generic nasal-tip-drop to expect, after revision

Question

hello, i had revision rhinoplasty a month ago for septal reconstruction and correcting alar retraction from prior surgery. I had an open procedure this time. The doctor placed a columellar strut to maintain tip projection not so much to elevate it because i had had lost some projection in my previous surgery and ended up with a columellar show. but i was happy with it more than i am now with the current tip as i now have a very upturned tip. I find the tip feels too upturned now than before specially when I smile, it pushes more skin upward making me look weird with a short stub nose. Please tell me how many millimeters of tip drop i can expect in the upcoming months. From post op day 7 when the cast came off, the tip dropped probably 1-2mm. I will be happy if my tip drops 2-3mm more in the up-coming months. is this feasible and a realistic expectation? More than whether the nose looks aesthetically proportionate, I am worried about retaining my family facial feature traits and don't want to look alien coz of my surgery. It would be good if my tip drops as stated above. Pls throw some light on this so i can wait in peace.

Kevin Sadati, DO · Answer

Dear Rhinoplasty Patient,
	It is difficult to render a professional opinion without examining your nose or having a picture to visualize it. Based on your descriptions, there remains some degree of swelling and tip rotation after your recent rhinoplasty surgery. I would recommend you to wait for at least two months until majority of swelling has subsided, if there is any issue with you nasal tip, then talk to your rhinoplasty surgeon.  Good luck and good healing. Dr. Kevin Sadati

Paul S. Nassif, MD · Answer

One month is still very soon after surgery, and your nose will continue to heal over time. In general, the final result of a rhinoplasty is not evident for 18-24 months following surgery. Swelling is a huge factor in the appearance of your nose shortly after your cast is removed. 70% of the swelling will go down in the first three months, and the remainder will go down over time. Your tip may drop slightly more, but it is difficult to say whether or not this will occur or exactly how much. Without examining and/or seeing your intra-operative photos, it is difficult to provide you with any advice. From here, I would recommend speaking with your surgeon regarding your concern, as he or she will be able to advise you on how to expect your nose to heal. Thank you and I hope this helps. I wish you the best of luck with the remainder of your recovery.

Robert A. Guida, MD · Answer

Yes, rom my experience with primary and revision rhinoplasties, most likely, the tip will drop a few more millimeters. At one month after surgery from an open approach, there is still a fair amount of swelling and stiffness (I am sure you can feel it if you try and wiggle your nose or smile). You have already seen it drop a bit, and it will probably drop a bit more. The hardest part now is waiting for things to settle in. Good luck.

Peter E. Johnson, MD · Answer

If the tip is well supported the tip may not drop at all after the splint is removed and without seeing you we can't give you much of an opinion. We hope you had careful planning before your revision so you do retain the features you want.

Gregory Park, MD - Account Suspended · Answer

The columellar strut usually consists of cartilage that has been harvested from the septum. It is used in situation where there is poor tip support. It WILL make your tip stiff. It can change the projection of the nose and generally does not drop in time. If the strut is too long and causes some over-projection that results in an upturned tip or exaggerated movements with smiling, the only way to change the rotation of the tip is to undergo a revision surgery.

Thank you for your question!

Gregory C. Park, M.D.

Thank you for your question!

Gregory C. Park, M.D.

generic nasal-tip-drop to expect, after revision

Answers (5)