Nose looks crooked from the front. Can this be fixed? (photo)

Question

I got a rhinoplasty in 2018 when I was 18 years old. I asked for the bump on my nose to be removed and the tip to be a little smaller. I asked for a pretty natural nose job. Everytime I take pictures with flash, my nose looks completely deformed. From the side it’s fine, but it’s crooked from the front. What happened during the original rhinoplasty? Is this normal or did the surgeon mess up? Can it be fixed?

Steven M. Denenberg, MD · Answer

The irregularity on frontal view looks like what we call an "open roof" deformity, where the upper part of the nose, where it's made of bone, is not connected to the middle and lower parts, where it's made of cartilage. But then, and I know you only posted this frontal view, it looks like the tip of your nose sits so low. I would expect the profile and 3/4 views to show a nose that might be longer than you ideally want it.
This nose requires a revision. How *much* to elevate the tip, or narrow the upper part, 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 frankly require advanced techniques, and skill that most plastic surgeons don't possess. It's much better to not have surgery than to have inexpertly-performed surgery.

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for revision rhinoplasty. The bridge may need to be reset to make it more uniform and straight as well. Be sure to see a rhinoplasty expert for consultation.

Eric M. Joseph, MD · Answer

Since you appear to have thin nasal skin, you are probably experiencing shrink wrap. That is when the overlying skin shrinks down onto underlying cartilages and irregularities may become visible many years after rhinoplasty. Depending on your examination, microdroplet Silikon-1000 nasal injections may be considered for camouflaging the irregularities that you are seeing. It is difficult to make a call, based on the photographs that you posted. I hope this is helpful! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty to straighten your crooked nose. There are many maneuvers that can be done to accomplish this.  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

William Portuese, MD · Answer

You have what's called inverted V deformity of the nose which is made worse by shadow effects when taking photographs. This happened because your upper lateral cartilages have collapsed inward, and your nasal bones are too wide, and you may not have had osteotomies at your primary rhinoplasty. A revision closed rhinoplasty can accomplish placement of spreader grafts to widen the mid vault that is collapsed, and lateral osteotomy to narrow the nasal bones. It's very important to know how much cartilage is left over on the inside of your nose to use as a spreader graphs. Revision rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, so choose your second surgeon very wisely based on extensive experience, producing natural results and dealing with this issue. Please see patient #7 in the rhinoplasty photo gallery who had the very same issue repaired by us

Nose looks crooked from the front. Can this be fixed? (photo)

Answers (5)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Answer: Nose looks crooked from the front

Answer: Nose looks crooked from the front

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Everything you need to know about Revision Rhinoplasty

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Nose looks crooked from the front. Can this be fixed? (photo)

Answers (5)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Answer: Nose looks crooked from the front

Answer: Nose looks crooked from the front

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.