San Diego Facial Plastic Surgeons

Squishy Skin on Nose 7 Months After Tipplasty, Is this Likely to Heal/Change?

I had a tipplasty about 7 1/2 months ago where my bulbous tip cartilage was reduced. Now, the skin on the front of my nose is squishy. When I touch it, it looks and feels exactly as if I was poking my cheek. Maybe its excess skin or fluid/tissue under the skin but I'm certain its not the cartilage structure underneath that is moving. Higher up on my nose where the skin rests on the bone is normal. Is this something that will heal/change with more time or is it just the result of the surgery?

7 months after your surgery should have given your tip skin ample time to settle down. The skin could be thicker than desired, especially if you have active sebaceous glands. I would see your surgeon and ask if a steroid injection might help to thin this tissue. A series of injections monthly may be indicated. Revision surgery or dermabrasion may also be considered after one year has elasped.

Maurice P. Sherman, MD

Del Mar Facial Plastic Surgeon

Is It Possible to Fix an Uneven Nostril? (photo)

It's been more than 2 years since my rhinoplasty, and since the surgery i notice a nostril is bigger than the other especially when it comes to smiling. the doctor said it was there before the surgery though i never noticed. is it possible to fix a uneven nostril like the one in the picture? many thanks - J

It is likely you started off with some degree of asymmetry of the nostrils prior to surgery as most, if not all, patients are asymmetric to some degree. That being said, you have what appears to be a more slightly retracted left nostril (your left in the photos). That means it is more arched than the other side. That is likely what is giving you the illusion that the left nostril is larger. It is certainly possible to revise this with placement of a composite graft to that side to lower the nostril rim. I would discuss this with your rhinoplasty surgeon to see if it is feasible for them to perform under local anesthesia. 

John M. Hilinski, MD

San Diego Facial Plastic Surgeon

Can an Alarplasty Be Done Under Local Anasthesia?

Im curious as to whether alarplasty can be done under local anasthesia? Can any rhinoplasty be done this way?

Yes, alar reshaping can be done under straight local anesthesia. However, rhinoplasty reshaping of the nasal tip and bridge does necessitate going under a full anesthetic in order to be done under ideal conditions. 

John M. Hilinski, MD

San Diego Facial Plastic Surgeon