Computer Imaging: Are These Reasonable Expectations for a Revision Rhinoplasty?

Question

I want the nose to be smaller, more squared/shaped, and with smaller nostrils. Are these reasonable expectations and will alar base reduction be necessary? Sometimes the nostrils appear pretty big, especially if I smile. At the same time, I'm afraid to incur breathing problems if they are reduced as much as I would like.

Stephen Prendiville, MD · Answer

Personally, I do not think digital imaging is as constructive in a consultation as your impression of the Surgeon and examples of his/ her previous work.  Digital imaging, even if a disclaimer is given, inevitably produces an implied result in a prospective patient's mind.  Recent studies show that digital imaging has about a 40% correlation with the actual final result.  For these reasons, I do not use it in my practice.  I recommend that you discuss your expectations and concerns with your Surgeon.

Thomas A. Lamperti, MD · Answer

With the limited photographic views and without examining your nose it's hard to say for certain what result is possible. Depending on your anatomy it may be hard to get as sharp a nasal tip as you've morphed, though.

	A full facial analysis and examation would allow your potential surgeon to perform digital morphing to allow the two of you to come together about what level of changes you're interested in.

David C. Pearson, MD · Answer

My only critique of this simulation is that the tip appears a bit too sharp and the alar base is a bit too narrow. The main issue seems to be the hanging columella. This tends to exaggerate the prominence of the nostrils, too. I do prefer computer imaging--if done in a realistic fashion--since it allows me to plan the case better and it improves the chances that the patient and I share the same vision for their nose. With any revision rhinoplasty, however, it's important to avoid making things worse, so surgery should be designed around improvement, not perfection, of course.

	All the best,

	--DCP

Manish H. Shah, MD, FACS · Answer

Hello,

	We perform simulations routinely, but only for surgical planning.  I let my patients know that I can make their noses look however I want on the computer.  They understand that healing forces will ultimately shape the nose and not the computer.  As a male you have thicker, more oily nasal tip skin.  I would be surprised if any surgeon could make the tip look that sharp during a revision surgery (? possibly with aggressive tip grafting ?).  Make sure you have a clear, realistic understanding of the probabilities that your nose will not be as finessed as shown in the after simulation photo.

	Good luck,

	Dr. Shah

Eric M. Joseph, MD · Answer

I read your concerns and reviewed your photos:

	You appear to have an acceptable Rhinoplasty result 1.2 years post-op, so you should reserve surgery as a last resort.

	Your nose is a bit long, and you appear to have a hanging columella and excessive nostril show. If you desire to improve the appearance of your nose, you should consult with several revision rhinoplasty experts to see what you might expect after revision surgery.

	Your imaged photos appear reasonable, but you should show these to your surgeon during your consultation to get his input and tailor a plan specific for you.

	I hope this is helpful.

	Dr. Joseph

Computer Imaging: Are These Reasonable Expectations for a Revision Rhinoplasty?

Answers (8)

Answer: Simulations aren't a guarantee!

Answer: Simulations aren't a guarantee!

Answer: Computer imaging is helpful for setting goals for Revision Rhinoplasty Surgery.

Answer: Computer imaging is helpful for setting goals for Revision Rhinoplasty Surgery.

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Everything you need to know about Revision Rhinoplasty

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Computer Imaging: Are These Reasonable Expectations for a Revision Rhinoplasty?

Answers (8)

Answer: Simulations aren't a guarantee!

Answer: Simulations aren't a guarantee!

Answer: Computer imaging is helpful for setting goals for Revision Rhinoplasty Surgery.

Answer: Computer imaging is helpful for setting goals for Revision Rhinoplasty Surgery.

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.