Lucas Boehm, MD

Hello and thank you for your question -

First of all congratulations on the weight loss! Short answer is no. When we lost weight we lose fat from all areas of our body, including our face. What you are experiencing is extremely common in someone who has lost significant weight. Many weight loss patients go on to have a face and neck lift with fat grafting to help correct the tissue sagging and areas of volume loss.

I have seen many patients attempt to correct these post-weight loss deformities with fillers and non-surgical treatments and they all inevitably end up dissatisfied with the results after spending thousands of dollars. My advice is to reach your goal weight and then consult with a Board Certified Plastic Surgeon to discuss options for correction.

Best of luck!

Hello and thank you for your question. Based on your photos I suspect you had a misplaced piece of nasal bone after your original rhinoplasty operation. In addition to the rasping you recently had performed it appears they also placed a graft and held it in position with sutures that went across the bridge of your nose.

The residual bump could still be a piece of displaced bone or a displaced graft your second surgeon used. It could also be a combination of swelling and scar tissue. It is best to give it some time. Your surgeon may offer a steroid injection if he or she feels it is scar tissue related.

If the bump is still present 3-6 months after your revision procedure I would recommend consulting with another Plastic Surgeon with experience in revision rhinoplasty operations.

Best wishes and good luck.

Lucas M Boehm, MD
ASAPS Fellowship Trained Plastic Surgeon

The answer to the question "am I a good candidate for a rhinoplasty" is difficult to answer without ever meeting the patient. Based solely on your photos you appear to be a good candidate for a preservation style rhinoplasty. In my practice I use this technique to lower the bridge of a patient's nose to provide a more feminine profile. The preservation technique leaves the dorsum very natural and stylized. Many surgeons, including myself, perform this technique with an ultrasonic device called a Piezo. It is less traumatic and allows for less bruising, less swelling, and a quicker recovery.

It never hurts to simply talk to a plastic surgeon to learn more about the rhinoplasty process. This could be virtual and then in-office once you are serious about scheduling the procedure. Be sure to seek out someone with experience in rhinoplasty.

Best,
Lucas M Boehm, MD

It is always best to be specific about what you'd like to change about your nose when you do consult with a plastic surgeon. That said, in my practice I like to talk to my patients about facial balance. Once of the keys to facial balance is the relationship of the nose to the chin. Your chin is weak and a chin augmentation with an implant would help balance your features. The second piece of the puzzle would be feminizing your nasal tip by making it smaller and more refined.

In my experience a deviated nasal tip after surgery is due to a lack of structural support on one side or a shifted nasal tip graft. Based on your photos it is difficult to determine if this is the case but I will say your alar rims appear poorly supported, especially on the left side. As your nose heals and scar tissue forms it contracts and if there is nothing supporting the alar rim it will retract/collapse and can cause a deviation in the tip.

Taping the nose is not a long term solution to this problem.