Rhinoplasty and Otoplasty Revision
Q: Dr. Eppley, I am interested in a rhinoplasty and otoplasty revision. I had a rhinoplasty and otoplasty two years ago when I was 18 years old.I believe the surgery did not go as expected because of healing and post-care reasons (wrapping and such). Maybe even due to my young age.
I am now 20 years old and am not thrilled with the outcome of these procedures. I can say that I am much happier with how I looked after then I did before, but I definitely believe he could have done better.I am not looking for perfection but I believe as humans we all enjoy the idea of becoming photogenic and being rather more symmetrical.
I will attach pictures before and after the surgery.
In regards to the otoplasty and rhinoplasty. The problem is the left ear, but I only want to fix it if you think it is possible to be perfect and make appear a but more natural. As for the right ear, I am extremely unhappy with. It looks like a cauliflower ear and mildly deformed.
I am mildly content with the shape when looking at my entire front facial profile, but the side profile bothers me, I am sure you will agree.
As for the rhinoplasty, I am mildly content with the side profile. However I would have liked a stronger profile, and not so much of a dip. As for front forward, it is crooked towards the tip. It is almost as if it looks like the right of my nose lacks cartilage due to the crookedness.
Ultimately looking to straighten, strengthen the bridge, and fill my nose with this revision (I want a more masculine/strong nose)
If you believe that you are not capable of making this my first and last revision, please let me know, with either surgery. If that is whether you believe there is another surgeon who may be able to better assist me or you believe I should seek a revision from my original surgeon, please be honest.
I initially came to you in hopes of jaw implants. I know that underlying, I have a nice base jaw structure, but I only want to improve it and strengthen its appearance in seek of a more masculine, well defined face, with sharp jaw edges.
I stumbled upon your YouTube videos and those results are priceless. There is no other doctor I would trust after seeing your work.
Looking at my pictures, what do you think? What do you recommend?
A: Thank you for sending all of your pictures and detailing your concerns. In answer to your rhinoplasty and otoplasty revision questions:
EARS. There is definite cartilaginous deformity of the upper antihelix/scaphal areas. This is undoubtedly caused by the way the sutures were placed to fold the ear back. There is also a bit of overcorrection of the middle third of the ear compared to the upper third and the earlobe. On the left ear it is also as you have aptly described a cauliflower ear deformity which is a result of the how the cartilage was folded and healed. While this is the ‘easiest’ problem that you have to treat, it also the most unpredictable of whether it can be improved. I would have to unfold the cartilage from the back side and see if the fold can be recreated in a more natural way. The middle third need to be brought out a bit and the upper third and earlobe to be move in a bit. None of this is technically hard to do but how the scarred ear cartilage will respond now can not be precisely predicted.
NOSE What you have is a lower middle third of the bridge with an overprojected and crooked tip. This creates the dip in your nose which is not the look most men want… a straighter dorsum/bridge is more desired. The tip needs to be shortened and straightened and the bridge built up. This requires cartilage grafts and I will assume that your septum was not touched during your initial rhinoplasty procedure. This would be critical to know as that would the first donor site chosen given the proximity and its straightness.
It goes without saying that it is always best, if you have confidence in him, to return to the surgeon who performed the original surgeries for your rhinoplasty and otoplasty revision as that would be your most economical approach. But revision ear and nose surgeries like yours requires an advanced level of expertise and experience for improvement…scarred tissues are never as responsive as before they ever had any surgery.
Dr. Barry Eppley