Bad Rhinoplasty

The nose is a defining facial feature, so many individuals who are unhappy with some aspect of their nose turn to rhinoplasty (Nose job) for improvement. As a whole, most patients achieve wonderful results. However, the fact remains that rhinoplasty is a complex procedure that requires master knowledge of the anatomical structure of the nose as well as meticulous precision and skill. It is imperative to select a highly qualified, board-certified, and reputable surgeon to achieve the best outcome.

The final result of nose surgery can sometimes be unsatisfactory, appear too obvious, or lead to other uncomfortable health problems. The good news is that patients can opt for revision rhinoplasty to address their concerns after their first Rhinoplasty went wrong.

Bad rhinoplasty results

Unsatisfactory plastic surgery results are always disheartening, but a less than stellar nose job can be extra disappointing. Your nose’s central position on your face can make its crooked, collapsed, or improperly angled appearance fairly obvious to the average observer. Your less-than-ideal rhinoplasty is sitting front and center.

Worst of all, since it can take up to a year to see the final result of a rhinoplasty, you had to wait quite a while before giving up on the idea that your nose would look better once the swelling resolved. A year has passed. You now realize that you need a revision rhinoplasty, but you don’t want to be disappointed again.

The first step is to make a decision: Can you live with the nose that you now have, or does it need to be fixed? If it needs to be fixed, and you have a good relationship with your original surgeon, and he or she is an excellent rhinoplasty surgeon, it may be worth discussing the issue with that surgeon. Even excellent surgeons sometimes have suboptimal outcomes. If, however, you cannot or do not want to go back to your original surgeon, you should start to search for an expert plastic surgeon to perform your revision surgery.

You can learn about the top plastic surgeons in the field by searching medical websites, getting recommendations from friends, and reading consumer forums. Conduct in-person interviews with surgeons who live in your neighborhood.

 

 

More than any other part of your revision surgery, finding a qualified expert is key. Make sure that you feel confident in their abilities and comfortable with their personality, and verify that they’ve performed many successful revision rhinoplasties.

As your disappointing results have shown, rhinoplasty is one of the most difficult types of plastic surgery to perform well. While it may not be any comfort, you’re not alone in feeling distressed about your nose job: we estimate that about 15% of women, men, and teens who undergo rhinoplasty request a revision.

Your nose is a complex structure that contains different types of tissues: cartilage, bone, and skin. The nose has delicate curves and planes that must be preserved or enhanced to ensure good results. Your plastic surgeon also has to be skilled in the tissue-quality and structural differences among different ethnicities to give you the right nose for your face.

In addition to the nose’s inherently complicated structure, your revision rhinoplasty surgeon has to deal with the presence of scar tissue. Because your nose already underwent major surgery, your skin quality and that of the deeper tissues is compromised by scarring, which makes reshaping your nose and fine-tuning details a more demanding task.

An expert revision rhinoplasty surgeon takes the pattern of your scarring, as well as any abnormalities that arose during your first surgery, into account when planning your revision.

If your surgeon didn’t successfully support the bridge of your nose, for example, our doctors may take cartilage grafts from another area of your body to restore your nose. A short nasal bridge is an important issue that less experienced surgeons may have trouble addressing when performing rhinoplasty on non-Caucasian noses.

You can get the nose you want, once you find an expert aesthetic plastic surgeon, be sure you’re clear about the improvements you want.

 

Bad rhinoplasty scar

Open rhinoplasty scar may be observed over the mid columella of the nose. The columella of the nose is described by the skin and soft tissue located at the central bottom of the nose and separates the opening of the two nostrils. When performing open rhinoplasty, an incision is extended from one nostril to the other across the mid columella level. If the columellar incisions are not repaired appropriately, then an open rhinoplasty scar may become evident. First of all, this incision must be repaired in layered fashion and not with a simple external stitch repair.

Bad rhinoplasty stitches

The use of an internal stitch using a reabsorbably suture allows for the incision line to continue having support despite removal of the external stitch after one week. The internal suture that we utilize provides support of the incision for up to 3 months thus allowing the incision to heal optimally. The second important consideration is that the upper incision flap must be directed centrally in comparison to the lower incision flap in order to allow for optimal columellar alignment.

Common rhinoplasty problems

Our doctors rectify common nose job problems, such as:

. Polly beak deformity

. Over-rotated tip

. Collapsed bridge

. Valve collapse

. Deviated septum

. Disproportionate nose

. Ethnically disharmonious nose

And the cosmetic concerns that weren’t effectively managed the first time, including:

. Long nose

. Wide nose

. Bulbous tip

. Nasal bumps

. Crooked nose

. Asymmetric nostrils

 

What should I do after bad rhinoplasty (nose job surgery)?

The steps you need to take after a bad Rhinoplasty

As the central feature of the face, the nose is perhaps the most important component of facial aesthetic harmony. If you had rhinoplasty to improve your nose’s appearance but are not happy with the results, it’s understandable that you might be stressed out or unhappy. But before concluding that the outcome of your nose job is poor, it is important to give your body time to heal, because the appearance of the nose will change as the weeks and months pass.

 

First step after bad Rhinoplasty:

Your first step after bad rhinoplasty is to follow your surgeon’s postoperative advice. It is normal for your face to be puffy. By following your surgeon’s instructions, you should be able to reduce the swelling. Two weeks after rhinoplasty your appearance should improve, and after a month you will look even better. However, in some patients it can actually take up to a year for swelling to fully subside.

If after a year you are still unhappy with your appearance, it may be time to consider undergoing a secondary (revision) Nose job procedure — possibly with a different surgeon.

 

Second step after bad Rhinoplasty

Should I ask my surgeon’s advice?

The answer to this question depends on the results of your procedure. If something is just a bit off, it might be OK to return to your surgeon and see if you can get a minor revision. However, if you are very displeased with the outcome and you think your surgeon may have contributed to the negative results, you should contact a second surgeon — specifically, a facial plastic surgeon specializing in revision rhinoplasty. Nose surgery is possibly the most difficult of all cosmetic surgeries to perform, and revision rhinoplasty is particularly difficult. For this reason, should you need to undergo a secondary rhinoplasty, it is very important that you find an expert.

Third step after bad rhinoplasty

Choosing a Revision Rhinoplasty Surgeon

Most secondary rhinoplasties are complex procedures involving an invasive method called the open approach. The procedure requires advanced surgical skill and may require harvesting cartilage for grafts from other areas of the body.

Many facial plastic surgeons in Iran are dual board certified in facial plastic surgery as well as otolaryngology (ear, nose and throat surgery). These surgeons have an in-depth knowledge of the nose’s internal structures and external appearance and are trained to know how to alter each, as needed, during nose surgery. Facial plastic surgeons typically complete a residency in otolaryngology or general surgery and then receive advanced training in facial plastic surgery.

Most general plastic surgeons do not receive as much training in each of these specific areas, as they also have to focus on plastic surgery procedures of the body.

One of the Iranian surgeons’ skills is a revision rhinoplasty technique that both improves his patients’ appearance and restores proper breathing. They have extensive experience dealing with functional problems as well as a multitude of aesthetic challenges.

 

Revision rhinoplasty

Revision rhinoplasty is designed to correct issues (both aesthetic and functional) from a previous nose job. Rhinoplasty surgeons in Iran typically performs rhinoplasty using either a closed or open technique. The open approach involves creating an incision across the nose base, while the closed approach requires internal incisions. The method that is used depends on the goals of the surgery as well as the surgeon’s recommendation. Surgical details are tailored to fit each unique case, but, generally, bone and cartilage are reshaped or removed. Cartilage may also need to be taken from areas like the ears or the septum to restructure the nose.

Communicating any issues or concerns about your rhinoplasty with your surgeon is important. Certain minor or temporary conditions may not necessitate a secondary procedure, but revision surgery is appropriate for correcting aesthetic imperfections or breathing problems.

 

Dos and Don’ts after bad rhinoplasty

Here are some dos and don’ts every rhinoplasty patient should adhere to following surgery.

Do:

. Consult a revision rhinoplasty specialist who is a board certified facial plastic surgeon.

. Follow your surgeon’s instructions to reduce swelling, pain, discomfort and bruising.

. Wait a year before you decide to have revision rhinoplasty.

. Avoid smoking.

. Avoid sun exposure.

Don’t:

. Touch, rub, or bump your nose.

. Smile, which can move the structures of the nose.

. Sniff or blow your nose.

. Sleep on your side. (Sleep on your back instead.)

. Bend over or lift anything, which can cause swelling, raise your blood pressure, and cause bleeding.

. Travel (for a couple of weeks).

. Play contact sports or engage in vigorous exercise (for 4-6 weeks).

. Consume alcohol, which thins the blood and may cause bleeding.

. Wear glasses (for the first few weeks).

It is also very important that you have realistic expectations. Oftentimes those who are not satisfied with their rhinoplasty results had unrealistic expectations. Plastic surgery cannot cure depression or other psychological conditions.

What should you know before revision rhinoplasty surgery?

External issues

The most common issue many patients have after a nose job gone wrong is in the outer appearance. Patients with external concerns are advised to wait a year for their nose to completely heal and take shape before considering additional treatment. Swelling is known to subside naturally after some time. However, there are more severe concerns that require surgery to correct.

Scooped Out Bridge

A scooped out bridge can occur when a cosmetic surgeon uses an osteotome or chisel when operating. Using a chisel leaves little room for error because it takes out the bridge of the nose in one movement. Revision rhinoplasty can correct this problem by rebuilding the bridge using cartilage from other areas of the body.

Pollybeak or Supratip Deformity

When the area above the tip of the nose appears overly full, it subsequently causes the nose to protrude downward. If the surgeon does not recognize the tip-supratip relationship or incorrectly predicts how the nose will eventually heal, it may lead to this type of complication. It can also occur if the surgeon did not reduce the cartilage enough or was too aggressive on a nose with thicker skin. Rhinoplasty revision can restore the aesthetic appeal between the bridge and tip of the nose by resecting the excess cartilage and supporting the nasal tip.

Tip of the Nose

The tip of the nose can be susceptible to several problems, primarily the loss of too much cartilage, which can distort or even collapse the nostrils. Overextension on the tip of the nose can also make the tip appear too prominent. A revision procedure may involve replacing the lost cartilage to restore the nose to a more natural appearance.

Twisted Nose

A twist in the nose can occur in the nasal bones on the top and tip of the nose. Straightening a crooked nose may be difficult to achieve during rhinoplasty, but strengthening the cartilage with sutures may produce the desired result.

Internal issues

Rhinoplasty can also, unfortunately, affect the inner areas of the nose. Although these types of complications are less common than external imperfections, they can present problems that may be permanently damaging.

Breathing Problems

Most nasal congestion that occurs after rhinoplasty is due to postoperative swelling or crusting that dissipates within a few weeks or months. Long-term nasal congestion is concerning but can be evaluated and treated accordingly. Potential problems such as turbinate hypertrophy, deviated septum, scarring, or major alterations can also contribute to breathing problems.

Nerve Damage and Numbness

Damage to the nerves and numbness are problems that are commonly resolved weeks to months after surgery. Motor nerves in the nose move the muscles, and sensory nerves correlate to the sense of touch. During rhinoplasty, the sensory nerves on the nose and occasionally on the upper lip are temporarily severed. In some cases, long-lasting or permanent numbness may occur.

Infection

Infection after rhinoplasty is an uncommon occurrence and can be treated with antibiotics. In exceptionally rare cases, it may require special care and attention from both the surgeon and an infectious disease specialist.

If you have any questions about rhinoplasty or revision rhinoplasty, please fill out our online contact form for more information.

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