Meir Hershcovitch, MD

Dear Jessica,

Based on the pictures you posted, you do have a nice result. However a full evaluation of the changes would need to be made by view the before pictures as well. Nevertheless, the most important outcome is YOUR satisfaction. An in person consultation would be most beneficial to assess your goals and desires with respect to the tip. 

Thank you for your photo. Without a before photo, it is tough to definitively say what went wrong. However it does appear you have some superior retraction of the left alar rim as well as collapse of the nasal valve on the left. Are you having new breathing problems as well? 

The good news is that this type of issue can definitely be fixed with a combination or solo use of alar rim grafts or alar batten grafts. This can help correct nostril asymmetry and improve breathing. 

Best of luck!

--Dr. Hershcovitch

Dear jjohnston25,

Unfortunately, when there is a lot of bruising, the hemoglobin (iron) from the red blood cells doesn't get fully resorbed and can hide in normal cells. The goal should be to promote cell turnover in the area. I agree with Dr. Nima that PRP can be helpful. Additionally, IPL laser and a medium depth chemical peel can also be helpful. 

Good Luck!

Dr. Hershcovitch

Dear LLL111,

This type of problem occurs when red blood cells settle in your skin from bruising. The hemoglobin (protein that carries oxygen) from your red blood cells can create dark circles. That protein is eaten up by one of your white blood cells (called macrophages). These will then slowly remove the hemoglobin debris from the area. But you are correct, this can take months. Often, Vitamin K cream can be helpful as well as bleaching agents such as Hydroquinone cream. Furthermore, many people have luck with non-ablative lasers such as IPL which target the brown spots.

Speedy Recovery,

Dr. Hershcovitch

You are correct, you do have some increased rotation of your tip. However, since it is only 3 weeks post op, the tip will settle over the next few weeks. The nose continues to change as we age, including lowering and decreased rotation of the tip. I would address the issue with your surgeon if you are still unhappy at the 1 year mark.