What Can Be Done In My Revision Rhinoplasty?

Q: Dr. Eppley, I am seeking a revision rhinoplasty. I had an open rhinoplasty about five years ago and I am unhappy with the results. It was a very conservative rhinoplasty little to no changes were noticed. Even my friends and family see no difference. I would love to have the tip refined (made thinner and lifted, if possible), a possible reduction of nostrils and even some bony adjustments.

A: In regards to a revision rhinoplasty, the first question is always what was done in the original procedure. That is not something you would ever know but if you could get a copy of your original operative note from your surgeon that information is always helpful. It is instructive to know from where you started and what was done to know what may be more beneficial in the next procedure. A revision rhinoplasty usually has to do things differently than the first time if a different result is to be expected.

Otherwise, although not uncommon, one just has to await what surprises one may find in there during the revision. (where grafts done?, where was the cartilage harvested? etc)  But in just looking at your photographs, I see room for improvement from the tip standpoint and in nostril narrowing. It is always easier to make a thinner tip when it is being lifted as opposed to being deprojected in thicker male nose skin.

Dr. Barry Eppley

Indianaolis, Indiana