Rhinoplasty in 2019, what did my primary rhinoplasty surgeon do to my nose? Looking into revision. (photos)

Question

I had rhinoplasty in 2019 and my dr told me that my nose was going to be shorter and deprojected, lifted and hump will be removed. After I saw the results he said a deprojected nose wouldn’t suit my features however my nose now looks longer compared to before and my tip looks more downturned than before. Did he shave the hump and over reduce my bridge? I have included my nose before (left) and what I wanted to achieve in the collage (right) followed by after pictures. Looking into revision.

Gary M. Horndeski, MD · Answer

At this time, you need a revision.  You still have a small dorsal hump and the columella-nasal angle is 90 degrees and it needs to be turned up.  This will shorten the length of the nose as well.

Best Wishes,

Gary Horndeski, M.D.

Donald Groves, MD · Answer

Hello and thank you for your question. Unfortunately, without having been in the operating room during the initial rhinoplasty operation, it is impossible to say exactly what was done. 
I have answered a similar question you posted on 9/25/23, where you asked if a revision surgery would be realistic to achieve your goals. To make it easier for other patients in a similar situation, I have included my response to that question below.
It sounds like your concerns are the your under-rotated and slightly over-projected nasal tip and the long appearance of the nose as a whole. Addressing the shape of the nose (particularly the nasal tip) is one of the most common reasons people seek out and undergo a primary or revision rhinoplasty. A revision (secondary) open septorhinoplasty can best address the entire nose, and is particularly effective for addressing all the issues you are concerned with. 
In addition to addressing your aesthetic concerns, your septal cartilage (if still present) would be harvested (removed) and turned into multiple cartilage grafts, which would then be secured into different areas of your nose for structural support to create a more rigid framework that resists the deforming forces of healing/scarring. 
The open approach is very effective in facilitating complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look. The deprojection technique, which I would recommend for your case, is a very complicated maneuver that only the most experienced surgeons can successfully pull off. Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery, and revision/secondary procedures are even more complicated. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible. 
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from photos and descriptions provided. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps! 
Best wishes, 
Dr. Donald Groves 
Plastic Surgeon

Randal Haworth, MD, FACS · Answer

Based on your pictures, your nose needs to be further recessed and your tip defined and superior my rotated. It’s obvious your previous surgeon reduced your hump and the reason your nose appears longer is because your tip is not rotated upwards to an harmonized position with your reduced dorsum.

I hope this helps,
best of luck !

William Portuese, MD · Answer

Overall nose looks very good, but the reason your nose looks over projected is because you have an under-projected chin. Probably best to leave your nose alone, and just consider placement of a chin implant to augment your recessive chin forward for better facial balance and proportions. This can be done the local anesthesia as an outpatient procedure

Rhinoplasty in 2019, what did my primary rhinoplasty surgeon do to my nose? Looking into revision. (photos)

Answers (4)

Answer: Rhinoplasty in 2019

Answer: Rhinoplasty in 2019

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Rhinoplasty in 2019, what did my primary rhinoplasty surgeon do to my nose? Looking into revision. (photos)

Answers (4)

Answer: Rhinoplasty in 2019

Answer: Rhinoplasty in 2019

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.