I have a bulbous tip 22 months after my surgery. Is it possible to have a revision for a sloped nose and smaller tip? (photos)

Question

Initially, I asked for a smaller more feminine nose with a slope and tip pointing upwards. I did not receive that. It has almost been two years since my open revision rhinoplasty. I am dissatisfied with my nose. I am looking for a revision specialist in either the Bay Area or Los Angeles who can listen to my concerns and work with me to achieve what I want.

Steven M. Denenberg, MD · Answer

Click on the "Learn more" link, just below my response, or go here:
FacialSurgery.com/RealSelf/RealSelf_botched2017.html
I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands.In most revisions, the patient is a better candidate for surgery, the *more* she wants to change her nose. It's hard to make tiny tweaks, but if the goal is a large change, then we're more likely to get a happy patient afterwards.In the morph, I elevated the tip of the nose, and lowered the bridge, making it a touch concave with that feminine slope. See if you think the morph captured what you're looking for. I think it's important to make the nose distinctly feminine, because it was your original goal, and also because you don't have a terribly long nose right now, and as I said above we'd want to make a large change.The woman in the short video that I posted with this answer had the tip of her nose elevated in a revision rhinoplasty, although more than you would require, I think.
You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Learn more" link on how to stay out of trouble while searching for a rhinoplasty surgeon, and read the essay on how to tell whether your previous surgeon should be performing your revision. 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. For most noses, it's better to not have surgery than to have inexpertly-performed surgery.
I'd love to hear what you think of the morph. Did it seem to address your main concerns? I could modify the morph to your taste if you wish. Maybe elevate the tip even a little more, or lower the bridge a little more.
Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
In your case in particular, you need to find a surgeon who understands all of the issues I mentioned, and how they fit together, and who can actually accomplish them in surgery.

Gerald Minniti, MD, FACS · Answer

Hello,Although you don't have a bulbous tip, your nose lacks a supratip break, making the tip poorly defined and giving it an appearance of being down-turned. This and other issues you may have can be addressed with a structural revision rhinoplasty. Go visit a few ABPS certified/ASAPS member surgeons (or AAFPRS equivalent) who specialize in revision rhinoplasty. Best of luck!

Ritchie Younger, MD · Answer

Seek out a Board Certified Facial Plastic Surgeon who has vast experience performing revision rhinoplasty, and you will find your answer.  Some patients can build up scar tissue under their skin following rhinoplasty which can fill in the nasal dorsum and blunt a  surgically refined nasal tip.  After 22 months your best answer is to visit  an experienced surgeon to see if it is safe and possible to not only  refine your tip further, but also to  lower your nasal dorsum more- so you can acquire the nose you've always  wanted  to have !!

Toby Mayer, MD · Answer

Revision rhinoplasty for a more feminine nose. Yes your goals of correction of your polybeak with lack of tip support can be corrected if you see a very experienced revision rhinoplasty surgeon who can show you natural results of revisions like yours.

Mohsen Tavoussi, MD, DO · Answer

Tip revision is one of the most common revision nasal surgery performed. It is difficult to develop a balanced tip and thick skin does not help. Revision surgery is more complex as normal anatomy is disturbed. Careful removal of scars and reconstruction is sometimes needed to achieve a refined tip. Before and after pictures will help determine the expected result. Best

I have a bulbous tip 22 months after my surgery. Is it possible to have a revision for a sloped nose and smaller tip? (photos)

Answers (6)

Answer: Revision rhinoplasty for a more feminine nose.

Answer: Revision rhinoplasty for a more feminine nose.

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

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Everything you need to know about Rhinoplasty

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I have a bulbous tip 22 months after my surgery. Is it possible to have a revision for a sloped nose and smaller tip? (photos)

Answers (6)

Answer: Revision rhinoplasty for a more feminine nose.

Answer: Revision rhinoplasty for a more feminine nose.

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

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