Pinched nose: what revision would widen the nasal tips making the bridge of the nose straight again instead of curved? (Photos)

Question

I had the primary rhinoplasty about a year ago and since then my nostrils have been pinched and the profile of my nose is too curved. The nostrils seem to have an indentation on the side. Is there any revision that would widen the nasal tips and make the bridge of the nose straight again instead of curved? and in general make the nose bigger Thank You

Evan Ransom, MD, FACS · Answer

Thank you for the question and your photos. It looks like your nostrils are poorly supported. This is likely related to the shape, size, and orientation of the tip cartilages. In some cases, the wings of the tip cartilages have been shortened too aggressively, making the nostril tissues appear overly thin and allowing collapse with breathing. In addition, it looks like your tip cartilages are vertically directed, instead of horizontally. The way to repair these problems would be to use cartilage grafts to support the nostrils and nasal sidewall, while also possibly reorienting the tip cartilages more laterally. Please meet with a revision rhinoplasty specialist to discuss your concerns. Best of luck moving forward!

Christian L. Stallworth, MD · Answer

Thanks for your question and your photos.  Without an exam and a full complement of photos it is difficult to address all of your questions.  In general, though, you appear to have a combination of facial asymmetry (we all have some degree of this and your right side seems slightly smaller than the left) and now alar retraction with loss of lateral wall (valve) and alar support.  A revision surgery with appropriate grafting to help restore structure to your nose can help provide the functional AND aesthetic goals you desire.  This may be needed for your dorsum as well if it was overly reduced.  I would first meet with your primary surgeon to discuss your concerns.  In addition, there are a number of world renown revision rhinoplasty surgeons in the Chicago area that I am sure would be happy to provide a second opinion.Best wishes.

William Portuese, MD · Answer

A revision rhinoplasty is more difficult than a primary rhinoplasty, so it's important to choose your surgeon wisely based on extensive experience. The photograph demonstrates an inverted V deformity with excessively wide nasal bones and pinched upper lateral cartilages, for which a spreader graft placement/  osteotomies on both sides of the nose would be helpful to improve. Alar rim grafts may be necessary help support the indentation in that area. It's important to know how much cartilage is left on the inside of the nose for potential grafting purposes with the revision rhinoplasty procedure. Choose your second surgeon wisely based on extensive experience. For many before-and-after examples of primary and revision rhinoplasty, please see the link and the video below

Steven Wallach, MD · Answer

You would have to be seen in person to determine what might be appropriate. Other views of your nose and possibly preops would be helpful.

Pinched nose: what revision would widen the nasal tips making the bridge of the nose straight again instead of curved? (Photos)

Answers (4)

Answer: Pinched nose

Answer: Pinched nose

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Everything you need to know about Revision Rhinoplasty

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Pinched nose: what revision would widen the nasal tips making the bridge of the nose straight again instead of curved? (Photos)

Answers (4)

Answer: Pinched nose

Answer: Pinched nose

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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.