Cartilage grafts placed in tip to slightly refine it however I would like my tip to go back to my pre op appearance ie round and what is typically called bulbous. What would need to be done? Is this easily feasible. Why is my current tip looks so pinched when I smiled, it looks very unnatural. Is there smtg with the columella?
Tip plasty only - to reverse overprotection? (photo)
Doctor Answers 3
Sometimes the tip of the nose can look too small or pointed after rhinoplasty
This condition can be reversed by revision tip-plasty. First we need to determine what is causing the pinched look. Most important is a personal physical exam when we can look at and feel the tip. Reviewing the original operative report is also helpful. As for how we treat it; that really depends on the findings during the consultation. If grafts were used, removing them or softening them often can do the trick.
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Your question is a good one and deserves some one on one discussion. You have had some favorable gains in you surgery yet I agree with a smile and at that angle the tip does look pointy - that is why a lot of mutual understanding would need prior to a revision, so as to touch upon the true goal. With that said if rounder is the goal, strategically placed cartilage grafts could round out the tip (a little more (1-2mm) length in the infratip location would be nice too).
Tip plasty only - to reverse overprotection?
Depending upon how cartilage grafts were utilized, this could be a very straightforward return to previous anatomy. 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