Is A Revisional Rhinoplasty Worth it?

Q: Dr. Eppley, I am seeking a revisional rhinoplasty. I have had three nose surgeries, the last two years ago. Five years ago I had a rhinoplasty and revision by one surgeon but I was left with a bone spur on the bridge and a long nose with a heavy tip. I then had a revisional rhinoplasty by another surgeon who removed the bone spur and shortened my tip. But my nose tip is still much fuller than I like and my nose overall still does not have quite the shape I would want. Do you think a third revsional rhinoplasty (fourth surgery) would be helpful at this point? I just want to get it finally fixed.

A: When it comes to any nose that has been operated more than two times, it is no longer an issue of ‘fixing it’ as scar tissues and other issues make the quest for an ideal result no longer possible. The multiply operated nose can only be potentially improved in some areas and other areas not at all. Thus it it important to clearly identify the exact nasal concerns one has, make a priority list of what is most important and then have me (or other plastic surgeon) decide which on that list has the potential for improvement and which concerns can not be improved. Whether further rhinoplasty efforts are worth it, no matter how unhappy one may be with their nose and what they have spent in the past, depends on whether the most important concern at the top of the list is one in which has the greatest chance of improvement with further revisional rhinoplasty. At your point in time with your nose, this is how you determine whether any further surgery justify the efforts. There are no simple or quaranteed fixes (as defined by one more surgery or tweak here and all will be better) in the tertiary or quaternary rhinoplasty patient.

Dr. Barry Eppley

Indianapolis, Indiana