Unhappy with January 1st, 2015 Tip Plasty. What can I do in terms of revision? Estimated Cost? Recovery Time? (photos)

My goal for the procedure was to refine my tip so that it looked less round and so that it didn't hang lower when I smiled. My tip was narrowed and my nose now hangs lower when I smile. I had a small even bump on the bridge which I asked the doctor not to touch, After the procedure he informed me he "took care of the bump for me" however he only smoothed it on one side so now my nose isn't symmetrical. I hate how small nose looks in proportion to my face, I refuse to even take pictures.

Doctor Answers 6

Revision Rhinoplasty

I'm sorry to hear about your experience elsewhere.  The best recommendation is to have a thorough evaluation of the inside and outside of your nose with a board certified specialist who can help you achieve the results you seek.  3-dimensional computer imaging can also help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon.  


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Small nose, nasal contour, visible columella

To cut to the chase, cost will be dependent on where you have your surgery.  There is a wide geographic variability that is also impacted by the facility where the procedure is performed. You are looking a a cost of from $10,000.00 to $25,000.00. I suspect that in the L.A. area your cost will be in the range of 18 -25 thousand.  Each of your concerns can be addressed.  You need to look at a rhinoplasty as creating a nasal contour that is symmetric and confluent from the brow to the tip and that does not look like surgery has ever been performed. Your columella can be raised, the tip can be refined and the dorsum can be maid more symmetric. Good luck Jenny

Edward Farrior, MD
Tampa Facial Plastic Surgeon
4.4 out of 5 stars 14 reviews

Revision rhinoplasty for a more defined and natural looking nose.

A revision can improve your nose to give you a much better result. See a very experienced revision rhinoplasty specialist who can ascertain the issues that bother you so that this time you end up with the nose you want.  An examination is necessary to feel the structures of the nose and then discuss with you what can be done to remedy these issues.  Look at the surgeons before and after gallery and you should see many photos of the surgeons work. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Unhappy with January 1st, 2015 Tip Plasty. What can I do in terms of revision? Estimated Cost? Recovery Time?

Hello jennyhxoxo - Thanks for your question. It appears as though your tip is still too big when compared to the rest of your nose. Revision tip rhinoplasty seems like a reasonable request at this point. You will definitely need rhinoplasty simulations to make sure that the surgeon that attempts to improve this result has the best chance to succeed. 40% of the rhinoplasty procedures I perform are revision rhinoplasty surgeries. Patients need to have realistic expectations prior to surgery and I believe that simulations help the surgeon "see" what you see to better guide you. Asymmetries are normal and natural, and there is no such thing as true symmetry. I will say that refusing to take pictures is a bit worrisome. From an outsiders perspective, your nose doesn't look as bad as you make it out to be. A little time with a therapist prior to revision surgery will help get you in the best headspace to tackle revision surgery. It is very common for patients of unsuccessful cosmetic surgery to be traumatized by the whole experience. Looking at the results of your surgery, I would bet that you had malposition of your lower lateral cartilages (tip cartilages), and that your surgeon handled them in the typical way when trying to reshape your tip. The problem is that most patients develop alar retraction and worsen any columellar hang, which is what you seem to experiencing.  This is something that can be repaired, but I encourage you to do your homework and find an expert in revision rhinoplasty for your surgery.  

Good luck, 

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 47 reviews

Revision rhinoplasty

You are a candidate for a revision.  The tip can be refined but it depend on how thick the nasal tip skin is.  Also, removing the muscle in your nose that causes it to dip when you smile is fairly straightforward.  Seek out a consultation with a board-certified expert in revisions.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Revision rhinoplasty procedure.

 Since it has been over a year, it is possible to consider undergoing another rhinoplasty procedure.. It's important to know how much cartilage is left on the inside of the nose for potential grafting purposes. Thick skin in the tip of the nose can be an impediment to seeing refinement in that area. Releasing of the depressor septi ligament will help prevent the tip from drooping when smiling. The hanging columella can also be reduced. Depending upon how much cartilage was taken out of the tip initially, suture techniques or conservative cartilage removal can help improve the aesthetics of the nasal tip. For more information  and many examples including our current price list, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

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.