Can the tip of my nose be pushed in more towards the face?

Question

I recently got a rhinoplasty about 9 weeks ago to flattern my bridge, however when I asked if my tip could be pulled in closer to my face instead of it staying projected a lot my surgeon said that that's very hard to do or something etc. so now I have a smaller bridge yes, however I'd like it a bit smaller along with the tip pushed in closer to my face. Is it possible to push my tip more in and flattern my bridge a bit more, if so how long should I wait considering my first was done 9 weeks ago?

Alejandro Nogueira, MD · Answer

Well... I don't want to imagine the rest of your nose if your surgeon told you such basic maneuver (tip deprojection) is "hard to do", obviously he means about his own skills which do not represent at all the average level of expert rhinoplasty surgeons.
There exists a stepped algorythm in tip deprojection, from simplest to complex, depending the requirements:
-medial cruras overlapping transection + free float
-medial cruras segment resection + free float
-lateral cruras overlapping transection free float
-lateral cruras segment resection + free float
-medial cruras overlapping transection + suture securization
-lateral cruras overlapping transection + suture securization
-medial cruras segment resection + suture securization
-lateral cruras segment resection + suture securization
-associated or not to the former: medial cruras strut graft suture securization
-associated or not to the former: lateral cruras batten graft suture securization
-associated or not to the former: medial cruras tongue-in-groove septal suture securization
-associated or not to the former: dome decapitation and rebuild by grafting (very extreme congenital Pinoccio's noses)
As you may see... there are plenty of resouces to deproject a tip, and actually I do perform deprojection in 80% of my reduction rhinoplasty cases... obviously... if you reduce a nose you have to shrink as well the tip, at least slightly.
Being done so recently you'll have to wait between 6 to 12 months, depending on the kind of rhinoplasty received initially, your individual evolution and the technique required to deproject the tip.
If you wish better grounded opinion please do post or send privately well lit, focused and standard images: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Bahman Guyuron, MD · Answer

The nose tip can be pulled back as much is needed. However, it is seldom the only maneuver that is necessary. if you believe the rest of your nose is fine then you may want to discuss it with your surgeon. It would be advisable to wait close to a year to make sure there no other imperfections are going to develop.

Robert Kotler, MD, FACS · Answer

Dear Jelena123 in California, PA
Nine weeks ago your rhinoplasty was done and it is a bit soon to consider a revision.  You must allow the tissues to settle in and let the swelling reduce.  It is possible that it may be recessed closer to your face and sometimes a tip recession requires sculpting some of the upper jaw bones to make room for it.  All of these things are possible.  The key is waiting until you reach the 6 or 9 month mark.  Re-evaluate at that time.  
  
If you wish a second opinion, it is always not a bad idea.  Consult a surgeon whose practice is nearly all rhinoplasty.  Do your homework prior.  Bring a list of questions.  Have a friend or family member join you.  Be sure to have computer imaging and, when you go for your consultation, be sure to bring all of your records and photographs so the consulting doctor knows your entire history.  
  
Best wishes,
  
Robert Kotler, MD, FACS

Can the tip of my nose be pushed in more towards the face?

Answers (3)

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