Is a supratip break point difficult to achieve in a revision rhinoplasty? How is it achieved?

A supra tip break can be created  with a primary rhinoplasty, or a secondary rhinoplasty. Sometimes, cortisone shots in the postoperative period will help dissipate fluid retention in that area. Thick skin in the supra tip area of the nose may prevent a  nice supratip break from being created. For many examples of supratip breaks with closed rhinoplasty, please see the link and the video below

This is something not ver orthodox anatinically and neither common among patients requests; recently I had the opportunity to carry out such procedure in one patient, but it is very rare patients wish such curve at the dorsum.Rhinoplasty is always something that should be discussed between patient and surgeon; if the surgeon is good and has good skill then his resources are close to carry out almost any patient's request.

Carefully discuss your goals with your surgeon. The relationship between the profile and the tip location is a conversation that I have daily with my patients before rhinoplasty. Reasonable goals and expectations are clarified before the operation.