How can I get the pyramid shape of my nose back? (Photos)

Based on your photos, you can do some of the things you are asking, although it will never look like your before photo. Some of the tip lift can be brought down, and the tip can be made wider. Then if the bridge is built back up you'll get that pyrimadal shape back. Be sure to see a rhinoplasty expert for consultation.

The angle between the bottom of your nose and upper lip is obtuse but not terrible. There appears to be a discrepancy between the overprojection of your tip, and the under projection of your bridge. Microdroplet Silikon-1000 nasal injections may be considered for raising an overly curved bridge appearance so that it is less distracting, and more harmonious with the projection of the nasal tip. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty with removal of the SEG. Tip derotation can be performed by releasing all scar tissue followed by placement of extended spreader grafts to derotate your tip. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

After you have waited at least one year from your primary rhinoplasty, you can consider a revision rhinoplasty. Since you've had a septal extension graft, you probably don't have any more cartilage left on the inside of the nose to build up your bridge line, therefore you're going to have to consider into several different alternatives to try to de rotate your tip and build up the bridge line