Revision with Rib Graft

Tomorrow morning I'm having a revision using rib...

Tomorrow morning I'm having a revision using rib grafts to hopefully restore some of my original features. My nose was thinner and longer before my first surgery, and I haven't felt much like myself since that was drastically changed. It's going to be a long surgery and recovery, so I'm feeling a bit anxious about it. But I think this will be a step in the right direction to moving with my life. Send me those healing vibes... :)

Surgery complete

My surgery was yesterday and I'm in a lot of pain. Not my nose but my rib. I spent one night in hospital and I wish I was still there, I was really scared to go back to the hotel on my own because it was so difficult to stand up. I've seen my surgeon 3 times since the surgery. He gave me some extra pain medication. The lady from his office drove me back to the hotel. The amount of time and care they put into their patients is great. I just wish I didn't have to go through this.


I can pull out this tube when the numbing fluid is gone. They said around day 5. I'm not attempting to move around much or get changed, feel too fragile.

Trying to be good

My surgeon was pretty strict about keeping things iced and elevated. I don't have any bruising yet, whereas I did during my primary, so perhaps the protocol is working. Once in a while I've been walking around my hotel in my hospital gown, lucky it's not too busy lol. :/

Comparison photos

Looks promising since it's definitely longer, but can't really appreciate it in my current physical state. My nose feels hard and swollen, and there's a spot on the tip looks a bit purple/reddish. Hopefully this is temporary.



The tip looked purple for a few days but is back to normal now. I removed my numbing tube yesterday which was a huge relief. Still on oral pain medication and will be for a bit longer, as I can feel the discomfort creeping up whenever it's due.

Cast off!

The cast came off today and everything looks good. I have a longer stronger profile and everything looks symmetrical. I'm still contemplating my front view, the width looks similar to before so if there is swelling then maybe I'll really like it in a few months? Overall I'm feeling positive and I don't have a horrible feeling of dread like I had after my first surgery.

Back in the good ol days

I caved, here are my frontal views accompanied by crazy editing. I think my revision nose is an improvement and actually seems to look like the morphs... However I feel conflicted. I miss my natural nose. I'm going to ask my surgeon more about why it looks so different and whether some things can be restored. What causes that inward curve? Is it the upper lateral cartilages?

Brow tip aesthetic line

My brow tip aesthetic line was lost during my primary rhinoplasty. I'm wondering if it can be restored.


There's a lot be grateful for and yet I find myself disappointed. Dr Davis was very forthcoming about the possibility of needing a touch up, so the fact my nose still requires narrowing is not the biggest issue. The biggest issue is the fact that my nose wasn't lengthened enough and I don't have any cartilage available. I brought this up with him and he said a tip onlay using ear cartilage will bring it down the rest of the way. I'm really concerned that it won't bring it down properly and also that my ear will change shape. My ears are already close to my head and there's no room for change.

You can see from the photos that there's a big improvement so I feel bad writing this. And yes my nose looks pretty good. But I want my dream nose and that nose is not upturned AT ALL. I'm really disappointed at the prospect of needing another surgery not just on my nose but also on my ear. We did detailed imagining so I just don't understand why this was not measured properly. I guess it's a case of different aesthetics.


My rib harvest area feels okay now but I've caught the flu or something. I think my body is in self destruct mode after all this!

Still looks upturned

Here's a comparison of my profile. It still looks upturned to me... :( Less concerning is the fact that I have a pseudo hump from the dorsal onlay graft which will probably need to be shaved down.

Natural nose

Return of the hump

It's a bit ironic that I originally had rhinoplasty for a small hump and now it's back again.

Septal extension graft

I believe the problem is the shape of the septal extension graft. "To treat an acute nasolabial angle, the caudal septal extension graft is triangular shaped with the longer margin oriented inferiorly."


I really feel like despite a lengthy consultation, detailed morphs, and a USB full of photos my aesthetic goals were abandoned on surgery day. I asked for my nose made narrower and I found out only by reading the surgery report that no work was done to narrow my nose. The spreader grafts add width to the middle vault and tip, while the added length gives the appearance of it being narrower. But as far as I can tell it isn't physically narrower. I asked for my nose to be lengthened and tip to be derotated, and instead of designing a triangular septal extension graft that would achieve this, a rectangular graft was used to lengthen my nose evenly. I don't see any good reason for this decision because I provided a morph showing a tip that is neutrally positioned... I also asked if my nose could be slightly deprojected and I was told this may affect the front view, so I accepted this may not be possible. But since the dorsal onlay graft was placed on the highest point of my bridge it actually adds 1 of 2 millimeters of projection. I don't get it.

Not worth it for now

I'm marking this as not worth it because I have a small improvement that is not worth $15,000 plus travel costs and rib pain. The worst thing is this used up my chance to derotate my nose. I'll never have my old look back unless I'm crazy enough to have another rib surgery. Make sure you ask your doctor if he will store your leftover rib cartilage or throw it away, just in case.

Swelling comparison

Here is a swelling comparison of my primary at about 4 or 6 weeks vs now. It hardly feels swollen this time.


When I was researching rib grafting a concern that came up sometimes was the firmness of the grafts. My nose kind of feels like a rock. But it actually feels better than my last nose because the grafting was done so poorly, with grafts that were too long or large, causing tension and pain. I think my smile has improved because of the better shaped grafts also.
Pembroke Pines Facial Plastic Surgeon

It looks better but nothing was resolved. I wanted the width and upturn fixed, and neither have been fixed.

3 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
3 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
1 out of 5 stars Wait times
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