Chester Doctors

Is a Revision Rhinoplasty Worth It? (photo)

I just had a rhinoplasty a month ago. Too early to judge I know, but my nose is still very big from the profile, and I do not see that changing since that's not going to change with swelling. The problems I'd like to correct with a revision in a year or so are: 1) Tip turns too much now (showing too much nostril and swoops up) 2) Deproject it more 3) Do an alar base reduction as well (my twin had this done) 4) And, making it narrower on the bridge as well... All this Possible?

You are getting way ahead of yourself.  I know you think it's not going to change, but you will be surprised how different it looks 6 months from now (or 1 year for that matter).  Most of the things you mentioned will get better on their own with time.   I'm not saying you won't need a revision, but it's definitely too soon to be planning it out already.  Hang in there.

Matthew Bridges, MD

Richmond Facial Plastic Surgeon

How to Thicken Skin After Rhinoplasty to Avoid Revision? (photo)

So apparently I have thin skin and it is showing imperfections on the tip of my nose. Is there a way to thicken the skin on the nose, I really would like to avoid having a revision if possible.

When I do rhinoplasty on patients with thin skin I always consider placing something over the cartilages to keep any edges from potentially showing.  This assumes everything is as smooth as possible already.  This usually involves crushed cartilage, but may also include temporalis fascia, or even acellular dermis (Alloderm).  Problems with thin skin tend to show up many months after surgery, so preventative measures should always be considered.  Admittedly, it is hard to tell much about your nose from the photo. 
 

Matthew Bridges, MD

Richmond Facial Plastic Surgeon

Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping? (photo)

I am ok with my small hump, width of nose bridge from frontal view, nostirls & alar base.I want to change my droopy tip. It points downwards, nearly touching my upper lip when I smile.I will stay with my hump cause a rasping plus an osteotomy will cause me too much down time, cost is fine.Will a tip rotation disguise a dorsal hump to be lower? Can suture technique alone elevate my tip without cutting of cartilage and implant? What do you suggest for me? My surgeon will rasp hump & suture my tip.

In my opinion, you do need something to stabilize the tip.  This usually is done with a columellar strut, but can be accomplished with other techniques as well (ie the septal tongue-in-groove maneuver).  You are right that by first projecting your tip, the amount of reduction of your bridge will be less.  You have basically a "pseudohump" caused by a low radix (the starting point of the nose) and an underprojected tip.  The key to having a long-lasting and pleasing result for your nose is stable tip projection.

Matthew Bridges, MD

Richmond Facial Plastic Surgeon