I am 8 months post-op. I initially had a bulbous nose, as well as a hump. My cosmetic surgeon gave me a round tip and apparently removed a lot of cartilage, though I'm slightly unhappy that it appears wide from the font whenever I smile. I hope that with a revision, I can achieve a slimmer, sharp-angled tip. My question: Is it reasonable to aim for that kind of result (if so, do I find a different surgeon?), or should I just accept my nose the way it is now and avoid disappointment?
Considerations on a Revision Rhinoplasty?
Doctor Answers (8)
Round tip after rhinoplasty surgery
Dear LeylaB: Having looked at you pics..I would give it more time for the nose to settle more. In some cases with thicker skin and broad noses (like yours), the skin can take 2+ years to contract and adapt to the underlying cartilages. Your nose to me still looks "swolllen" at the tip and not quite settled into place. At the minimum, I would wait another 6-months. Too much surgery, too early after rhinoplasty can also create other problems that we want to avoid. If you are still unhappy with your nose, then there are several things that I can recommend to further refine your nose. In summary, wait another 6+ months before judging your nose. All the best, Dr. Vartanian.
Round tip after rhinoplasty
As others have stated time is your friend and may improve the fuller appearance of your tip. Also there is possibly some improvement to be gained from a few steroid injections
Web reference: http://www.seattlerhinoplasty.com/html/index.php
Revision rhinoplasty for defined tip
Web reference: http://www.michaelelammd.com
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Attaining a sharper, more refined nose
Being 8 months postop you still have quite a bit of tissue swelling to resolve yet. As this occurs (over 2-3 years) you may find the definition you're looking for.
I would give it time to see how things evolve. You would hate to have revision surgery too soon.
Web reference: http://www.drlamperti.com/facial-plastic-surgery/rhinoplasty
Revision of Nasal Tip
You should wait a little longer before considering a revision - your tip may improve with your "thicker" skin. It is always best to avoid judging your tip when you're smiling.
I do allot of work on patients with bulbous tips. The majority of these patients have fatty tissue in their tip and need cartilage grafting. As well, a small implant raises the bridge to give the appearance of a more aquiline refined nose. My website below shows many examples of patients with bulbous tips.
Web reference: http://www.africanamericanrhinoplasty.com
It is very difficult to achieve what you want. You have very thick skin on the tip of the nose and the skin of the ala.
Revision tip sculpting
Although you may have some residual swelling left over in the tip, 95 % of tip edema should have subsided by this time if surgery was properly performed. If you have thicker skin and you get reduction rhinoplasty, then you may end up with a rounder and more amorphous looking tip. I also see that you may have some alar and upper lateral cartilage collapse,- a sign of reduction rhinoplasty. It's good that you are starting to think about revision options at this time. I would wait until 12 months before seeking consultation. The key to achieving the results that you want is to perform structural grafting and actually add cartilage. This sounds counter-intuitive, but if placed in correct areas, your tip could look more angled and sculpted. You may need to have ear or rib cartilage grafting though. Good luck!
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