and no bridge. Afterwards, I saw that he barely touched my bridge and my tip was very crooked. I came back 5-6 times to have injections for swelling and to heighten my bridge. Now, my left profile is good but my right profile looks different, and my tip and nostrils are uneven. He recommends no revision because apparently I had a deviated septum, which he didn't tell me until the 5th visit. I am unhappy and do not trust his opinion. What do I do?

Doctor Answers 7

Considering revision rhinoplasty

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I'm not sure you should assume your surgeon did something wrong.   Rhinoplasty is the most complex and sometimes unpredictable plastic surgery.   The forces of scar contracture can make nostrils that were symmetric at surgery become asymmetric as they heal.  Bone callus and cartilage scar formation can make bridges becme asymmetric and elecated.   It can be a very frustrating surgery for both patients and surgeons.   Also deviated septums are frequently noted at surgery and fixed if needed.   The surgery becomes more complex with each revison.   The fact that you had  a deviated septum doesn't typical mean that a revison is contraindicated.   You should clarify this worth your surgeon.   You can always get a second opinion (in person)... 

Richmond Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Revision nose

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Emeraldp, no one can or should tell you what you need done without a personal evaluation; especially for revision work. See an experienced surgeon that does "only faces" and make sure they have a lot of good photos on their web site. Search the Internet and review the movie. Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 55 reviews

Unhappy Rhinoplasty patient, What to do now

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Rhinoplasty can be executed correctly and not heal as anticipated resulting in an unsatisfactory result. Regardless the only permanent solution is revision rhinoplasty with structural grafting which may involve grafting of the tip, dorsum and columella. In your case it will be necessary to reset the caudal septum in the midline, straighten the septum and reconstruct the lower lateral cartilages to achieve improvement and symmetry. It will be necessary to choose an experienced surgeon with and appreciation for the function and appearance of the nose.

Edward Farrior, MD
Tampa Facial Plastic Surgeon
4.4 out of 5 stars 14 reviews

Unhappy with nose 3 years after rhinoplasty: asymmetric

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I would recommend you get another opinion if you have lost trust with your surgeon. However, rhinoplasty more than other aesthetic procedures is not entirely predictable in outcome due to the healing process.  The nose has 5 major cartilages including the septum that are placed into position at the conclusion of the procedure, but are not rigidly fixed.  The healing process places forces that can be asymmetric and change the appearance even in the well performed surgery, so that revisions are necessary in approximately 10% of cases even in the most experienced surgeons hands.


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Dear emeraldp, If you do not trust your surgeon and the patient surgeon relationship has become fragile then I would suggest seeking a secondary opinion with some experts in the field of revision rhinoplasty. If you have a copy of your operative report and original pre-operative photographs these can be helpful to your consulting surgeon. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Unhappy with My Rhinoplasty Results

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I understand your disappointment but your surgeon may not have done anything wrong. If your surgeon does not want to make any changes I suggest you get a second opinion from a revision rhinoplasty specialist.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty for the deviated nose etc.

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Revision rhinoplasty for the deviated nose etc. is the only way to correct this. Get another opinion from a revision rhinoplasty surgeon. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

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.