Hello,I think you should have a revision rhinoplasty to definitively fix the irregularity of the tip. It should be performed in an open procedure ensure tip symmetry. Revision rhinoplasty almost always causes as much swelling as the primary surgery, and in some cases more. However, you will not need osteotomies, or the 'breaking of bones', which cause much of the bruising and swelling in initial rhinoplasties. Filler will be unreliable, temporary, and add bulk.Best of luck!
Cartilage showing through.
After a year if an irregularity in the tip cartilage shows through we favor revision rhinoplasty rather than fillers for a stable and permanent result.
Tip Deformity after Rhinoplasty
I am sorry that you developed a tip deformity one year after your rhinoplasty. This condition requires an open approach revision rhinoplasty for optimal correction. Please discuss your concerns with your surgeon or an experienced Facial Plastic Surgeon who regularly performs revision rhinoplasty for tip bossa deformities. I would recommend avoiding fillers due to high risk and ineffective result for this condition. Best Wishes.
Filler to camouflage cartilage versus revision rhinoplasty
The answer depends on your goals. If the visible left tip cartilage is the only feature of your rhinoplasty result you are unhappy with then camouflaging this with filler is a reasonable approach. It carries some risk and might not produce a satisfactory result but it is temporary and reversible. If you are not happy with other features of your new nose then revision rhinoplasty is likely your best choice. Revision rhinoplasty usually leads to more prolonged swelling compared to a primary rhinoplasty but it all depends on what is revised. It you and your surgeon decide a small tip revision is all that is necessary then your swelling will not be too bad. The expected swelling will increase as more revision work is performed. I suggest you discuss this issue with your rhinoplasty surgeon as he/she knows your anatomy best and can help guide you to a solution.
Rhinoplasty: cartilage showing through
Rhinoplasty is a surgery to change the shape of the nose for breathing or appearance. It's one of the most challenging surgeries because the results do not appear for many months or years after surgery. Visible cartilage can be frustrating for both the patient and the surgeon. Patients with thin skin are more likely to have visible structures. Camouflaging techniques during rhinoplasty can help. Seek out a revision rhinoplasty surgeon to see what options are possible with your nose. I would avoid having any filler injected into the tip of the nose. The blood supply is not robust. And the skin may be challenged. The risk with filler in this area is high in my opinion. Safety comes first.
Revision, some advices:
Thank you very much for sharing your concerns about your Rhinoplasty with us.
After having analyzed all the info and photos provided to us, i recommend to perform a Secondary Rhinoplasty (not a tip revision) this means (basically) treat the nasal bones and the nasal cartilages.
Therefore i would perform a narrowing of the nasal base (nose osteotomy) and alar and triangular cartilage shaping.
Dr. Emmanuel Mallol Cotes.-