Will I be able to get a more deprojected nose via revision rhinoplasty? (Photos)

You already know that your nose is too projecting, especially in relation to your bridge. You might be underestimating how much tip elevation your nose can use, however. When a nose is deprojected, it has a tendency to make the nose *look* longer, as though the tip had actually dropped, so a goal would be to get the tip up enough that it looks good with the newly-deprojected tip. The good news is that, in expert hands, these two changes, deprojection and elevation, are two of the more predictable changes to make in a nose, even in a revision.


How *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

Based on your photos, you are a candidate for revision rhinoplasty. The nasal length can be made shorter. You have to be realistic in that it will never be tiny, but it can be less tippy. Be sure to see a rhinoplasty expert for consultation.

Hello and thank you for your question. It sounds like your concerns are the your under-rotated and slightly over-projected nasal tip and the long appearance of the nose as a whole. Addressing the shape of the nose (particularly the nasal tip) is one of the most common reasons people seek out and undergo a primary or revision rhinoplasty. A revision (secondary) open septorhinoplasty can best address the entire nose, and is particularly effective for addressing all the issues you are concerned with.
In addition to addressing your aesthetic concerns, your septal cartilage (if still present) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support to create a more rigid framework that resists the deforming forces of healing/scarring.
The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. The deprojection technique, which I would recommend for your case, is a very complicated maneuver that only the most experienced surgeons can successfully pull off. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision/secondary procedures are even more complicated. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from photos and descriptions provided. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon