32 Year Old Female, Open Revision Rhinoplasty - Shawnee, KS

When I decided to have my primary rhinoplasty I was told that complications can occur during healing. I acknowledged this but didn’t think it would actually happen. Well, it did, and now I joke that, that is why you should never have surgery on Friday the 13th!

My complication is minor and can be fixed. It was explained to me that a bone shifted during the first few days of healing contributing to the different look of my nose when viewed comparatively from the right and left oblique views. Asymmetries in my tip were also completed during my primary rhinoplasty however; the reduction was not enough to be considered a great improvement. The tip was successfully reduced enough that my nose no longer points down when I smile or give a kiss. My nose has always been a tough case as it started out with many asymmetrical features.

I have chosen to have my revision with the same doctor that did my primary. He is highly qualified for revisions and specializes in reconstructive rhinoplasty. This brings me to my second joke, I think he did not fix it well enough the first time because he prefers to do revisions! Plus we have all read in our research that even the best surgeons do not always achieve the ideal outcome with the first procedure. The last piece that adds to my trust in him is that he did not botch or overdo me to begin with. Little is more in this field and my nose received a conservative amount of work the first time.

The surgery is scheduled for August 27th (six months after my primary post-op) which is great because we wanted to start trying for baby number two in September! Of course my Dr. did not rush the revision date earlier due to this desire; he is just very comfortable doing my revision at six months. My swelling is very minimal and my scar tissue is softer than what is normally expected at this point.

I was told that this will be another open procedure in which my bones will be broken again, the tip and bridge will be refined further, and he will most likely need to harvest some cartilage from my ear as well as some soft tissue from behind my hairline to complete the work. I was in such shock that I needed a revision at my 3 month postoperative appointment that I forgot to ask where these cartilages would be used. I will be sure to ask at my one month preoperative appointment along with some additional questions.

My doctor is covering his surgical fees and I am left only responsible to pay for the anesthesia and hospital cost.

Reading through the abundance of revision surgeries on this network has given me comfort and hope that this will be successful. My battle is easier than most, I do not have to search for a new surgeon this time. Wish me luck!

I am very fearful that this revision will not be my last. Not because of my faith in my surgeon but because of all the multiple revision rhinoplasty reviews on here! It is a very difficult procedure even for the well-practiced expert. I am doing everything within my abilities not to have that happen. I think having all of my questions answered will help.

Here are some questions I plan on asking during my August 3rd pre-operative appointment:

How many revisions do you perform every year?

How long do you expect the surgery to take?

What are my chances of having a greatly, not slightly, improved result?

How will my nose continue to change over 10, 20 years’ time?

What do you think are all the factors contributing to the curve in my nose?

Will my projected tip be further revised?

Will my dorsal hump, more of a slight curve after my primary, be further revised?

Will the asymmetries in the top and bottom view of my nose (may be caused by tip cartilage) be corrected? What is causing these asymmetries?

Is there a chance that you would harvest rib cartilage? If so, can the incision be made through my breast implantation scar?

If you do harvest cartilage from my ear, what will it be used for, where will the scar be, and can we agree on which ear it would be taken from?

If you do harvest soft tissue from my hairline, what will it be used for and will part of my hairline be shaved?

How do all these different types of soft tissues last throughout the years?

What can be done to stay ahead of my nausea this time?

How soon after surgery will it be safe for me to try and get pregnant?

I had my preoperative appointment this past Monday. I was brave enough to ask all of my questions and my doctor was patient enough to listen and answer them fully. He took more pictures, had me pay for the hospital and anesthesia fee, and sent me home with the anti-bruising medicine to start the day before my surgery.

The appointment started out with him reassessing my nose. I kept quiet for this part. He said we need to shave down the bone on the right side, decrease the remaining dorsal curve, do some rework of the septum to help straighten the current shift to the right, and further revise my tip cartilage to increase symmetry and reduce the projection of my tip slightly. These were all the things I too thought needed improvement so I agreed fully with his assessment! My only disappointment was that he will not be able to significantly improve my projection. I guess there are some long term risk with that and being that he is a reconstructive surgeon by nature; he does not like to cause an overly aggressive/ temporary result. When I really think about this I too would rather have a long term, more natural look, than a possibly wider or even collapsed nose.

Now all I have to do is wait about three more weeks. I am excited but VERY SCARED for my revision. I see so many people on RealSelf who go through it over and over again only to remained dissatisfied. I believe my expectations are much more aligned with my doctor this time as I now know what to expect and what kind of results are long lasting and safe (the true ideal). I have also told him of this fear and we have talked through it as much as we can. His nurse is helping with these anxieties too and said to call at any time if I need anything.

Here are some of the interesting answers I received during the consultation:

How long do you expect the surgery to take? – About two hours

Will my projected tip be further revised? – Yes however, we are limited slightly by what you were born with. Over resection of the underlining structures can result in other problems such as a widening of the nose and destabilization over time.

Is there a chance that you would harvest rib cartilage? If so, can the incision be made through my breast implantation scar? – The chance of this is very low however; we will go through your implant scar under the breast if this becomes necessary.

If you do harvest soft tissue from my hairline, what will it be used for and will part of my hairline be shaved? – No shaving is necessary, the scar will not be seen, and it is used to help contour the nose.

How do all these different types of soft tissues last throughout the years? – They usually age naturally and nicely with the existing structures of your nose. Scar tissue is the bigger issue.

What can be done to stay ahead of my nausea this time? – We will notify the anesthesiologist and send you home with a patch and a prescription for Zofran.

How soon after surgery will it be safe for me to try and get pregnant? – It is okay as soon as you have been off of all your pain medicine for at least a week. Check with your OBGYN.

I will post before photos the week prior to my surgery. Take care everyone!