Do I have open roof deformity? How can I improve the shape of the tip of my nose? (Photos)

Question

Primary closed rhinoplasty was done 5 years ago with a board certified surgeon in California. Although it looks better than what I had before, I am not happy with the results. The side view isn’t bad but the lack of shape on the tip of my nose really bothers me. Any advice?

Erin Smith, MD · Answer

Hi, thanks for your question. An open roof deformity may occur after taking a hump down and failing to adequately reposition the nasal bones back towards to the midline. From photos alone, it is hard to tell if that has happened. Depending on your goals, you may be a good candidate for revision rhinoplasty to address tip symmetry. Surgery would likely entail an open approach to enable full access to the nasal tip cartilages. Good luck!

Jeffrey H. Spiegel, MD · Answer

You may indeed have something of an open roof, but that is, curiously, not much related to your stated concern - the tip.  Creating more tip definition may be possible, and narrowing the nose should help with overall appearance from the front (and the open roof). It will take about 1 hour.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a revision rhinoplasty. You do likely have an open roof deformity. This can be corrected with spreader grafts and placement of a fascial dorsal onlay graft or morselized bone dorsal onlay graft to provide a smoother straighter contour. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. 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

Best wishes and good luck.

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

Do I have open roof deformity? How can I improve the shape of the tip of my nose? (Photos)

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