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Victoria, Canada

do I really need an open procedure for revision?

I had closed rhino but am not happy with the results. One nostril is higher than the other and the tip looks funny because of that. Profile is beautiful but front view is not. Do not want to go to original PS- he is not comfortable with open rhinos (had I done my homework I would not have gone to him for my primary). Consulted with a different PS. Says I must have open rhino to correct problem, closed does not address tip issue and cartliage cannot be properly evened out in tip without an open procedure. Also, my bridge from the front looks not great because the sides of the nose do not slope down evenly and there is a "ridge" where the top of bridge is narrow but then goes out wider where it attaches to the cheek. PS says I need to have some bone gound and placed there so it looks more natural. Does that sound right? How difficult is it to get the tip even with open rhino (PS says right now one side has more cartilage and is pulling the opposite nostril side up more).

My original rhino was Nov 2008, I had a small revision that didn't do anything (but because it was free went to original PS who did nothing about the tip and nostrils and tried to even out the sides of the bridge as there was a boney asymmetry but didn't really do much- that was in April 2009.)
If I have the open procedure in Dec 09 or Jan 10, is that waiting long enough? My nose would NOT need to be broken.

THANK YOU for any feedback!

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Doctor/Professional Answers (2)   


Facial plastic surgeon
Fleming Island, FL
United States
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  Open rhinoplasty is usually preferred for revisions
October 29, 2009 10:03 AM

Open rhinoplasty is usually preferred for revisions. That approach allows good visualization of the anatomy and allows for more precise fixation of tissue, which is critical for achieving (more)
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Plastic surgeon
Baltimore, MD
United States
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  secondary rhinoplasty
October 15, 2009 9:48 AM

The longer you wait the better it is. Scars will be mature, all tissue are stable.
Open rhinoplasty is more accurate, How ever secondary rhinoplasty is more difficult, and require an (more)
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