A revision rhinoplasty is a complicated surgery, because the surgeon now has to contend with thick scar tissue—which makes it difficult to raise the skin and soft tissue off the cartilage. “Plus, we often need to reconstruct part of the nose, so we need to take cartilage from other sources,” says Dr. Miller. Surgeons say that the minimum amount of time to wait before you can do revision rhinoplasty, even if there is an obvious problem, is a full year.
This procedure is for women who need additional volume as well as a lift. Depending on the placement of the implant, a breast lift can occur as a result for women with a low degree of droop, without the need to make any incisions. For women who have a moderate to severe breast droop, breast lift incisions along with breast implant insertion will be needed to achieve optimal results.
Case 96: To see how well our results last, see these photos of our patient 8 years after rhinoplasty and facial fat transfer! Her rhinoplasty involved softening her look and removing the convexity on the bridge that made her tip look downturned. Fat transfer under the eyes has stood the test of time and really helped to reduce her under eye hollows to noticeably brighten her appearance.
Case 4: Some might think that this patient had had previous rhinoplasty with tip collapse, but she did not. Occasionally, the shape of the tip cartilages is very vertically-oriented, causing a deep groove in the nostril. She felt this, along with her marked tip crookedness, drew unwanted attention to her nose. Now, her nose is smaller, smoother, more defined, and just blends with the rest of her face.
Case 43: Rhinoplasty in this pretty professional woman was all about removing the bump she had hated for years and correcting the tip droop and asymmetry that had worsened with age. Relatively small changes here have created a real sense of refinement while maintaining her long, elegant profile. A lower face and neck lift along with facial fat transfer helped to round out the enhancements in her already beautiful appearance.
Case 22: This young woman was happy with her profile but wanted to reduce nasal width, tip boxiness, and nostril flare on front and three-quarter views. The combination of narrowing her bridge, tip refinement, and nostril reduction helped bring her nose into balance. At the same time, fat transfer to the under eye hollows did a fantastic job of brightening her eyes and giving her a more youthful look.
However, it’s not without real risks. A liquid nose job should be done only by a skilled plastic surgeon with extensive knowledge of facial anatomy, using only hyaluronic-acid-based fillers. Misplaced filler can cut off blood flow and cause skin necrosis (tissue death). If it’s caught quickly, the hyaluronic-acid filler can be dissolved by a doctor, using an injection of hyaluronidase. But because this risk is serious, fillers have not been approved by the U.S. Food and Drug Administration for use in the nose.
The procedure also does not permanently change the breast shape and firmness. As time marches on, you may expect the effects of aging and gravity to continue. In these cases, a secondary revision surgery may be required. The best candidates for this cosmetic surgery are women who are emotionally well-adjusted, have realistic expectations, and understand the procedure thoroughly.
Case 38: This beautiful young lady is an early 6 month example of a finesse rhinoplasty. On front view you can see the bridge is narrower and the sense of hang is improved. On profile, the tip looks undone, natural and less projected with correction of the slight hanging columella. The result is a beautiful, natural look that corrects the issues but leaves her looking totally natural and undone.