Her revision changed the way she could breathe.
The patient wanted a natural aesthetic revision and says she had no breathing problem before it. Two and a half years later, she described severe obstruction, nasal-valve collapse, daily discomfort, and no clear path to a third operation.
AI-assisted editorial analysis based on the linked patient discussion and named sources.Educational only—not medical advice. How we write
The search moment
How do I evaluate a third operation when the second one created a functional problem?
Original goal
Aesthetic revision
New complaint
Breathing
Next step
Tertiary review
Photos from the original post
Labels follow the poster's own description.
Compare real results
Compare revision cases, not primary rhinoplasties
Look for similar scar, support loss, grafting, skin thickness, and airway work.
See rhinoplasty results2.5 yr
Follow-up
No obstruction
Before revision
Valve collapse
Now reported
This article treats the post as one patient’s account, not an adjudication of care. The clinical discussion is checked against AAO-HNSF and ASPS patient guidance.
Here is what the original post actually said.
Before revision
"I did not have any issues with breathing."
After revision
"I’ve experienced severe nasal obstruction, nasal valve collapse, and daily discomfort."
The next problem
"I’m having difficulty finding a tertiary revision specialist I feel comfortable trusting."
This is no longer an appearance-only revision.
A third consultation has to begin with function. The patient needs a history of when obstruction began, whether it changes with exercise or sleep, and whether pulling the cheek sideways improves airflow. The examination may include septal position, turbinate size, scar, valve narrowing, and the strength of the sidewall.
AAO-HNSF guidance calls for airway assessment before rhinoplasty and patient-reported outcome tracking afterward. In a tertiary case, those basics become more important, not less. A surgeon should be able to name the suspected site of obstruction and the evidence for it.
The old operative records may matter more than another morph.
Revision anatomy is shaped by what was removed, divided, grafted, and scarred. The operative report can show whether septal or ear cartilage remains available and which support structures were altered. Preoperative photographs help separate an old asymmetry from a new one.
Computer imaging can organize appearance goals, but it cannot prove that a graft will restore airflow. Ask the next surgeon to review the prior reports, examine the nose inside and out, and explain what cannot be known until surgery.
Bring more than photos
Request both operative reports, implant or graft records, anesthesia records, and every standardized before-and-after view.
A tertiary surgeon should describe the reconstruction, not promise rescue.
Nasal-valve repair can involve structural grafting, sutures, or other maneuvers chosen for the failed area. Cartilage may come from the septum, ear, or rib; donor material has its own tradeoffs. The right plan depends on the actual deficit.
Ask how the operation could change width, tip position, stiffness, sensation, and breathing. The most credible answer includes limits: scarred tissue is less predictable, symmetry may remain imperfect, and another operation can create another set of problems.
Support after a complication is part of the result.
The patient’s account is also about follow-up. She says she struggled to get consistent guidance while daily discomfort persisted. A complex revision plan should identify who evaluates worsening breathing, how urgent concerns are triaged, and who owns long-term follow-up.
Before scheduling, ask what happens if breathing is worse at six months, one year, or later. A revision policy that discusses only appearance leaves out the problem that now matters most.
Questions for a tertiary revision consult
Each answer should connect a symptom to an anatomical finding and a proposed repair.
Where is my airway narrowing, and how did you confirm it?
Which support structures appear missing or weakened?
What do the prior operative reports change about your plan?
What graft material might be needed and why?
How could reconstruction change the outside of my nose?
Who manages my care if obstruction persists?
Reddit: the patient’s 2.5-year account and photo
The patient’s stated preoperative function, current symptoms, photograph, and difficulty finding tertiary care.
AAO-HNSF: rhinoplasty clinical practice guideline
Recommendations on nasal-airway assessment, counseling, complications, and outcome measurement.
ASPS: rhinoplasty and breathing
A patient explanation of how narrowing, septal work, and structural grafts can affect airflow.
The questions that usually come next
Can revision rhinoplasty make breathing worse?
Yes. Structural changes, scar, narrowing, or weakened support can affect airflow. The cause requires an examination.
Does nasal-valve collapse always need surgery?
No single Reddit story can answer that. Treatment depends on symptoms, anatomy, prior operations, and specialist assessment.
Why obtain the old operative report?
It records prior grafts, resections, and techniques that can change both the diagnosis and available reconstruction options.
When is a rhinoplasty called tertiary?
The term commonly describes a third rhinoplasty. It signals more prior surgery and scar, not a single standardized procedure.
Compare revision cases, not primary rhinoplasties
Look for similar scar, support loss, grafting, skin thickness, and airway work.
See rhinoplasty results