Plastic Surgeon
Dr. Semih Yıldız graduated from Istanbul University Faculty of Medicine in 2014. He is a European Board-certified (EPOBRAS) plastic surgeon and a member of ISAPS and TPRECD. He has performed thousands of operations, specializing in breast, facial, and nose aes
Asked By: Plucky949567
ANSWER
In my experience, a septo-rhinoplasty can be planned to improve the bridge while preserving a masculine dorsal profile; the key is conservative structural work rather than simply lowering the bridge. Tip definition may also be improved, but that depends on skin thickness, cartilage strength, the nasal airway, and the exact source of the irregularity. The photographs show a side-profile concern, but they cannot assess the front view, nasal base, or septal deviation reliably. An in-person examination with standardized views is needed to judge whether these goals can be approached without unwanted widening or a change in the upper-lip–nose relationship.
Asked By: esp
ANSWER
The photographs show a bulbous tip with thicker skin and downward movement on smiling. The morph appears to show a narrower, more defined bridge and tip, but a computer morph is a planning and communication tool—not a promised result. A surgeon cannot reliably guarantee 90–95% similarity, especially when the skin envelope is thick and the tip changes dynamically with facial movement. A rhinoplasty may improve the dorsal contour, tip definition, and resting tip position. Depending on the examination, the plan might involve conservative lower-lateral cartilage reshaping and sutures, structural tip support, a columellar or septal extension graft, and assessment of the septum, alar base, and depressor-septi/dynamic component. Thick skin can limit how sharply the underlying framework becomes visible, and aggressive thinning or cartilage removal can create irregularities, stiffness, or breathing problems. The downward movement on smiling may improve but may not disappear completely. When two surgeons disagree, ask each to explain the exact anatomic limitation, what changes are realistically achievable at rest and while smiling, and how breathing and tip support will be protected. Review their unedited results in patients with similar skin thickness and starting anatomy, not only edited morphs. Choose the surgeon whose examination, risk discussion, and expectations are most specific and credible rather than the one quoting the highest percentage.
Asked By: Genuine244257
ANSWER
A caudal projection graft can sometimes be reduced, repositioned, or removed, but that decision cannot be made safely from symptoms alone. Tightness at the base of the columella may be related to a prominent or overly long graft, scar contracture, fixation to the anterior nasal spine, tension in the soft tissues, or another part of the reconstruction. The operative report and an examination with palpation are important to identify what was actually placed and what is causing the restriction. Removal is not always a simple solution. A caudal graft may be providing tip projection, columellar support, septal stability, or airway support. Removing it without a replacement plan can lead to loss of projection, tip or columellar retraction, asymmetry, instability, or breathing problems. Depending on the findings, a revision may involve trimming or releasing the graft, replacing it with a shorter or differently positioned support, and treating scar tissue rather than removing all support. Because difficulty closing the mouth and trouble drinking from a straw are affecting daily life, arrange an in-person review with the operating surgeon and obtain the complete operative report. If communication remains difficult, seek a second opinion from a high-volume revision rhinoplasty surgeon. Bring your preoperative photographs, operative records, and a clear description of when the tightness began. Do not try to massage or manipulate the columella without guidance.
Asked By: kari233
ANSWER
A small amount of congestion or drainage can occur during the early healing period, but daily leakage one year after rhinoplasty should not simply be assumed to be normal. More common possibilities include allergic or nonallergic rhinitis, irritation or dryness, changes in the turbinates, infection, or medication-related symptoms. The history and an examination of the nasal lining, septum, and turbinates are needed to distinguish these. Please arrange an evaluation with your operating surgeon or an ENT specialist, especially if the drainage is persistent. Describe whether it is clear or thick, one-sided or both sides, associated with sneezing or itching, and whether it has a salty or metallic taste. Clear, watery, predominantly one-sided drainage that increases when bending forward—particularly with headache, a recent injury, or fever—needs prompt medical assessment to rule out uncommon but important causes such as a cerebrospinal-fluid leak. Until you are examined, avoid forceful nose blowing, picking, or high-pressure rinses. If your clinician confirms ordinary rhinitis or dryness, gentle saline spray, humidification, and appropriate allergy treatment may help. Do not start repeated decongestant sprays without medical advice, because they can worsen congestion.
Asked By: Tasteful653730
ANSWER
The external cast is usually removed after about 7–10 days because it is mainly an early protective dressing and helps control swelling while the skin and soft tissues begin to settle. It is not intended to hold the nose in place for the entire six-week healing period. The nasal bones are repositioned in a controlled way, and the septum, cartilage, sutures, and any grafts provide additional support. Bone and soft-tissue healing continue for many weeks, and subtle swelling and refinement can continue for months. Removing the cast at that time does not normally allow the nose to simply return to its original shape. The cast would not be able to prevent every movement, and keeping it on too long can irritate the skin or create pressure problems. Some surgeons use taping or an internal splint for a further period depending on the operation. After removal, follow the surgeon’s instructions carefully: avoid pressure, impact, strenuous activity, and anything that could shift or injure the nose. A small amount of movement or swelling is expected, but a new deformity, significant bleeding, increasing pain, fever, or breathing difficulty should be reported promptly. Ask your surgeon exactly what bones and cartilage will be changed and what protection is recommended for your specific procedure.
Asked By: DelicateFlower1
ANSWER
A C-shaped or crooked dorsum is usually a structural problem, so the treatment depends on where the deviation originates—septum, nasal bones, upper lateral cartilages, or several areas together. Spreader grafts are one way to support and straighten the middle vault, but they are not the only possible tool. Depending on the examination, a surgeon may use septal correction, asymmetric cartilage or bone reduction, controlled osteotomies, suture techniques, camouflage or onlay grafts, or other structural grafts. Sometimes a combination is needed to straighten the nose while maintaining an adequate airway. A photo or the phrase “C-shaped” is not enough to choose the operation. The surgeon should examine the external nose, septum, internal nasal valve, breathing, and skin/soft-tissue envelope, and review any prior surgery. If the deviation is mainly functional, preserving or rebuilding support is particularly important; aggressive reduction alone can worsen obstruction. I would obtain an in-person assessment from a surgeon experienced in functional and revision rhinoplasty. Ask what structure is causing the curve, how the airway will be protected, what graft material is proposed, and whether the goal is straightening, improved breathing, or both. Filler may camouflage a minor contour irregularity but does not straighten the underlying framework or reliably improve breathing.
Asked By: Exquisite688548
ANSWER
Skin necrosis after primary rhinoplasty is uncommon, but it is a serious complication related to compromised blood supply. Risk can be influenced by smoking or nicotine, excessive tension, trauma, infection, prior surgery, and overly aggressive dissection or thinning. Your surgeon can best discuss their own experience and your individual risk; there is no useful universal percentage for one patient without knowing the technique and medical history. Early warning signs include skin that becomes unusually pale, dusky, purple, cool, increasingly painful, blistered, or develops drainage or a wound. These changes require prompt contact with the operating surgeon—do not wait for a routine follow-up and do not apply pressure or unapproved creams. Once tissue is clearly nonviable, treatment is more difficult, but early recognition may allow the surgeon to address pressure, circulation, infection, or other causes. Avoid all nicotine around surgery. A thick-skinned bulbous tip can often be refined without routinely removing large amounts of skin. Options may include conservative cartilage reshaping, suture techniques, carefully selected structural grafts, and management of the soft-tissue envelope. If subcutaneous thinning is considered, it should be limited and individualized because excessive thinning can cause vascular compromise, contour irregularities, or visible graft edges. Ask your surgeon exactly what “thinning” means, how much is planned, and how breathing and skin blood supply will be protected.
Asked By: Nice491946
ANSWER
At 17 months, some residual soft-tissue thickness can still be present, especially with thicker skin, but significant persistent fullness is less likely to be simple postoperative swelling alone. The photos show a broad, full tip, but they cannot determine whether the main contributor is edema, scar tissue, thick skin, or the underlying cartilage framework. Two steroid injections do not necessarily mean that treatment has failed. Improvement may be gradual and the response depends on the medication, concentration, injection depth, spacing, and the tissue being treated. However, if there is little or no change, your surgeon should reassess the diagnosis before giving more. Steroid injections cannot reliably narrow cartilage or correct a structural tip problem, and repeated or overly deep injections can cause skin thinning, dents, visible vessels, or discoloration. I would ask your surgeon to compare your preoperative, early postoperative, and current photographs and examine the tip by palpation. If the issue is primarily scar or soft tissue, carefully timed treatment may help; if it is structural, a revision tip procedure may be the appropriate discussion after healing is stable. Seek a second opinion from a surgeon experienced in thick-skin and revision rhinoplasty before additional injections, and do not self-massage or inject the area.
Asked By: Shivam5915
ANSWER
Yes, a wide nasal bridge can often be narrowed with rhinoplasty, but the plan depends on whether the width comes mainly from the nasal bones, the upper lateral cartilages, the skin and soft tissue, or a combination. Bone width may require controlled osteotomies, while cartilage width may require reshaping or adjustment of the middle vault. The goal should be a balanced bridge that remains strong and preserves breathing—not simply the narrowest possible nose. An in-person examination is needed to assess your frontal and profile views, skin thickness, septum, internal nasal valve, and airway. Standardized photographs and computer imaging can help discuss realistic goals, but they cannot guarantee the result. I cannot give a reliable cost estimate without an examination and knowing the surgeon, hospital, anesthesia, and follow-up arrangements. In West Bengal, consult a board-certified plastic or facial plastic surgeon who performs rhinoplasty regularly and request a written, itemized estimate. Choose experience and safety rather than a low price, and ask how breathing and revision risks are handled.
Asked By: Lively8
ANSWER
Your profile photo shows a prominent dorsal hump and a strong nasal profile, while the frontal photo suggests some width and a less defined tip. The chin also appears relatively less projected, but photos alone cannot assess the underlying jaw, teeth, or soft-tissue proportions. A rhinoplasty could potentially reduce the dorsal hump and refine or rotate the tip, but the exact plan depends on your skin, cartilage, septum, airway, and facial proportions on examination. If the chin is genuinely retrusive, chin augmentation or genioplasty can sometimes improve profile balance; that does not mean you necessarily need it or that both procedures must be done together. Your bite and jaw relationship should be assessed before making that decision, and an orthodontic or maxillofacial opinion may be useful if there is a significant bite concern. I recommend an in-person consultation with a board-certified facial plastic or plastic surgeon who performs both primary rhinoplasty and facial-profile assessment. Bring standardized front, oblique, and profile photographs, and discuss conservative goals, breathing, and realistic limitations. Computer imaging can help communicate preferences, but it is not a guarantee of the surgical result.
Dr. Semih Yildiz is highly regarded for his exceptional surgical skills, patient-centered care, and successful outcomes across various procedures including , , , , , and . Patients consistently praise his thorough explanations, attentiveness, and ability to make them feel comfortable and confident. His dedication to personalized care, integrity, and attention to detail are frequently highlighted as key strengths.
