How to Decrease Indentation and High Nostril Crease After 1st Rhinoplasty

The most common cause of a pinched tip  (what some patients call a "sausage nose") after rhinoplasty is contraction of the skin and soft-tissue envelope of the nose without adequate support of the lower lateral cartilages. In your case, it appears that perhaps the lateral crura of these tip cartilages were too weak or flimsy to support this contraction process. This issue can be corrected in revision rhinoplasty by placing lateral crural strut grafts. These grafts are ideally harvested from your septum (but in some cases from the ear or rib) and sutured underneath the lateral crura to support and strengthen them. When performed by a revision rhinoplasty specialist, this technique should restore a more natural, unoperated appearance to your nose and may improve your ability to breathe. The tip of your nose shouldn't look any bigger or wider and may, in a sense, look less prominent because it blends in better with the rest of your face. Hope this answers your question.

Regards,

Umang Mehta, MD

I read your concern and reviewed the photo of your nose.

I have had wonderful success filling deep supra-alar creases with Silikon-1000 as an off-label, permanent injectable filler. In my practice, Silikon-1000 is also used to lower the height of your nostrils with permanent results.

I attached a photo from my RealSelf gallery demonstrating correction of supra-alar creases after previous rhinoplasty surgery.

I hope this is helpful for you.