Would a revision rhinoplasty help create more harmony and improve the appearance of my pointy tip? (photos)

Question

I had a rhinoplasty 2 years ago. While the shape of my nose was greatly improved, the tip is still very pointy and projects a lot from my face. I’m wondering if a revision rhinoplasty would improve my result and create better harmony for face. The tip of my nose still points down and feels quite large for my face.

Steven M. Denenberg, MD · Answer

I think you identified what changes would benefit your nose. The tip is more projecting than it needs to be. Then, when a nose is de-projected, it tends to make the nose *look* longer, as if the tip had drooped, so it's *very* important to elevate  the tip at the same time. 
The good news is that, in expert hands, deprojecting a tip and elevating a tip are two of the more predictable changes to make, even in a revision. The bad news is that they are not changes that most surgeons can accomplish. You need to be very careful in evaluating your surgeon. 
How *much* to elevate the tip, or deproject the nose, 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.)

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.  Although an exam in person is ideal, from your photographs alone it appears that you can benefit from nasal tip de-projection. This maneuver can also rotate the tip up as you requested.   I typically perform a tip de-projection with medial crural resection secured to a columellar strut.  If your cartilage was already harvested from your septum in your original surgery, I would utilize MTF (Musculoskeletal Transplant Foundation, aka cadaver) cartilage during your revision surgery.

The next step for you is to talk to your plastic surgeon.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, a Revision with Nasal Tip deprojection to shorten your entire trip complex would be very beneficial.  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

Would a revision rhinoplasty help create more harmony and improve the appearance of my pointy tip? (photos)

Answers (3)

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.

Would a revision rhinoplasty help create more harmony and improve the appearance of my pointy tip? (photos)

Answers (3)

Browse related questions

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.