Hello, I had a third rhinoplasty last October. It looks too narrow and my nose used to look much fuller and natural. What are the possibilities of restoring a more full, natural tip? What kinds of grafts would be used? How should I talk about it with my doctor? Thanks for your help.
What Kinds of Grafts Could Fix This? Revision Rhinoplasty (photo)
Doctor Answers (5)
Too thin and too long
An expert can interpret even the worst of photographs as I'm asked to do since I have international clients. Although prior to surgery a more detailed analysis will be done, it does appear your nose is somewhat long and pinched . I presented to the rhinoplasty society my non graft technique for pinched tip which I have performed over 100 times. It uses the natural cartilages present to expand to a more desirable shape
Nasal Grafts after 2 Rhinoplasty Revisions
It is impossible to make specific recommendations with the pictures you have sent but the most common material used for nasal grafts are cartilage from the septum, ears, or ribs, or fascia from the scalp. Gortex or Medpor are available, but most of us prefer to use the patient's own tissue. An experienced revision rhinoplasty specialist will discuss alternatives after getting a detailed history and examining your nose.
What Kinds of Grafts Could Fix This? Revision Rhinoplasty
I have performed Rhinoplasty and Revision Rhinoplasty for well over 22 years and IMHO, you should have several in person consultations with experienced Revision Rhinoplasty Surgeons. A single photo, of you smiling, doesn't allow adequate information about the asymmetry, condition of nasal tissues or the overall aesthetics of the nose. Be sure the Rhinoplasty Surgeon, you select, understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally, more attractive nose and face.
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Improving a Rhinoplasty Result
It is difficult to determine the specific issues or problems with your nose from the photos provided. However, any patient considering a fourth rhinoplasty would need to be seen in the office to give any formal opinion. There will be significant scarring of the underlying framework and loss of stretch of your skin. To correct a problem nose after three operations will almost certainly need additional cartilage that would be taken from the ear or rib depending on the degree of cosmetic issues. See a surgeon who specializes in revision surgery as you may not have too many opportunities left to get your nose "right."
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon
Depending on your condition, you may be a candidate for a Non-Surgical Rhinoplasty to restore volume to your nose.
I read your concern and reviewed your photos:
Your recent photo is not adequate for evaluation. In my view, you should avoid a fourth nose job, if possible. In many instances, an overly narrowed, pinched tip may be improved non-surgically. My experience is with Silikon-1000, an off-label filler for permanent results.
Feel free to re ask your question with an updated full-face photo that clearly shows your concerns.
Hope this is helpful.