Hi, I had open revision rhinoplasty 7 months ago. Polly beak removed, shield graft put in. The supratip area is still swollen and I can feel the skin has not contracted yet to the cartilage. The tip appears somewhat ptotic as a result. When the skin contracts will it elicit cephalic rotation of the tip?
Will I End Up With Cephalic Rotation from Healing?
Doctor Answers 7
More cephalic rotation after 7 months
It is unlikely that after 7 months you will get more rotation of the nose - but the tip likely will look better as edema settles down more
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Cephalic rotation from skin healing
One wouldn't expect there to be increased rotation of the nasal tip from skin contraction, though there can be rotation as the internal nasal framework heals (usually related to planned cartilage trimming).
Discuss your concerns with your surgeon. If the supratip swelling seems excessive to your surgeon it may be worthwhile to inject kenalog or 5-FU.
Supratip Swelling of the Nasal Tip after surgery
In general, you do get some cephalic rotation of the tip if you have had cephalic trim of the lower cartilages. In your case, the problem may be do to prolonged swelling of the supratip and an injection of dilute steroid may be most beneficial. Discuss your concerns with your surgeon.
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Tip Rotation 7 Months after Rhinoplasty
It is unlikely you will have any additional significant tip rotation 7 months after your rhinoplasty. Tip and supratip swelling may be present, especially in a male with thicker skin who had a shield graft placed. Ask your surgeon if he/she would consider the use steroid injections in the supratip.
Seven months post-op rhino
If you had a polly beak deformity, it appears you have a very nice result from the profile. More than likely it may get even better with some more time.
7 months post-op Rhino revision
You still may have some residual swelling or scar tissue in the the supratip area. At this point I would inject a little Kenelog 40% 0.1cc to the supratip area to decrease the scar tissue. This may give you some more supratip definition.
Tip Ptosis after Rhinoplasty
From your photo it appears that there is a slight loss of projection and a downward orientation of the tip. It is possible that you will see some rotation as time goes on, but not more projection. I would recommend waiting until you are one year from surgery, then consult with your surgeon about the tip position. If a little bit of projection is needed, that is not a complicated fix.
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