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Looking for a surgeon for revision rhinoplasty

My background is Initial Rhinoplasty 20 years ago in Perth with Dr Fiona Stanley Revision Rhinoplasty in conjunction with Breast Aug 2005 with Dr Mark Duncan Smith, was not unhappy with initial operation – just after some further refining Revision Rhinoplasty 2011 with Dr Michael Zachariah, due to breathing difficulties. Cartledge from my ear was used on the bridge of my nose to fix collapsed nostrils. On removal of the splint necrosis of about a 10 cent coin had occurred. I have had several course of PRP and fillers to lessen the effect of the scar, it is noticeable but not terrible (like it was when the splint was removed) Revision Rhinoplasty 2012 with Dr Michael Zachariah, further refinement Revision Rhinoplasty 2013, Dr Michael Zachariah, further refinement What I would like to address is lessening the width of my nose where the cartledge was placed. I feel the tip of my nose has dropped and I would like it raised. I would also like the overall size of my nose reduced. I feel like I constantly have phlegm in my throat that needs clearing and a cough that is worse at night. I can breath through my nose but it is noisy. I would be looking at an operation some time mid year next year and travelling from Darwin.I am willing to travel for the operation for a doctor who is experienced in revision rhinoplasty.

June 26th, 2016 NT

  • Answer
    Dr. Raymond Goh

    Raymond Goh

    123 answers

    Plastic Surgeon
    Queensland, Australia

    Hi there Sel0303.
    You present with a very difficult and complex situation. You have had 5 previous rhinoplasties. There will be a lot of distorted anatomy, extensive scarring, a deficiency of support, and a probable lack of cartilage donor options from within the nose itself. in addition to this, your skin will be thin and anything we do underneath the skin will likely be visible unless an extra soft tissue layer is placed under the skin. 
    The key to establishing a good, strong, and aesthetic nose starts with good structural support. This is achieved with cartilage grafts. In your case, and depending on how your nose feels clinically, consideration may have to be given to harvesting rib cartilage for this. Your inner skin (lining) may be scarred and contracted. This may require addressing as well.
    All in all, you should discuss your options and best strategy with a surgeon experienced in revisional rhinoplasty work. Recovery from revisional work is always going to be longer.I think it will be difficult to get things perfect, but consideration can certainly be given to improve on the state of the nose. 
    All the very best.
    Dr Ray GohValley Plastic Surgery