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)

Question

I had a rhinoplasty in 2021 to shave down a large bump as I had a very ethnic nose. Post surgery I noticed that there was a dip in the left side of my nose and bone that was still large or gave a bump look, as well as a curved appearance to the left. In 2023, I went back in for a “revision rhinoplasty” in which the bumps were further shaved down and a crushed cartilage graft was placed in the dip of the left side. I am now 2 years post op and have noticed that the curvature has not gone away from both the bridge and tip of my nose. I went into my plastic surgery office to see what my options were and my doctor suggested an in office procedure where he would shave the right side of my nose as he believes that is what is given the curved/crooked look. Should I move forward with the in office procedure or look to another doing another revision operation? I am very unsure of what to do in this situation as I never anticipated that 4 years after my initial procedure, I would still be dealing with the appearance of my nose. What are your recommendations?

Eric M. Joseph, MD · Answer

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

Mark Beaty, MD · Answer

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.

Gianfranco Frojo, MD · Answer

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.

Steven M. Denenberg, MD · Answer

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.

Richard G. Reish, MD, FACS · Answer

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

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)

Answers (5)

Answer: No "in-office procedure." There is possibly much that can be done for your nose ...

Answer: No "in-office procedure." There is possibly much that can be done for your nose ...

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

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)

Answers (5)

Answer: No "in-office procedure." There is possibly much that can be done for your nose ...

Answer: No "in-office procedure." There is possibly much that can be done for your nose ...

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.