What can be done to lengthen/fix my nose from an old rhinoplasty? A doctor told me it's too "tight" (Photos)

I had a rhinoplasty about 11 years ago. The doctor made my nose very short, with an upturned, bulbous, asymmetrical tip. I went for a revision consultation, and the dr advised against surgery, saying he would use fillers to raise the bridge. He said my tip was very "tight" and it might not be able to be rotated down. Is this a common problem with revisions? Is there anything else that can be done to fix my nose? I'm a little leery of the fillers, and my main issue is with how bad the tip looks.

Doctor Answers 4

Revision Rhinoplasty

I completely disagree with his statement.  Tip de-rotation is a challenging aspect of rhinoplasty but should be in any revision rhinoplasty surgeon's repertoire.  I think filler is the wrong answer in many aspects.  Probably the most difficult challenge to your nose is the alar base reduction that was done incorrectly.  Tip de-rotation will help to hide this and is a very important aspect of your revision.  Filler will not change the tip and will not hide the alar base, so it will not accomplish the majority of the goals you should have with any revision.  If you would like to travel to Utah, we can show you many cases of tip derotation in primary and revision cases.  Some of these can be found on our website.  


Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 78 reviews

Revision rhinoplasty for the short nose etc.

your nose can be lengthened with a septal extension graft and possible alar grafts.  The bridge can be augmented as well if needed. See a very experienced revision rhinoplasty surgeon who does many revisions and can show you his actual results in noses like yours.  Do not rely on imaging. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Revision to Lengthen My Nose

Your nose may be "tight" but it is very unlikely that it cannot be lengthened with septal extension cartilage grafts. Your wide asymmetrical tip can be improved at the same time. Fillers will augment the bridge but that will not lengthen your short nose. 


Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty candidate

  A revision rhinoplasty is much more difficult than a primary rhinoplasty, therefore and in-person examination is usually required to determine what the patient's wishes are, and what can be surgically accomplished with a difficult surgical procedure.  It is also important to know how much cartilage is left on the inside of the nose for potential grafting purposes to build up the bridge line.  Is also helpful to obtain the operative report find out what was done in the first procedure.    Make appointments with 3 busy rhinoplasty surgeons in your area to get second opinions.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.