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Obtuse naso-frontal angle and bulbous, upturned tip post-rhinoplasty (Photo)

At 19 days post-rhinoplasty, my bridge appears low & scooped, not high and straight, as in surgeon's pre-op computerized projection. Nasofrontal angle is extremely obtuse, though the surgeon said he'd use a 'notching' tool to retain the angle between my forehead and bridge. The tip is pointy, which I wanted, but appears over-projected and a little bulbous/upturned. Is all this just the result of post-op swelling? Might the shapes and angles of my nose still change for the better?

Doctor Answers (8)

Overprojected Tip -Possible Pollybeak

+2
Hi,


Although its early in the post -operative period, it does seem like the tip is overprojected and you have a slight pollybeak forming. However, it would be prudent to wait 3 to 4 months post-op to assure that most of the swelling is subsided.

Best,

Dr.S.


New York Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Obtuse naso-frontal angle and bulbous, upturned tip post-rhinoplasty

+2
   There is definitely swelling present, and I think that as the swelling resolves you will likely be happier.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 194 reviews

Obtuse naso-frontal angle and bulbous, upturned tip post-rhinoplasty

+2
I believe that once the supra tip swelling subsides, you should have a better profile. An obtuse naso frontal angle can be improved by bridge augmentation should it persist after the healing period in about 6 months, or more.

Somyos Kunachak, MD
Thailand Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

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Length of time for post-operative edema to resolve

+2
Thank you for posting your question. 
It can take a year for post-operative edema to fully resolve and the nose to achieve it final appearance. I think you look very good for 19 days post-op. Also, without a frontal and "worms eye" view, you can't really determine if the tip is bulbous. With that said, your tip doesn't appear bulbous nor upturned (over rotated). Your dorsal hump is reduced and you have columellar show. Overall, I think its a good result. 

Matthew Becker, MD
Knoxville Plastic Surgeon
5.0 out of 5 stars 10 reviews

Still very early in the recovery

+2
At 19 days postop, time is still very much on your side. At this point in your recovery, the major changes need to be visible. For instance, looking at the profile preop and postop views, the dorsal hump (bump on the bridge) and underrotated tip are significantly better after surgery. It will take months and sometimes up to a year after primary rhinoplasty to fully appreciate some of the more subtle changes in the nose. This is particularly true for areas in the nose with thicker skin like the tip and just above (the supratip) and the radix (the depression where the forehead transitions to the nose). Your particular concern of the nasofrontal angle being more obtuse will likely improve. There is exaggerated blunting of the angle in the early postop recovery because the thick skin at the radix needs to be elevated to adequately address the dorsal hump leading to more swelling in this area. As the swelling resides the radix will deepen and your nasofrontal angle will appear less obtuse. Hang in there-it'll take a few months to see this improve.

Jamil Ahmad, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 6 reviews

Expectations during recovery after rhinoplasty

+2
The appearance of your nose will certainly change from what it looks like 19 days after surgery.  Your nose will continue to undergo changes for the entire year after surgery, while 60-80% of the changes will be evident in 3-6 months.  Follow up closely with your surgeon to ensure the best result, and try not to fixate on the day to day variations of your nose while it heals.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

19 days Postop

+2
I carefully reviewed your photographs. I think the nose looks very good for 19 days, and I would expect more definition to the nasofrontal angle and improvement overall  over the next 2 to 3 months. I think you should be very satisfied with the results after 2 - 3 months and I would sit tight and follow your surgeons instructions

best,

Dr Del Vecchio

Daniel Del Vecchio, MD
Boston Plastic Surgeon
4.5 out of 5 stars 43 reviews

Obtuse naso-frontal angle and bulbous, upturned tip post-rhinoplasty -- a surgical mistake or simply swelling?

+1
This is a great question! It demonstrates many cosmetic surgery issues. First; Realistic expectations. Seriously the "early" result looks great!. Second; Understanding the healing phases following a rhinoplasty. It can take up to 1 year to attain full result. Third; The use of a computer imaging. Computer generated results will NEVER be the same as in vivo live results!!! Fourth; "a surgical mistake"? Why are you so quick to place blame upon the surgeon, after ONLY 19 days is beyond me. Look at your before posted photo and the early post op posted photo. What a nice early result!!!!! All these issues should have been discussed prior to any surgery. Obviously you were not afforded this opportunity or if you were than you did not understand these issues fully. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 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.