I had rhinoplasty in 2005, a bump on the nose was removed, but left the nose and tip of the nose a narrow and pointy had before surgery rounder shape of the tip of the nose. Recently, I also got breathing problems and feels like it is coming from the lower part of the nose. What can be done to correct the nose shape and breathing problems?
Narrow Pinched Nose? (photo)
Doctor Answers (6)
Treating a pinched tip following prior rhinoplasty
The problems you've encountered are fairly common, unfortunately, after reductive rhinoplasty in which the structural support of the nose is weakened. The result is pinching and collapse of the nose along with breathing difficulties.
You want to be careful about relying on filler injections to address your issues as this is unlikely to improve your breathing problems.
You can learn more about pinched tip treatment at my web reference link below.
Improving a pinched nasal tip and improving breathing
A revision rhinoplasty can help redefine your nasal tip, while at the same time improve your breathing problem.
Web reference: http://surgery90210.com/face/4/rhinoplasty.aspx
If the nasal tip appears pinched in, soemtimes manuevers intra-operatively during revision surgery can improve this. Occasionally I will use fillers for minor irregularites.
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Non-surgical Rhinoplasty is great for revision cases
Dermafillers are great to use for revision rhinoplasty cases because an expert injector can contour and shape the nose very carefully. If there has been an over reduction during the initial procedure, fillers can rebuild your shape.
Look for someone who has a lot of experience with non-surgical rhinoplasties as this is an advanced technique.
Reductive cosmetic rhinoplasty resulting in functional problems
During your previous rhinoplasty a significant amount of cartilage was removed in order to achieve a more narrow and pointy appearance, and over time the healing and scarring forces on this framework have caused it to collapse and give you breathing issues. The solution is to restore the strength of this framework by adding cartilage back to it. Structural cartilage grafts (alar batten or lateral crural struts) can help your nose and nasal valves to resist the collapsing forces during dynamic inspiration, and help restore your breathing.
Reduction rhinoplasty can cause functional problems many years down the road
Your story unfortunately is one that is very common in my practice. Reducing the nose in shape and size, especially reducing a hump and refining a nasal tip, can cause horrible functional problems later in life. Over the last 20 years a true paradigm shift in rhinpoplasty has occurred. Nasal surgeons have shifted away from the old practices of removing cartilage and have developed procedures to preserve the function of the nose while at the same time providing the aesthetic benefits the operation can provide. Revision rhinoplasty aims at restoring the competency and strength to these cartilages and to the internal and external nasal valves which can become damged during traditional excisional procedures. These revisions most often entail getting grafting material from your septum (if any cartilage is left), your ear, or from a rib. My advice would be to find a surgeon who is experienced in revision surgery and is also an expert in nasal function such as a board certified facial plastic surgeon.
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