I had an open rhinoplasty 14 months ago and am not happy with the endresult. I've been thinking about having (alar batten?) grafts to fill up the alar crease which I don't like (esp. when I'm smiling the tip looks isolated from the alar), having the hanging columella raised and having the droopy tip shortened. Would this make my nose look better or are there other things that can be done to improve my nose? It doesn't have to be perfect, just a better version of what it is now...
Not Happy After Unhappy With Rhinoplasty Result, What Can Be Done to Make my Nose Look Better? (photo)
Doctor Answers 3
Corrective Rhinoplasty Necessary
I am sorry that you are not satisfied with your results and it seems that you are a good candidate for a multifaceted corrective rhinoplasty.
Based on the photos attached, it is hard to assess the correct projection of your tip.
As for the alar crease you mentioned, battened grafts is possible but other techniques may be found more suitable with your case upon physical assessment.
Finally, your columella needs to be readdressed and your nasal septum requires some modifications; you have irregularities in your nose leading to an hour glass shaped nose and so spreader grafts may be required.
That being said please remember that commendable results require an exceptionally skilled surgeon to perform a surgery as delicate as yours and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.
Thank you for your inquiry.
The best of luck to you.
Improving rhinoplasty result with revision
There are a few ways to improve your alar crease that you don't like. Batten grafts are one possibility. Another is lower lateral crural reposition. My link below discusses this approach in more detail. This would likely give you a more refine appearing nose that has improved contours.
It's hard to assess the columella position and tip position without a profile view, but if these are issues they could also be addressed during revision surgery.
Improving Nose with Revision Rhinoplasty
I agree that alar grafts should be placed to overcome the tip problem secondary to vertically oriented lower lateral cartilages. The columella should be lifted as you suggest. You also have an hour glass shape from the front and probably some breathing obstruction secondary to this contour which could be improved with spreader grafts. With the pictures submitted I cannot tell if you have a "droopy tip".