Would a revision rhinoplasty help correct drooping tip 18 years post initial rhinoplasty (photos)

I would recommend a revision rhinoplasty with rib cartilage. I would find a plastic surgeon certified by the American Board of Plastic Surgery. I always tell prospective patients to look at the plastic surgeon's training (ideally a 6 year integrated plastic surgery residency and a 1 year aesthetic fellowship accredited by The Aesthetic Society). In addition, examine before/after photos on social media platforms. I would also look at Google or RealSelf reviews. This will help you get a comprehensive understanding of your provider.

From what I see in the photos, the plan would be to significantly elevate the tip, and de-project the tip (bring it back closer to your face), lower the bridge to match the new position of the tip, and re-shape the lower part of the tip so it doesn't appear to droop so much on the frontal view.

It's surprising that the nose looks *this* long after what appeared to be a satisfactory rhinoplasty, no matter how far in the past.

How *much* to elevate the tip, or deproject the nose, or lower the bridge, 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.

To answer the question in your title- yes, a revision rhino can correct a drooping tip. To answer the question in your body- only you can determine if you "should" do surgery for that. Most likely you will need some cartilage for this, so if you have some left in your nose, that's great, but if not, you should be prepared that you may need cartilage from elsewhere.

A revision rhinoplasty can accomplish many different maneuvers in the nose, including elevating the droopy tip. Also important to release the depressor septi ligament, which dynamically pulls the tip downward when smiling. Digital computer imaging of your nose currently would be helpful to understand what can and cannot be accomplished by an experienced revision rhinoplasty specialist.