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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
revision rhinoplasty
 
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Even though it seems that only small changes were made in the revision, revision rhinoplasty is still a difficult operation.  After the first operation, the inside of the nose contains scar tissue, and the second surgeon must fight through that scar in order to make the changes he and the patient desire.  The scar tissue can put a limit on what is possible in a revision operation.


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"...he is straight forward with you
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he thinks are realistic. "
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current: Right oblique
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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: What is Wrong? What Should I Do Next? Revision Rhinoplasty 21 Months Ago?
My initial operation left me being unable to breathe through my left nostril. My nose looks ok from profile but facing on, very wide and a small piece of cartilage??is poking out mid bridge on the right side! Should my nose be this wide after grafts? Initially my nose was slim with a bump. I would be grateful for some advice. Thankyou
(Questioner submitted photos)

Dr. Denenberg's answer: That bump can be removed, and your nose might benefit from a profile adjustment, too
I see the areas that you complain of. If you have grafts in the nose, and it is hard cartilage that is causing the bump on the right side and the excess width, it can be predictable to narrow the nose by removing or adjusting the offending graft. You probably also have some scar tissue under the skin that could be trimmed. See the Web reference link for a digital modification of your photo showing the improvements.
I personally think your profile could be made more natural as well. The tip of your nose is projecting forward, beyond the line described by the bridge of your nose. I'd like to see the tip of your nose closer to your face, and the very bottom of the nose tucked up a small amount to decrease the amount of the inside of your nose that is visible from the side view. I made a modification of that view as well. Bringing the tip of the nose back closer to the face is one of the most predictable changes in revision rhinoplasty, in competent hands.

Link to this question on RealSelf.com