· There is often asymmetry and pinching of the nasal tip. · The tip cartilages may have a pointy, unnatural, and uneven appearance. · The bridge of the nose may be crooked, off-center, and feel irregular. · The bridge may be “scooped out”, giving a “ski-slope” appearance to the nose, often referred to as a “saddle nose deformity”. · Sometimes, the upper bony bridge is over resected and the lower cartilaginous bride is not proportionally low enough, giving a “polly-beak” deformity. · Occasionally, too much of the middle third cartilage has been removed, causing an “inverted – V” look to the sides of the nose, exacerbating nasal obstruction. · Functionally, there may be nasal obstruction due to a deviated nasal septum, internal scarring, nasal valve collapse from over resecting nasal cartilage and bone, or from excessively large turbinates. 
Dr. Guida also has extensive experience achieving excellent results performing revision rhinoplasty.  He has performed revision rhinoplasties from patients around the world for over twenty-five years.  Just as with primary rhinoplasty, the revision rhinoplasty operation must be individualized, taking into consideration the patient’s goals, but also understanding as much as possible, what transpired during the primary operation.  Success in revision rhinoplasty surgery necessitates experience, understanding all aspects of rhinoplasty surgery, as well as having experience with major nasal reconstruction.
Rhinoplasty is a difficult operation in the best of hands and must always be performed with great 
thought and care. When the results of a primary rhinoplasty result are suboptimal, often due to a
combination of cosmetic and functional concerns, the patient has several difficult decisions to make.
Should she/he return to the original surgeon for a revision? If not, how does one decide which surgeon
should perform a revision operation? And finally, the patient may ask themselves, “Do I really need a
revision operation and how do I know the results will be positive this time around?” These are
challenging questions and Dr. Guida can objectively help patients decide which direction to go in.
​ When choosing a doctor to perform a revision rhinoplasty, it is important to find a surgeon who is
highly skilled at both cosmetic and functional nasal surgery, has years of experience, can demonstrate many positive before and after photos documenting their work, and has the concern and willingness
​to perform the revision operation.

Most Common Reasons for a 
Realistic Revision Rhinoplasty

Realistic Rhinoplasty in New York

"All through school I was teased, and at 18, I got

the operation, and ended up with a ski slope...

And my mother could tell that I was not

comfortable, so she said 'let's try someone else.' Dr. Guida was the referral... And now, I just feel like I'm the person I'd like to be, the person that I'm meant to be."

​- Dean, Realistic Revision Rhinoplasty Patient

"I was always self-conscious of  my nose.  Even

back in middle school, I remember sitting with

​my head down with my hair in front of my face so no one could get a side view of me... When people see my results,  they're just blown away by the change in the before and after.  I think seeing it in real life, it becomes a reality for everyone."

​- Deanna, Realistic Revision Rhinoplasty Patient

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