Why is my nose tip still swollen? Would revision be an option for me? (Photo)

Of course, I don't have the opportunity to *feel* your nose, but the swelling should be subsided by now, especially in the tip, and even with the bridge small touch-up at four months. That history suggests that the "swelling" and fullness that we see in the tip is actually your tip cartilages, which probably could be further modified to make the tip look less broad. The clue I have here is that the tip looks low to me. If I were operating on this nose, I would want the tip elevated quite a bit from its current position. Not to make an unnatural too-Barbie nose, but you can decide whether your ideal nose is shorter than the one you have now. The reason that's a clue, is that when inadequate work is done on the tip cartilages to get the tip narrow enough, the remaining cartilage often holds the tip down, making the nose appear too long. So the goal in a revision would be to smooth the profile, elevate the tip, narrow the tip, and there may be other changes that are on your list that we can't see in the photos.

How *much* to elevate the tip, or narrow 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.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.