James H. Fuller, MD

One's ethnicity must be considered in any rhinoplasty.  To me your entire nose is a little large - not just the tip.  It would be helpful to see before pictures!  However,my ideal, or any other surgeon's ideal, is not always appropriate to the patient.

Whether or not you had a tip rhinoplasty if that is all you want addressed I believe you could have that redone with success.   Even if you did not have tip work I would wait until at least 18 months from the original surgery for further surgery.  

I think your computer modeling provides a great goal.  This is a good starting point to discuss your ideal with your surgeon, However, skin thickness and other issues may prevent an exact match.

Probably, there is significant change with further definition of the tip the first six months and some out to eighteen months or longer. I would wait until at least eighteen months after the original surgery.

The pictures presented are not adequate for a full evaluation, but it looks to me that the upper tip (lateral cartilaginous framework) is too wide and that the tip projection is too long.  This can be corrected with a revision tip rhinoplasty.  The only concern is what cartilage framework remains from the previous surgery.  A cartilage graft could possibly be needed if the cartilages are too severely missing.  

Acute displaced nasal fractures should be reduced within two weeks.  My ideal time is ten days except a little sooner in a child and a little longer if there is massive swelling and bruise or lacerations. At that point the swelling is usually down so the reduction can be done with visual cues and by feel,  and the bones usually stay in place nicely without packing or splinting.  I generally do this in the office for patients who are comfortable with  the office procedure - even 12 years old children.  I like to see the patient as soon as possible after the injury to be sure there are no complications such as blood clot in the septum that can weaken the nasal structure..