Rhinoplasty: Q&A

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Is my Nose Tip Too Round Following Rhinoplasty?

I had Rhinoplasty done four months ago, and I feel that the end or tip of my nose from profile view looks a little round. Also, there are two lines on each side of my nostrils that don't look too great. I'm more concerned about the rounded tip, though. I'm thinking about having another Rhinoplasty done, as I've heard most of the swelling has gone down by now and the final shape will be set. Could someone please give me some advice on how my nose looks and if I should go through another surgery?

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35 Doctor Answers | Asked by cupcakeceri in london

Doctor Answers (35)
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What kind of rhinoplasty did you have

As a doctor who performs many revision rhinoplasties, I typically wait a minimum of one year for the most straightforward of corrections. If you had an open tip rhinoplasty, tip delivery or tip defatting procedures, the time I will wait will be even longer, and will depend on the texture and softness of your nose. This time can be from 18 months, up to 3 years! Most importantly, regardless of the type of procedure performed, 4 months is too short to decide if anything needs to be done. more

Don't do it!

I must give a compliment to your surgeon. The nose looks great. Your tip is still actively healing. There is STILL considerable swelling present, and this will take up to 2 years to totally resolve. So, my advice to you is not to have any more nose surgery until the swelling resolves. Most rhinoplasty surgeons won't revise a nose for at least a year.

Nasal tip swelling after rhinoplasty

Give it time! You will do beautifully based on these early postoperative photos. You have a nice straight dorsum, slight break (or upswing) in the supralar region (just above the tip) and you will notice continued and significant improvement throughout your recovery. The text books don't lie. 12 months is absolutely necessary for complete healing and based on these views you should expect a very natural result in the long run that you are quite pleased and proud of. more

The nose tip is the last to evolve after rhinoplasty

I agree with Dr. Kasden. Your nose will continue to evolve over the next 8-12 months. The tip is the last to evolve. In your profile picture you can see a significant amount of swelling especially at the columella (the hanging strip of tissue below your tip that separates the nostrils.) You should ask you surgeon if he/she feels that tip taping might improve the swelling more quickly. After one year has passed, should your nose not meet your expectations, see your surgeon for advice or... more

Swelling one year after rhinoplasty

Typically it takes a year for the majority of swelling to resolve. The tip is the LAST part of the nose to resolve swelling. In open approach revision rhinoplasties that have extensive tip work, the swelling can last up to two years with subtle changes occuring over 5 years. Symmetry is the key here, the tip swelling will come down.

Double break.

While this photo is certainly taken during a relatively early stage in the healing process, I think that what you're noticing is the slightly exaggerated "double break" of the columella (the part between the tip and where the nose meets the upper lip). The supratip itself shows only a minor amount of fullness, however. I'd be curious to see what your nose looks like now since several months have passed since this question was posted. In any event, certainly wait a full year...and... more

Swelling in the tip resolves last

There is a modest amount of swelling remaining in the nose and especially the nasal tip at four months after rhinoplasty. There will be continued subtle changes in your nasal tip for two years. It is definately too early to consider any kind of revision surgery, especially (as you've heard in many of the posts) since your nose looks pretty good. The rule of thumb is to wait a year after a rhinoplasty prior to considering a revision. The only exception to this is if there is an obvious... more

My nose tip is too round: Give it more time

From your picture, it looks as if you are experiencing some normal swelling. Unless you are experiencing redness, drainage, etc, this may be expected from the surgery that was performed However, it is best that you report this to your surgeon. If it is of any consolation, we generally do not take any pictures until 6 months afer surgery. This is a general indication of the amount of time it takes for us to assess the final result. Furthermore, it is generally too early to even consider a... more

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

You should wait 1-2 years

You will not see your true final result for at least one year after a rhinoplasty. Unless there is something dramatically wrong with your early result, you should wait and see if some of your issues don't resolve with time. Repetitive rhinoplasty surgery often causes more problems than it solves so don't take this lightly. Plus, looking at your photo, your tip doesn't look bad at all.

Too early to tell

You are still very early in your recovery period and the tip of the nose takes the longest to see the full effects. It is very common to have rounding of the end of the nose for the first 8 - 12 months. At 4 months there is still swelling present, gently massage of the nose can be beneficial especially in this early time period. It is most important that you wait until all of the swelling has resolved. If you reach the one year point and are still not satisfied with the result then... more

Nasal revision surgery

It is difficult to tell from the single view that you posted. However, I will tell you that 4 months is still a bit early to make a final assessment. I usually wait at least 6 months to 1 year. Remember revision surgery is a potential for more problems. Often, patients find after they have had multiple revisions, that they would have preferred to be back to an earlier result. Steven Wallach, MD www.stevenwallachmd.com

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Caution with nasal revision is best

Your picture shows a result that is quite nice and I am certain that the tip of the nose is still stiff. You may not be completely sold on the result however four months is too soon to give final judgement. Revision is possible at this time but I would urge caution. I see softening and refinement in most after a year or more. You can discuss the healing process with your surgeon, and try computer simulation to help anticipate if your revision would be worth taking a chance with a good result. more

Further reduction of the tip

Further reduction in the tip (making it smaller) will indeed make the tip smaller, but the lines you are starting to see on the sides of the tip will become deeper as it becomes overresected. If you place cartilage grafts into the tip, even if you secure them in place with an open rhinoplasty, these can shift and warp over the years and cause a change in your appearance. You have a pretty face (and nose), and you may definitely want to hold off on further surgery. We have a saying in plastic... more

Wait

The posted photo looks great, and you really owe it to yourself to wait longer. If, after 1 or 2 years, you still feel you want to change the tip, see your surgeon and discuss the situation then. But remember every operation has risks, and in your case, it appears that you have a very good result. Sometimes it's better to leave well enough alone. see video

Swelling can take a year or more to resolve

Your nose, particularly the tip can be swollen for well over a year. Let it settle, and keep your surgeon informed of how you feel and what you think. The shape will keep getting better over the coming months. If you choose to re-operate too quickly, then your outcome will be less predictable. If you think about it, your nose is still healing, and the swelling is still slowly going away. Asking a surgeon to reshape your nose while your nose itself is undergoing remodeling and reshaping... more

No - your nose looks great

I agree. It will take 1 -2 years for all of the swelling to be gone from the tip of your nose. Try to enjoy the postive changes that have occured and just give it some time.

Tip Swelling Post-op

I agree with Dr. Kasdan - Four months is entirely too early to consider revision rhinoplasty, which could cause significant problems. It can be hard, but waiting is the best course right now. The nasal tip can have swelling up to one year post-rhinoplasty. Revision considerations should wait at least until this time. I hope this helps.

Not too rounded for 4 months out.

Swelling sticks around the longest in the tip of the nose in someone with thick or moderately thick skin. Grafts placed for tip definition are often hidden by the swelling for 4-6 months. Some steroid injected into the tip can help, but only your surgeon will know if that is safe for your nose. I have even seen tips that I did not like at 12 months that looked great at 18 months. Your surgeon will guide you on this.

Be patient with your rhinoplasty

Don't fret about your tip at this point. I think that rhinoplasty is one of the procedures that requires the most patience during healing. The best think you can do to speed healthy healing is follow your doctor's orders. Be conscious of factors that can inflame swelling like excess salt intake, altitude changes, allergies, etc. Remember that only a a very small percentage of rhinoplasties require a revision. You look great so far and you will only look better. Best of luck! more

Swelling After Rhinoplasty

At four months following rhinoplasty, you still have a considerable amount of swelling in your nose, particularly the nasal tip. It will take up to a year or more for the swelling to resolve, and you will continue to see small refinements in your nose for up to two years. Despite that, I think you have a very nice result on your profile picture, particularly for being only four months out. If for some reason you are still unhappy with your results, most rhinoplasty surgeons would... more

Nose tip too round- Please be patient

I know being patient is very difficult but at 4 months post rhinoplasty, your photo shows good early results. I am sure your surgeon told you that a nose can take 12 months to finalize results and sometimes longer. As already answered by other surgeons, the tip is the last to lose swelling. Keep talking to your surgeon and the two of you will resolve this with time.

Harold J. Kaplan, MD

4 reviews

Los Angeles Facial Plastic Surgeon

www.celibre.com

Nasal Tip Fullness After Rhinoplasty

It is very normal to have nasal tip fullness, swelling, and numbness in this area even after rhinoplasty. It takes 6-12 months to resolve. It also depends on whether the patient has had 1. previous surgery 2. the thickness of the skin and 3. male patients tend to have more and prolonged nasal tip fullness and swelling up to 12 months. The key is to maximize shaping and contouring accurately intraoperatively so that the swelling will resolve over time. Tincture of time and patience is... more

Rod J. Rohrich, MD

10 reviews

Dallas Plastic Surgeon

Rhinoplasty Swelling

It is still too soon to say that your nasal swelling has completely gone down. It typically takes up to 8 months for the tissues to mature. I would not consider a revision until at least 1 year after the surgery. Give it time. It should improve.

Tip of nose too round after rhinoplasty

Wait before revision, of course, but it appears that the angle between columella and tip is the source of your concern. This may be a straightforward correction in the office. If it is the very tip you believe is too round and even after one year it remains so, this is likely partly due to your skin thickness and the anatomy of the underlying cartilages. A more angular tip may be achieved with a graft, also potentially an office procedure.

Round Nasal Tip after Rhinoplasty

If you're still following this thread then you've probably gotten the message that you should wait before making any final decisions about your nose. In the absence of any obvious 'deformity' after Rhinoplasty - time will be on your side. The nasal tip take much longer to clear swelling than the upper bridge of the nose. You are likely to find that with time the tip will take on a better shape. If you've waited an appropriate amount of time and still feel things could... more

Nasal profile after rhinoplasty - choosing to do a second surgery

It seems that your overall nasal profile is well positioned and there is residual swelling in the nasal tip, especially at the four month interval. I would wait at least one year to see final results and then discuss further corrective surgery.

Don't do more nose surgery

Given the short time (4 mos.) since your Rhinoplasty, it would be very unwise to have additional surgery on your nose. From my view, your early results are expected and show normal results. Swelling reduction does take a full 12 months. Be patient, time will improve your aesthetic results. I have seen many 'round swollen noses' shape up beautifully over time. Dr. G

Time needed for swelling to regress after rhinoplasty

After four months, particularly if you had an open rhinoplasty, the tip swelling will not be totally resolved. Many factors determine the final outcome, especially the thickness of the skin originally. Your profile looks pretty good at this point, but there is a background item in the picture that obscures very fine detail, and it is not a real close-up view. My advice would be to wait a MINIMUM of 6 months and perhaps up to a year. A tip graft is often a good way... more

Nasal tip swelling after Rhinoplasty can take up to a year to resolve

I know that after 4 months you are probably feeling frustrated that your tip is not exactly the way you expect it, and looks wide or round. It takes up to a year for all this to resolve, but you can have kenalog (a steroid) shots in your nose to help the swelling go away quicker.

Revision Rhinoplasty Can Make a Profound Difference

Most rhinoplasty specialists would wait for 12 months before proceeding with any revision. The reason for this is that it can take 12 months (or longer) for the majority of the post-operative swelling to subside and for scar tissue to mature. There are certain circumstances in which patients could undergo surgery sooner than 12 months -- this is something that needs to be addressed on an individual basis. It is early to be making final judgements on your surgical results, but when analyzing... more

Might be helpful to know exactly what is making you think tip is rounded

If it is above the tip area, this might be because you don't have a supratip break point. This helps to distinguish your nasal tip from your nasal bridge and should be above your nasal tip about 1-2mm. Also the angle from your tip as it approaches the columnella might be a little obtuse and the angularity could be adjusted so that it has more of a contrast as the tip gradually transitions into the columnella, the area below the tip. Four months is still early though and things can change... more

Philip Young, MD

6 reviews

Bellevue Facial Plastic Surgeon

Consider steroid shots and tape

Hi Cupcake, Four months is too early to be considering a revision for the tip. It will continue to go down. I continue to be amazed by how much the tip goes down over time. I would give it at least 7 to 8 months if it was done closed and 1 year if done open before considering a revision. However, some tips to help it go down include asking your physician if Kenalog (steroid) shots would be helpful. An injection of 0.1 to 0.2 cc of 10mg/cc of Kenalog can help to reduce tip edema and is... more

Healing after rhinoplasty takes a while

Your nose looks really good. There is some fullness in the supratip area (above the tip), and in the columella region (below the tip). At four months, there is usually still some swelling present, so it is best to leave it alone. You can address it with your surgeon as well.

Wait till all swelling is resolved

From the picture your nose looks good, but the best thing is to wait at least a year after surgery and then look at the before and after pictures. There is more risk of scarring with redo rhinoplasty.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Wait at least a year before undergoing revision rhinoplasty

Hi Cupcake, It is difficult to evaluate your tip in the photograph that you have submitted. You appear to be a beautiful woman and have a very nice nasal profile. Your nose will continue to refine its shape over the next year. Wait at least until a year after your surgery before going back for revision surgery. This should all be discussed thoroughly with your rhinoplasty surgeon. Good luck and be well. Dr. P