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Ended up needing a revision.
After around 3 months post-op with Dr. Undavia I noticed my tip appeared to be progressively drooping downward, which ultimately resulted in a polybeak deformity. Dr. Undavia continuously told me that this was swelling in the supratip area, and attempted to treat it with 3 different sessions of kenalog injections. This was not the solution, and made no difference except resulted in denting every time I received the injections. Unlike some, I am very lucky that the dents always resolved after a few months post each session of kenalog injections. My doctor who performed my revision knew right away that the polybeak was certainly not a result of swelling, and was a poor positioning and support of my tip.
In addition, around 6 months post-op I began seeing a weird dent around the mid portion on my nose, only on the right side. I also felt that there was something in my nose. It was a weird sensation that I couldn’t quite explain. I had multiple friends comment that my breathing was noisy, and it often sounded like I was exerting myself. I brought this up to Dr. Undavia and he labeled it a “contour deformity”, and suggested that if it really bothered me he could use filler to make the dent less noticeable. When I told my revision doctor that that my primary doctor called it a contour deformity he disagreed and told me that I indeed had a collapse of a nasal valve.
I am extremely happy with how my revision turned out. My collapse is fixed, my polybeak deformity is gone, and my bridge is built back up. When I realized I likely needed a revision I was distraught, as you see many failed surgeries on here but never think you’ll be one of them. The thought of having surgery again, spending all that money for second time, and then possibly having a worse outcome kept me up at night. I didn't show my revision doctor any photos, we just agreed to do whatever would make it functional and appear normal. My revision surgeon also planned on using cadaver cartilage but said my septum was practically untouched, so he had enough of my own material to work with.
I also want to say that I happen to work in the operating room and I know by all means that surgery and healing are at times very unpredictable. I just wish there was more transparency about what was actually occurring, opposed to making up excuses for what I was seeing, or potentially pretending not to see them at all.

20 Sep 2023
I’m so sorry you needed additional work after your rhinoplasty with me. I wish you had kept in touch with me, as I would have been more than willing to help. Supratip swelling is so common after rhinoplasty I like to try steroid injections 2-3 times before committing to anything more invasive. I don’t like to bring up surgery at 6 months since 95+% of patients never need that. Thats the only reason I hadn’t brought it up yet - but it was on my mind. I’m glad your revision was successful!
Provider Review

20 Sep 2023
I’m so sorry you needed additional work after your rhinoplasty with me. I wish you had kept in touch with me, as I would have been more than willing to help. Supratip swelling is so common after rhinoplasty I like to try steroid injections 2-3 times before committing to anything more invasive. I don’t like to bring up surgery at 6 months since 95+% of patients never need that. Thats the only reason I hadn’t brought it up yet - but it was on my mind. I’m glad your revision was successful!