Before, simulation, and 10 year post operative result. Why doesn't it look like the simulation? Is it scar tissue? (Photo)

Tough to say based on one lateral view picture alone. To begin, any simulation is exactly that, a simulation. No rhinoplasty result will ever be exactly what the simulation shows, and I try to be very clear about that when discussing rhinoplasty and showing simulations. As to what has happened, it could be a number of things, including scar tissue, warping of the rib cartilage, or loss of some of the important structural elements of the nose. Steroids or any nonsurgical measures are very unlikely to do anything meaningful this far out; you would likely need a revision rhinoplasty to address your concerns. You should be seen in person and evaluated for your concerns, and come up with a plan with a plastic surgeon you like. The good news for revision rhinoplasty is we now have fresh frozen donor rib cartilage, which allows us to use rib cartilage without harvesting your own rib again! Best of luck.

Hello! The lump on your tip could be scar tissue given how far out your procedure is. Steroid injections would be worth a try in addition to compressions over the full area with nightly taping. I repeat this several times to see if any improvement is made. If no result, a procedure to remove the bulk would likely be needed as it could be excess rib cartilage graft. Hope this helps!