M. Hugh Bailey, MD FACS

Difficult to evaluate your deformity on a single photograph! Also with your face cropped, impossible to tell if your result is ethnically appropriate. In the photograph, your result might be good or bad! So I can only discuss in general terms how the problems you describe might be fixed. The surgery is usually more challenging. An over-resected dorsum will usually require a graft, which can shift after surgery, distort during healing or become visible if the tissues are thin. Likewise, over-resection of the tip may require multiple cartilage grafts with the same potential problems. I suggest getting at least two consultations from appropriately qualified surgeons before making any decision.

Without knowing what your nose looked like before, both inside and out, and what was done at your prior surgery, I cannot give you definitive answers. You also do not say how long ago the rhinoplasty was. An in-person consultation and your prior records are needed. However it appears that the attachement of the cartilage to the nasal bone has been separated on the right, which is a deformity I have seen many times, both after trauma and after an unsatisfactory rhinoplasty. Sometimes that can be filled with a filler injection or fat graft, sometimes it is better to reattach the cartilage, or place a cartilage graft at surgery. I would be confident though that this problem will not correct itself.

It also looks like your nasal bones are shifted a little to your right and the cartilage curves back to your left. This would go along with the septum still being deviated. When the cartilage is curved before surgery, it has a tendency to curve again, even if the surgery straightened it. Sometimes there are non-surgical fixes for that.

If your surgeon is well trained and has experience and a good reputation, I would try to work with him/her on these problems. If you feel you have reached a dead end with your surgeon, then it is time for a second opinion from a board-certified plastic surgeon who has skill and experience with revision surgery.

I think a series of subtle refinements would add up to a very nice improvement. Overall, your nose is a pleasing fit with your facial proportions, but small adjustments would add up to a big difference:
1/ Slim the nose on the frontal view
2/ Carefully remove the bump visible on the side view without significantly lowering the overall profile
3/ Raise the tip a small amount, so the angle between the tip and the upper lip is 90° or a little more
These would all be part of a standard rhinoplasty. Hope this helps your decision-making!

I can see an apparent bump on your photos, but I cannot diagnose the cause without an in-person examination. It looks like you may have damaged and/or displaced the upper lateral cartilages, which is waht shapes the flexible part of your nose above the tip. Probably fixable, but with a higher risk of an unsatisfactory result than a simple rhinoplasty. Perhaps that is why your surgeon was not keen to fix it. If it really bothers you, I suggest a second consultation with another plastic surgeon who is experienced in dealing with the results of nasal injuries.

Narrowing the nose, without lowering the profile on the side view can be done by cutting and repositioning the bones. It also looks like your tip would need to be slimmed to match, by adjusting the tip cartilages. I normally do the nostril reduction as a no-cost touch up under local anesthetic after everything else has settled at about 6 months post surgery. So long as everything is done in moderation, should be a very natural looking improvement!