Revision rhinoplasty - tip lifting? (photo)

I am not satisfied with my nose job. Bridge is too narrow and tip is still droopy. My question is, 1) What can be done to my tip for revision? Just lifting OR lifting + trimming cartilages 2) For my tip to be lifted, will my bridge needs to be shortened? Since the bridge and tip are connected... Just lifting the tip seems like wont work and it'll drop to where it was before since the bridge is long... Am I right?

Doctor Answers (3)

Revision rhinoplasty - tip lifting?

+1

I would recommend that you not try to analyze the problems with your nose and methods for correction. I can say that there are multiple techniques to address your concerns.

Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD

Los Angeles, CA


Los Angeles Plastic Surgeon
5.0 out of 5 stars 204 reviews

Your Revision Rhinoplasty Should Be Done Very Conservatively

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Dear germangirl1990;If you are not satisfied with your nose after rhinoplasty, it may not be that the "bridge is too narrow," but rather, the tip is slightly full for the bridge that was created. Without seeing the before photos, it is hard to know for certain, but that can certainly be evaluated. Now, with respect to the tip being droopy, I would agree with you that it does deserve a little lift. Lifting the tip will make a big difference for you. That should be done very conservatively. Generally, the tip can be lifted by further trimming of the upper part of the tip or alar cartilage as well as perhaps trimming the upper lateral cartilages. Both of these together have an impact on the length of the nose.The longer the nose is, the droopier it is.The other factor is the septum. It may be that the septum, that partition separating the two nostrils, needs to be trimmed to allow the tip of the nose to ride upwards a bit, but you want to be very careful.You need to be very conservative, and one factor that needs to be looked at is whether or not you have an overactive depressor septi muscle. An overactive depressor septi muscle will tend to keep pulling the tip of the nose down, elongating it, and contributing to that droopy look.I recommend you do as much study as possible before proceeding to consultations. Have multiple consultations and be sure to meet with surgeons whose practice and the majority is nasal surgery. This is very important. Nasal surgery is the most complex and challenging, and revision nasal surgery is even more so.Study up, read books, visit websites, do as much homework as you can, and talk to people who have had revision rhinoplasty surgery.You want to do it right.The most important factor will be whether or not your desires can be achieved through standard techniques. Don't look for any wild and crazy or experimental processes. Often, we see people who are attempting to change the shape of their nose by putting plastic parts into the nostrils.These are not solutions.These are just gimmicks.After you have done your homework, be sure to have computer imaging with the doctors whom you visit in consultation.Let them show you what they believe they can achieve. Equally important is, let them share with you other patients who have similar imperfections and the before and after photos that show how successful the doctor has been. If the doctor has been successful for other people with the same problem, chances are, he or she can deliver a good result for you.

Robert Kotler, MD, FACS

Facial Plastic Surgeon

Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON

Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Revision rhinoplasty

+1

Rhinoplasty is a very difficult endeavor and its best to look for a very experienced revision rhinoplasty specialist for best results. A full set of quality pictures would be needed to given any specifics upon what may need to be done regarding this nose. Reverse osteotomies will widen a narrow bridge, while lifting the tip is performed with a variety of techniques such as shortening the caudal septum and tip suturing techniques of the lower lateral cartilages. Virtual rhinoplasty software is available on the link below along with our rhinoplasty photo gallery to get an idea of what can be accomplished

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

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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.