This young woman had three previous rhinoplasties for improvement in the shape and width of her nose (it was done by someone else). She complained that it was still too wide and too big with a poorly shaped tip. Her surgeon told her that she needed more time. She waited several years and not much changed. While I was evaluating her sister for her nose, she told me her story and I told her I felt strongly that I can make a significant improvement in her nose.
She was confident in my skills as her sister enjoyed a nice result from the work I did with her nose. At surgery, I removed a lot of scar tissue just about the tip, sutured the tip so that it was shaped better and smaller, and fractured her nose in several places to narrow her rather wide nasal bones.
Post operatively, she required several injections of steroids into the tip area to help the swelling resolve. She is seen here about two years from her original surgery. It’s a nice improvement if you ask me. She agrees that her nose is much more refined, less “bulbous” and round. Her nose fits her face much better, and her breathing wasn’t compromised with my surgery as I opened her nasal passages at the time of her revision.
Patience is a virtue with all nose surgery as it takes up to two years for the swelling to subside. It may appear initially disappointing that you nose isn’t smaller immediately after surgery but this is because of swelling. It the nose looks perfect right out of surgery it entirely likely that it will shrink even more after time and be too small or weird looking.
It’s important to choose a surgeon who has experience with the nose. It can be challenging for even seasoned surgeons, a black box for those just cutting their teeth with this delicate procedure. In my mind, she simply went to a surgeon who didn’t know what he/she was doing and that’s why she got the suboptimal result in the first place. It’s difficult for the patient then to visit with another surgeon who says that he/she can fix that problem and it should be relatively straight forward. There is no guarantee, however, that your revision nose job will work out just as you would like. They are even more challenging than a nose that’s never been operated upon.
I like a nose that fits the face, has nice even lines on the bridge and a tip that is elegant and well-shaped.
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