Revision rhinoplasty

Q: I had a tip rhinoplasty because I was unhappy with my bulbous nose and big drooping tip. I am thrilled that the ball on the very end and the dropping tip are gone, however, and I am not happy with the new shape of my tip from the front angle. I wanted to preserve the round "ball" because it was what defined me as a person. If I shove tissue balls or q-tips into my nostrils, it spreads my nose out to the shape that I want it again. Is there a surgical way to correct this back? Please help.

A: Nasal tip revision. Thank you for sharing your experience and photos. My first question to you is "when did you have your rhinoplasty." The nasal tip is the last region of your nose to finish healing. This reason is that the tip is the most cosmetically sensitive region,even the most subtle changes are significant. Also, the nasal tip is the most gravity sensitive region of the nose. So complete healing to the tip can take up to one year after a primary rhinoplasty. To help control tip healing, the rhinoplasty surgeon may elect to use injections. If you are more than one year out, a revision rhinoplasty can address some of your goals. However it would be best to be evaluated firsthand to see what techniques would be necessary for you.

Q: I am 11 days post op from my primary rhinoplasty and I am very unhappy with the results. I realize I still have swelling but my tip and show of my nostrils are unnatural and unattractive. It looks like a ski slope! Will my tip come down over time as the swelling decreases or will it continue to get worse? How much of an improvement could I expect with a revision? Thank you for your advise.

A: Yes, a short nose and over rotated tip can be fixed, but..... 11 days after rhinoplasty surgery is very early. Your tip position can be expected to change over the next year. Right now, patience is paramount. At your next postoperative visit, discuss your concerns with your surgeon. It would be beneficial to see your results in six months to reevaluate your current concerns. There are several options to correct your nose if it requires lengthening.

Q: I had my Rhinoplasty surgery done 3 days ago and am very concerned about my nose now. I had a downward turned tip, which I asked to be corrected. but now when i look at it, it seems to have gone totally opposite and now looks upturned like a pig's nose. I am very concerned as I have so many events to go to and i feel it's a drastic change and not a subtle one. I trusted the doctor and asked him to work with it to suit my face, but now I'm very very worried and feel people will comment. Can this still be corrected? I think I'm going to need revision surgery, but I am also very worried about it being made worse and people laughing at me. I wish I had not done this now.

A: Three days is too soon to tell. Your concerns are common after tip rotation rhinoplasty. For three days out, I assume you probably still have a cast and tape on your nose. With this on, it can be very hard to tell your true tip position. Also, individuals can frequently have tremendous concerns and emotions immediately after rhinoplasty surgery. Rightfully so, it is your nose! However be a little patient. Even when the tape and cast is removed, your tip position may still seem overly rotated, this is common. The tip position may require up to six months to settle into its proper position. Please discuss your concerns with your surgeon, I'm sure he/she will want to know your concerns.

Q: I had open revision rhinoplasty 11 weeks ago and the sides of my nose are still swollen as well as my nostrils are uneven. Also, when I smile my face looks swollen still and the left side of my nose goes up more than the right. Will this get better over time? I am getting very frustrated.

A: It will get better. Your concerns are common. During this time your patience can be one of the most difficult parts of your recovery. The nasal tip is the most cosmetically sensitive region of the nose also it is the most gravity dependent. Revision rhinoplasty patients can expect longer healing times because of altered anatomy and scar tissue. It is important that you communicate your concerns with your surgeon.