Unhappy with Nasal Tip After Rhinoplasty? Will Secondary Revision Cost? (photo)

Hi. The problem is not so much the asymmetry. It's that inadequate work was done on the tip of your nose. The tip of your nose is drooping down, and it projects strongly forward off of your face. See my "Web reference" link for a morph showing what your nose could look like with a revision rhinoplasty. In the morph, I brought your nose back toward your face, raised the tip, so it doesn't look so long, and I also tucked up the columella, which is the little piece of skin that separates the left nostril from the right nostril.

Small asymmetries are difficult to correct, but often, when a nose is deprojected, which means brought back closer to the face, some of the asymmetries go away, because asymmetries are frequently more noticeable when the nose projects strongly.

In selecting a surgeon, you need to see before and after photos of his work in revision rhinoplasty, and especially work on the tip of the nose. Tip work is the hardest part of the rhinoplasty operation to teach and to learn, and many doctors don't do it well enough.

The good news for you is that, in capable hands, deprojecting and elevating the tip of the nose are two of the most predictable parts of a revision operation.

           Your tip can be refined and deprojected.   The columella droop can be improved as well as the tip asymmetry.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

I personally do not charge a revisional professional fee after rhinoplasty. This is an issue however that you need to discuss with your plastic surgeon. You look to be a good candidate for revisional surgery.