Follow-up Question: Why does my nose do this post primary rhinoplasty and can this be fixed with revision? (photos)

My primary rhinoplasty left a lot to be desired and I am not happy at all with my results 6 months out. Why does my nose appear to droop this badly? Is it the tip drooping or the nostrils pulling up to much? What can be done to fix this? I did not have this issue pre-rhino

Doctor Answers 6

Revision rhinoplasty at one year

 The photographs demonstrate fullness in the supratip, a wide and droopy tip, and an active depressor septi ligament in addition to hanging columella. A revision rhinoplasty at one year can accomplish lifting the tip, releasing the  depressor septi ligament and reducing the fullness in the super tip portion of the nose. Choose your second surgeon very wisely based on extensive experience with the procedure, since revision rhinoplasty is one of the most difficult procedures to perform correctly in the entire field of cosmetic surgery 

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Can My Nose be Improved with a Revision Procedure?

Unfortunately you will need a revision to lift and refine your tip and elevate the hanging columella (the strip between your nostrils), but wait another 4-5 months until healing is complete. Consult with your surgeon and consider getting a second opinion from a rhinoplasty specialist.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty for the unsatisfactory results.

you will need a revision rhinoplasty done in 3 to 6 months. The refinement of your tip as well as correction of the droopy tip etc can be done by a very experienced revision rhinoplasty specialist. Look at the before and after photographs of revision rhinoplasty  that the surgeon has done of noses like yours or worse and choose one that produces very natural results. Do not rely on imaging but rather the actual patient results. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

Revision rhinoplasty candidate

Dear lookitscrystal, You need to have a revision rhinoplasty and can start looking for surgeons in about six months when you are fully recovered from your primary surgery. Unfortunately you are correct and your results do leave a bit to be desired. Basically you need a full revision that will address the supra-tip, tip-projection and tip refinement. Seek some consultations with expert surgeons and if possible bring a copy of your operative report with you as well as your original pre-operative photographs. Have imaging performed so you can see the proposed results and make sure you and your surgeon are on the same page this time and that your surgeon has the expertise to provide the desired result. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 196 reviews

Droopy tip after rhinoplasty

Your photos show a heavy, droopy tip with excessive fullness above the tip. This can occur after rhinoplasty when the support your surgeon used could not stabilize the nose sufficiently. Revision rhinoplasty would require significant strengthening and defining of your tip with cartilage grafts, with possible excision of soft tissue scar. Consider seeing a board-certified rhinoplasty surgeon with experience in performing challenging revisions.

Minas Constantinides, MD
Austin Facial Plastic Surgeon
3.9 out of 5 stars 7 reviews

Nasal droop following rhinoplasty


Upon reviewing the photos you provided it is difficult to get a good appreciation for your condition. Certainly there may be options to improve the appearance. The tip and nostrils are affected by the position of the lower lateral cartilages. Examining the nose would allow one to get a better appreciation for possible revision. I would recommend following up with your primary surgeon for further discussion. This would also allow you to compare post-op photos with pre-op. 

Take care,

Dr. Dominic

Dominic Castellano, MD
Tampa Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.