Our beautiful patient from AZ is seen 5 months following revision rhinoplasty. After her first surgery, she was bothered by her overprojected tip, hanging columella, and severe right nasal obstruction. You can see a smaller, straighter, and less distracting nasal appearance. Her deviated nasal septum was corrected, and she required a right spreader graft, and a right lateral crural strut graft to improve her nasal appearance and airway.
Our beautiful 29 year old patient is seen photographed 1 year following functional and cosmetic revision rhinoplasty surgery. When she came to our office, she was bothered by her nasal appearance and breathing after previous rhinoplasty performed elsewhere. She was mostly bothered by a persistent bulbous and droopy nasal tip appearance, and by a persistent dorsal hump. Her airway was compromised by narrowed internal nasal valves on both sides and a persistently deviated nasal septum. Her revision rhinoplasty consisted of nasal narrowing, hump removal and tip rotation. We used spreader grafts to repair her internal nasal valves, and we performed septoplasty - these maneuvers were to improve her nasal airway. An extended shield graft was used to maximize tip support and tip definition with her thick skin type.
Our beautiful 51 year old patient is seen 7 YEARS following tertiary revision rhinoplasty surgery. Tertiary means that two other surgeons operated on her nose before we did. She had repair of a persistently deviated nasal septum, and was provided a straighter and less distracting nasal appearance. Seven years after her surgery, you can see that she looks un-operated and she is breathing very well.
Our beautiful 44 year old patient is seen 16 months following tertiary revision rhinoplasty - that means after her third rhinoplasty. Her first two procedures were performed by another surgeon. Our patient had nasal obstruction and she was unhappy with her persistently wide nasal appearance and bulbous nasal tip appearance. During her surgery, it became clear that her previous surgeon removed too much tip cartilage. She required tailoring of her remaining tip cartilages, and total tip reconstruction with alar batten grafts. These are also called "lateral crural extension grafts" since they replace or strengthen the nasal tip while opening the external nasal valves. Our patient also required repair of her "poly-beak", which is an excessively high dorsal septum above her tip. The top of her nasal bones were rasped, and osteotomies were performed to achieve narrowing of the upper 2/3 of her nose. She additionally required cartilage spreader grafts on both sides to reconstruct her internal nasal valves. You can see a natural looking nasal appearance that breathes better.
A prospective revision rhinoplasty patient should be carefully evaluated in-person for candidacy. The results of revision rhinoplasty surgery will be the centerpiece of our patient’s face. The esthetic endpoint of successful surgery is to allow our patient’s nose to blend in, and become less distracting—not to transform the centerpiece into a masterpiece. Our patients must accept that the goal of revision rhinoplasty surgery is improvement, not perfection. Your revision rhinoplasty consultation is the first, and best time to determine whether your goals may be achieved through additional surgery. During the consultation we determine, to the best of our ability, that if all goes as planned, our patients will be pleased with the outcome of revision rhinoplasty. We may observe while taking a history, that revision rhinoplasty may be suitable from an esthetic standpoint, but careful listening, questioning, examining, and computer imaging may be necessary to ensure that our patients have realistic goals and expectations.
Our lovely patient is seen six months following revision rhinoplasty and otoplasty surgery to set back her outstanding ear appearance. After her first rhinoplasty, she was dissatisfied with a persistent dorsal hump and bulbous, droopy nasal tip appearance. She also was insecure about her ear appearance when her hair was in a ponytail. You can see a natural-looking ear appearance, and ears that don't stick out so far. Her otoplasty was performed with conchal setback sutures, and Mustarde sutures in both ears. Her nasal dorsal hump was removed, along with a nasal mole, and tip-plasty was performed.
© 2025 Eric M. Joseph, M.D. Telephone: (973) 325-1155
22 Old Short Hills Road, Suite #112 Livingston, NJ 07039