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How can I help with tip shape when smiling? (Photo)

H
harvey69Mar 24, 2024

I have had two rinoplasties and I am still unhappy with the “V” shape my nose makes when I smile. A few surgeons have declined further work on it.. They were both open rhinos with no cartiledge used from elsewhere.

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Dr. Richard G. Reish, MD, FACS
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Dr. Richard G. Reish, MD, FACS
Board Certified Plastic Surgeon
4.9 | 1738 Reviews
Answered on Apr 8, 2024
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Richard G. Reish, MD, FACS

Hello and thank you for your question. Based on your photographs, you may benefit from a a Revision with a nasal tip deprojection to shorten the entire tip complex. A mastoid fascia tip graft can be placed at the same time to prevent asymmetry and camouflage the tip. With good surgical...

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Richard G. Reish, MD, FACS

Hello and thank you for your question. Based on your photographs, you may benefit from revision to derotate your tip with extended spreader grafts. Even in thick skin patients, this is possible. With good surgical technique, you could have an outstanding result. I recommend that you seek...

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Richard G. Reish, MD, FACS

Hello and thank you for your question. Photographs would be very helpful here. The overall feeling may improve with time as the swelling continues to decrease. However, the sense of overprotection and tip asymmetry will likely not improve and may even worsen with time. You may want to consider...

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Hello and thank you for your question. Since you are only two days after removing the splint, you are very swollen. The final results take at least 1.5 years for the swelling to fully resolve. This can require lots of patience and waiting. Steroid injections performed by your surgeon can be...

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Eric M. Joseph, MD

Since you had vascular occlusion after your second surgery, rhinoplasty with either approach may not be a terrific idea. Please consider re-asking your question with photos that demonstrate your concerns and what you were looking to achieve. The feasibility of surgery in your case would require...

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Stephen Prendiville, MD

Based on your history alone, further surgery carries a high risk of vascular compromise to the skin. Your case requires in depth discussion in a consultation. But the simple answer, is "yes", you should be careful.

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