Can drooping cartilage in right side of nasal tip be improved without taking apart left side of nasal tip? (Photos)

Question

Closed rhinoplasty 14 years ago leaving right side of nasal tip w/drooping cartilage which protrudes from end of tip/columella causing an obvious appearance of hanging cartilage. And prior surgery. Left side looks good. been told by multiple surgeons entire tip has to be taken apart to fix. However left side looks good and I am afraid of messing it up if entire tip is taken apart. Are there any maneuvers which can focus on protruding cartilage on right without taking apart left side?

Randal Haworth, MD, FACS · Answer

Hello !

If it is something very localized, it can be done directly without having to open up the whole nose (I’ve done it) but if it is more complicated, the nose would have to be open so that the surgeon can assess the internal structure of the right and the lest side simultaneously.

It is best to do consult with a plastic surgeon expert in rhinoplasty.

I hope this helps,

Best of luck !

Randal Haworth

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. With revision surgery, it is possible to remove excess cartilage on the right side of the tip while preserving the structure of the left. However, the entire nasal structure should be taken into account to create a symmetrical appearance that also complements the rest of your facial features. 
Please keep in mind that each subsequent nose surgery becomes more complex due to the loss of structural support, scar tissue, and other factors. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to review your surgical history, discuss your concerns and goals with you, and answer any questions you may have.

Nima Shemirani, MD · Answer

Hi @beautyqueen2023. Based on your photos, you have a wide asymmetrical tip with flaring nostrils. This can be fixed with a revision rhinoplasty with possible rib harvesting. Best of luck to you!

Eric M. Joseph, MD · Answer

Please consider re-asking your question with a frontal photograph so we can see both nostrils at the same time. Depending upon your examination, Micro droplet silicon 1000 injections May be considered for achieving nasal tip symmetry without revision rhinoplasty surgery. Based on your photos, I agree that taking the path of least resistance may be best for you. Hope this helps! Doctor Joseph

Jeffrey H. Spiegel, MD · Answer

The answer is it is potentially possible...
The lower cartilages are closely related to one another, however, it may be possible to just lift and secure one side. If that's possible, it would likely be doable right in the office.

William Portuese, MD · Answer

When performing a revision rhinoplasty, there's always risk versus reward versus complication risks. Revision rhinoplasty is more difficult than a primary rhinoplasty. From the very limited photographs presented, the only thing appears to be wrong with your nose is a hanging columella.

Can drooping cartilage in right side of nasal tip be improved without taking apart left side of nasal tip? (Photos)

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