While most rhinoplasty patients are happy with the outcome of their surgeries, dissatisfaction with results is not uncommon. In rare cases, patients end up with deformities. If you had a nose job and are unhappy with the outcome, you’re probably anxious to get to a facial plastic surgeon, like NYC double board-certified plastic surgeon Dr. Sam Rizk, to address it.

Revision rhinoplasty can address deformities, from the excessive reduction of the nasal bridge to asymmetry in the nasal tip.

Types of Deformities Revision Rhinoplasty Addresses

Below are explanations of some of the most common deformities addressed in revision rhinoplasty procedures.

  • Inverted V Deformity
    It is characterized by an inverted V-shaped shadow in the area of the middle vault of the nose. It occurs at the over resection of the upper lateral cartilage, the cartilage that forms the sides of the nose’s bridge. It often occurs when the surgeon who performed the original procedure made a mistake during removing a nasal bump and fracturing the nasal bones (this destabilizes the upper lateral cartilage).
  • Hanging Columella
    The columella is the strip of skin between the nostrils. A hanging columella, or “alar-columellar disproportion,” is visible from the profile and hangs lower than desired, typically about 4mm or more. There are many potential causes of hanging columellae. Some people are born with it, which is often the result of either a long septum and the columella cartilages pushing down on the columella. Other people have deformities due to a mistake made during their primary rhinoplasty procedure.
  • Saddle Nose Deformity
    This is a saddle-like formation in the area of the septum. This type of deformity is known as a “scooped” nose and typically, some type of trauma to the nose, like a blow to the face, causes the septum to lower.
  • External Nasal Valve Collapse
    An external nasal valve collapse results from weakness or narrowness in the nasal valve, the thinnest portion of the nasal airway. Trauma to the nose or mistakes made during the original rhinoplasty procedure often results in this type of deformity.
  • Pinched Tip
    A nasal tip that appears too narrow, or “pinched”. Some patients are born with a pinched tip, but this type of deformity is often the result of over resection of the tip cartilages during the original rhinoplasty procedure.
  • Pointy Nasal Tip
    A nasal tip that appears pointy essentially means that the alar cartilages are too prominent and appear too pointy, or stick out too much. Many patients are born with pointy nasal tips. This deformity is more common in individuals with thin skin.
  • Open Roof Deformity
    This occurs when a space is formed when the nasal bones do not come together near the top of the nose. An open roof deformity makes the nose appear excessively wide. Typically, the nasal skin grows or droops, and vertical lines or depressions start to appear.
  • Cleft Lip Nose Deformity
    Cleft lip nose deformity is a common birth defect that can severely impact a person’s appearance. In the United States, nearly all cleft lip nose deformities are corrected in infanthood, as failure to correct this deformity can result in developmental impairment, infection, and even death. Cleft lip nose patients commonly require additional surgery later in life to fully correct the deformity.
    Cleft lip nose occurs when the upper lip does not form completely in utero, leaving a separation or “cleft” in the lip. In minor cases, the cleft may appear as a small notch or bump on the upper lip. In other cases, the split may extend up to the nose, leaving an opening in the lip and lower nose.

Located in NYC, Dr. Sam Rizk draws on his years of surgical training and experience when performing complex rhinoplasties to correct nose deformity.

What Are the Potential Complications?

Revision rhinoplasty is a tricky procedure for many reasons, but primarily because the nasal structures of patients in need of this procedure are often compromised. The presence of scar tissue and the lack of cartilage and tissue to work with often make this procedure very challenging. Cartilage may need to be harvested from other areas of the body.

In addition to these issues, your revision rhinoplasty surgeon will also face all of the challenges posed by a primary rhinoplasty procedure.

Though rare, some patients can react to the medications or anesthesia administered before the surgery. However, an airway tube is placed in the throat to ensure proper breathing, should this take place.

Following the procedure, while you are still in the surgical facility, potential revision rhinoplasty complications include bleeding or reaction to medications.

Some potential complications can arise once you have gone home, including unexpected swelling, bleeding, reaction to the medication, and trauma to the nose (if you bump into something, for example); if you experience any of these complications, you must contact your revision rhinoplasty surgeon immediately. In addition, all patients undergoing primary or revision rhinoplasty procedures experience some swelling around the eyes. However, Dr. Rizk uses special techniques to minimize both swelling and bruising.

In addition, there are also some potential complications you should be aware of following the recovery period. These include:

  • Sun damage
  • Injury to the septum
  • Infection
  • Nasal blockage
  • Skin-related problems

You can go a long way to preventing postoperative complications by closely following the instructions given to you by your surgeon.

Minimizing the Risk of Rhinoplasty Complications

You can do some things to minimize your risk of experiencing complications.

  1. Choose the Right Surgeon: Many revision rhinoplasty procedures involve grafting and other complex techniques. As a result, the first — and perhaps the most critical — step is to choose an experienced, board-certified facial plastic surgeon specializing in rhinoplasty and revision rhinoplasty procedures.
  2. Prepare for Your Surgery: One step you should take before the initial consultation with your surgeon is to stop smoking because smokers do not make good candidates for rhinoplasty. Before heading to your consultation, gather all your medications, over-the-counter products, and any supplements you take so that you can show them to your doctor (in case any of them might cause problems with your surgery). Finally, make sure to arrange for someone to help you with your aftercare. All rhinoplasty patients need some assistance during the postoperative period.
  3. Do not have your surgery overseas: While it might save you money in the short term, it might cost you more if something goes wrong. More importantly, the care you receive will likely be lower-quality than the care you would receive in the U.S.

There are also a number of things you should avoid AFTER your rhinoplasty procedure.

  • Avoid any situations that might put you at risk of sustaining trauma to the nose
  • Avoid exposing your nose to the sun for six weeks following your revision rhinoplasty
  • Avoid sniffing, blowing your nose, smiling (it moves your nose)
  • Do not touch, bump or rub your nose
  • Sleep on your side (it can move the nasal structures) and do not bend over
  • No traveling for a couple of weeks
  • Avoid caffeine, alcohol, contact sports, and wearing glasses

For more information on rhinoplasty to correct deformities, get in touch with Dr. Rizk’s New York practice and make an appointment today.

Sam Rizk, MD

By Dr. Sam S. Rizk, M.D., FACS.

Dr. Rizk is a double board-certified facial plastic surgeon who specializes in rhinoplasty surgery and a recognized expert on the latest advances in facial plastic surgery techniques. He performs a range of facial plastic surgeries at his New York practice.

Learn more about Dr. Rizk | Dr. Rizk's Google Scholar