Revision for Tip Refinement

In December I will have a revision to correct my still "swollen" tip. It seems that too much cartilage was removed during my primary and my tip was left with insufficient support. Also the skin got thicker and scar tissue formed that was not treated by my surgeon. During revision another surgeon will place an additional tip graft for support, projection and definition. This time the approach will be closed (primary open) to not disturb the already scarred tissue too much.

Last Wednesday I visited my surgeon to have exactly clear what will be done in the revision. He again confirmed that my nose now is a bit underprojected and the tip is too full/round. The general result of my primary is good. So what needs to be done is adding some extra cartilage to my tip. To minimize extra scar tissue and swelling it will be done through a closed approach. The graft will be a cap graft, placed in a pocket. A shield graft is not necessary because my columella is fine and does not need extra cartilage. My primary operation took 3 hours (!), but the revision will take (only) 1 hour maximum. This will also lead to less swelling I hope. Actually, because the rest of the nose is OK it will be a tipplasty.

The plan is to use steroid injections after 6 weeks when there is still remaining fullness/roundness. My first surgeon refused to give any, which in my opinion is part of my current problems.

Let's hope for the best. At least now I am in the hands of a very skilled nose-specialized surgeon with 35 years of experience. My first surgeon performs rhinoplasties and revisions only as a part of the total treatments he offers in his work.

My surgery was planned on December 12, but due to heavy snow in Europe on Monday it had to be delayed. My surgeon wasn't able to arrive on time; he got stuck on an Italian airport. The good news is that it was rescheduled to the 15th, so two days ago. Last Friday I finally had my revision, after a very exceptional power breakdown in the clinic that again delayed my surgery for a few hours.

During surgery (it lasted 45 minutes instead of 3 hours the first time) my dr. harvested a bit of cartilage and used it for 2 small grafts to support and better define my tip. The other surgeon removed too much during my primary.

The first two days of my recovery went well so far. No bleedings and the internal packings just removed today. From the front and sides I can already see the difference. My nose is better projected. Hopefully we can control the scar tissue this time. In 6 weeks I have another consult to see if kenalog injections are necessary.