“Unsuccessful rhinoplasty experience”

Pros: The operating procedure and the physical pain experienced afterward weren't nearly as awful as I thought they'd be.

Cons: The "stuffed up" feeling during the recovery period was uncomfortable, but that was to be expected. However, I'd honestly feel relieved if the recovery period was the extent of the problems. It would have been completely worthwhile had the results been in any way what I'd desired.

I'd gone in for 2 consultations on possible solutions for my protruding, large, convex nose with an obvious hump, but I hadn't really connected with the first doctor on a personal level, and I thought he seemed a bit distant and aloof. The second doctor seemed infinitely better in my inexperienced eyes, and it seemed he really wanted to help me out. His level of friendly care immediately put him in a better light. As far as I could tell, he knew what I expected and seemed confident in his ability to bring about the desired results--a straight nose.
So I proceeded to schedule the necessary appointments, and surgery day finally arrived. We went in and the doctor informed me there seemed to be no problems, and I should be happy with the result. As I recovered over the next few weeks, I felt great anticipation and excitement for what was going to be revealed after the removal of my splint, and to my great delight, it seemed perfect! I felt the whole thing was completely worthwhile after seeing my new, straight nose. I was informed that this was just the first stage, it was still swollen, and the true result would reveal itself in time. I was told it would get better and better as it became more defined in the coming months. I guess I was a bit too naive when I believed this. Over the next few months, I was overjoyed that I could finally be myself without feeling overly self-conscious about my huge honker of a schnoz. I went on with life with this new feeling of accomplishment and acceptance of my myself with my new and improved nose.

But to my utter dismay, after about 4 months, I noticed a slight downturn in the lower 1/3 of my nose. Slowly and despairingly, my nose began to show it's true shape as the swelling receded. I did some research online hoping to find some answers about the new shape my nose was taking on. Almost everywhere I looked the same answer almost immediately popped up-- the the Pollybeak (supratip) Deformity. I fell into somewhat of a spiral of depression and anger, asking myself why I hadn't just went to the first doctor, telling myself the results would have been better. When I revisited my doctor and asked what he thought of it, he went on and on about how it hadn't taken it's final shape yet, and how I should come back after a few months for a real evaluation. He denied the possibility of it being a Pollybeak deformity, and told me to come back in 3 months.

During this time, I took the liberty to consult with a different plastic surgeon in the area, only to confirm my fears that it was in fact, a pollybeak deformity. Upon looking at it, he immediately came to the same conclusion I had.

When I went back to my surgeon, he again denied that it was a pollybeak/supratip deformity, and tried to seem oblivious to that concern. He did realize that the cartilaginous section protruded farther up than the tip, and was elevated higher than the bony dorsal section of my nose, along with poor tip support. (My right nostril also seems to be elongated compared to the left one, and my nose seems to be slightly crooked as well.) It seems that he had only worked on reshaping the humped bone of my nose and had not done work on the cartilaginous part to allow it to match up with the now straightened top section.

^^ Now here is where I would really appreciate some input on what to do in this case. In the event that I consider allowing the same surgeon (for a greatly reduced price) to do revision work on my nose, what, in a professional opinion, should be done to straighten and define the lower section of my nose? Should excess cartilage by removed along the supratip, or would doing so create higher risk of that area having too little support and perhaps collapsing? Would a tip graft work to alleviate such a problem? Would elevating the tip of my nose slightly decrease the chance of the tip falling into it's original, poorly defined structure? I would greatly appreciate some professional advice or advice from someone who experienced something similar. I've included some pictures for further understanding of the problem.

Updated on Aug 4, 2009: