Nasal Tip Refinement 13 Years After Initial Rhinoplasty? (photo)

Since I had my initial rhinoplasty 13 years ago in June of 2009, I've felt like the tip is not proportionate to the rest of my nose. I feel like the tip could be lifted a bit and the bottom part of my nasal opening could be lifted and the nose holes smaller, but need an expert opinion on what could be done.

Doctor Answers (6)

Revision rhinoplasty is appropriate

+2

Based on your (excellent) photos, I would completely agree that revision rhinoplasty to rotate, debulk, and deproject your nasal tip would be very rewarding.


You do have a couple challenges in your situation. Revision rhinoplasties are tougher than primaries, and your skin is very thin and unforgiving. Make sure to use an experienced rhinoplasty surgeon!

 

Best,

 

Mike Nayak


Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Revision rhinoplasty for nasal tip refinement

+1

Revision rhinoplasty is always more difficult than the primary, but that said, there is room for improvement on this nose.  The tip should not be lifted, however, the columella should be tucked inward to shorten the nose.  There is also over projection of the nasal dorsal cartilage in the lower half of the nose and the entire tip needs to be de-projected.  There may need to be additional cartilage grafting placed to the low bridge, but that will depend upon how much deprojection of the lower half of the nose can be accomplished.  A spreader graft may be needed on the concaved side of the nose and a small amount of refinement of the nasal tip can be performed as well.  Revision rhinoplasty is done under general anesthesia.  Look for someone who is very experienced in rhinoplasty and revision rhinoplasty procedures before undergoing this difficult endeavor.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Tip plasty and refinement of the nose with secondary rhinoplasty surgery

+1

A tip rhinoplasty would enhance your lateral and oblique nasal proportions.  I would recommend a tip-plasty for your nasal refinement. Surgery90210

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

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Non-surgical rhinoplasty is a great choice for revision rhinoplasty

+1

I know your first thought is, "I want to make my nose Smaller, Dr. Mabrie!" however, the roundness of your tip that can be seen on the profile can be decreased by augmenting the nasal tip and the nasal bridge.

I am placing a link to a similar patient where I made a round tip more defined using dermafillers for a non-surgical rhinoplasty.

I really like the non-surgical approach to revision rhinoplasty because often too much has been taken in the wrong places and the tip is still undefined.

Look for someone that really does a lot of non-surgical rhinoplasty, good luck in your search for information!

David Mabrie, MD
Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 54 reviews

Nasal Tip Refinement 13 Years After Initial Rhinoplasty?

+1

 Aesthetically speaking, the nasal tip is wide and appears over-projected.  A Revision Rhinoplasty would thin and de-project the tip.  The nostril flare can be reduced with internal weir incisions.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Nasal Tip Revision

+1

You can improve your tip by decreasing projection, narrowing and refining the tip, as well a elevating the columella. Unfortunately over the past 35 years I've seen similar problems after the patients had their original rhinoplasty.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.