2 years post op, the curvature has not gone away from both the bridge and tip of my nose. Can this be shaved in office? (Photo)

Do not accept:
-office based procedures without life support resources, offices are not for revision rhinoplasties, you can either risk your life or get a failed result
-crushed cartilage to correct what actually are technical defects needing comprehensive revisions
-minimally invasive touch ups, your nose shows multiple imperfections and errors, you need a full blown revisional procedure
-exotic theories about what the reasons are for your current look
-shaving the essential nasal wall to correct what actually is other type of problem, you'd get a hole in it with difficult, if any, repair option

In short, you have now:
-open roof deformity (no osteotomies, back-to-school situation)
-inverted V deformity
-assymetrical middle vault collapse, this explain your crookedness, it has and needs treatment... but not by shaving
-total nasal valve collaps and nasal pinching, has to be addressed too
-bad alar rim retraction, no nostril edge support
-poor tip support, assymetries at the domes
-etc

You need better opinions by an experienced and resolute revision rhinoplasty surgeon.

Based on your singular photo, you appear to have very thin nasal skin which is unforgiving after rhinoplasty surgeries. That means that your skin will reveal many indentations and irregularities left behind from surgery. You're crooked appearance appears to be due to a convexity along the left side wall of your nose, along with an indentation of your left hip that is deeper than your right. Sometimes, microdroplet Silikon-1000 nasal injections can be useful for improving upon nasal symmetry, if another nasal surgery is not feasible. I hope this is helpful, and I wish you all moving forward. Sincerely, Dr Joseph

While some minor nasal procedures can be done in the office under local anesthesia with oral sedation, I don’t believe this is the right approach for your situation. Simply shaving the right side of your nose is unlikely to correct the curvature or give you the result you’re hoping for. I recommend consulting a facial plastic surgeon with extensive experience in revision rhinoplasty.

Each surgery increases scar tissue and healing unpredictability, so the next procedure should ideally be your last. In your case, addressing both the bridge and tip together would likely provide the best chance for a balanced, straight result.

Before your consultation, be sure to obtain your operative notes and medical records, as they can help your surgeon plan the most effective approach.

It appears that there is a serious midvault deformity that has an S shape. The bones essentially do not line up with the middle vault cartilages and the tip cartilages. I would recommend a full revision rhinoplasty with rib cartilage.

Understand, I'm trying to work from only this one photo. It appears that your nose is still quite long, meaning the tip is drooping down. I'll bet the profile view and 3/4 views show that you might like having the tip elevated. When you take a hump down off the bridge, especially a large-ish hump, you have to be very careful to then elevate the tip, because lowering a bump has a big tendency to make the nose look longer. Also, it's important to narrow the remaining nose after lowering a significant bump. It doesn't appear that those other two tasks have been attended to.
Shortening a nose by elevating the tip often goes a long way toward correcting asymmetries, too. You notice the asymmetries because your eye follows the nose from where it begins between your eyes all the way down to the tip. If that's a long distance, it's difficult to keep *all* of that nose looking straight. If the nose is shortened, there is less length of nose to show off any asymmetries. Also, the surgical techniques that are employed in raising the tip give the surgeon more opportunities to correct asymmetries.
It's almost impossible that an in-office minor procedure or filler would make any improvement in your nose. What you need is excellent morphs of your profile and 3/4 views, and a real revision rhinoplasty to address every issue. Chasing bumps and dents will add more scar tissue and make an eventual real correction harder in the future. Finally, this is not a procedure that most plastic surgeons can handle. You must be careful in selecting your next doctor.

Hello and thank you for your question. Based on your photograph, a formal revision would help straighten your nose most. This should not be attempted under local anesthesia. 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