I had a rhinoplasty 20 years ago, and was never happy with the result. My nose are wide, flat , scooped with a boulbos tip. Before surgery I had a strong profile with a bump, and my tip was a lot more refined. I would like to narrow my nose, build up my profile (straight), and to have tip refinement. and Can I sucessfully have a revision? Who are the rigt surgeon/surgeons for my nose? (Both experienced and skilled for my case) I live in Europe and will travel to USA. Thanks!
Am I a Revision Rhinoplasty Candidate? (Photos)
Doctor Answers 6
Revision rhinoplasty for bulbous tip
The pictures show a wide And asymmetric tip, wide nasal bones, a slight inverted V. deformity. Revision rhinoplasty would improve the symmetry and narrow the tip, a slight dorsal augmentation of cartilage to be placed across the bridge, osteotomies will be most likely require to narrow the nasal bones and possible small spreader grafts to help with the inverted V. deformity. This can be performed through closed rhinoplasty techniques as an outpatient procedure under general anesthesia.
Thanks for sending the pics. It appears that you have some tip asymmetry and overprojection giving you a scooped out look. You may also have an open roof deformity.
Do your research and I'm sure you will find a qualified surgeon to improve your nose.
Am I a Revision Rhinoplasty Candidate?
According to what we can see from the picture, you really are a candidate for rhinoplasty revision, we can see that you have an asymmetrical and bulbous nasal tip, the nasal pyramid is wide and the nostrils are a little asymmetrical: I consider that the ideal surgical approach is an open rhinoplasty technique which allows a wide visualization of all structures and work directly on it, the tip may be defined and refined by correctly modeling and approximation of the alar cartilages, we can use the nasal septal cartilage or ear cartilage to place a columellar strut and give more support and projection to the tip, we can also define and project the nasal tip by means of cartilage graft over the columela strut like an umbrella, through the middle and lateral osteotomies we can reduce the width of the nasal pyramid and increase slightly the dorsum. Finally, I think that With the closed rhinoplasty technique is very difficult to get satisfactory results in this case.
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you m ay be a candidate for a revisoin rhinoplasty. I think it is key to be evaluated in person to be properly evaluated.
Revision Rhinoplasty to Refine and Narrow the Nose
Thanks for the question and photos. I definitely agree with your assessment regarding your nose. You have somewhat wide nasal bones (both along the bridge and at the base) and your bridge could certainly be raised a bit if you wish. Also, you have a bit of an asymmetric and bulbous tip. Lastly, I can see an inverted-V deformity, resulting from your upper lateral cartilages falling in against your septum along the sides of your bridge, below the nasal bones. This may be impacting your ability to breathe, as this collapse can narrow the internal valves of the nose.
Correction of these issues during revision rhinoplasty requires cartilage grafting, done through an open approach. I would perform osteotomies, which are precise, controlled fractures of the nasal bones to narrow them. I would also place spreader grafts and an onlay graft of cartilage on top of the bridge to raise it a bit. As for the tip, suture techniques and cartilage grafts would help to narrow and refine it. Hopefully you have enough cartilage left in your septum to accomplish all of this. If not, cartilage grafts can be taken from one or both ears or from the ribs. This could be determined from an in-person evaluation.
We offer Skype and FaceTime consultations for patients coming from outside of the San Francisco Bay Area so feel free to get in touch with my office if we can be of service. I would recommend computer imaging, so that you can properly express your aesthetic desires to your surgeon and your surgeon can give you an idea of what would be realistic and appropriate, given the anatomy of your nose and other facial features.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.