Troubled by my nostrils and tip after rhinoplasty

So the projected image looks nothing like what my profile ended up as and even worse my front looks horrible. I asked my surgeon if he should be taking in my nostrils and he said no. Since he didn't, they are huge after taking out the bump and I have a drooping tip even though it was supposed to be lifted. Also... are those big dents in my nostrils going to soften or go away? What can be done in a revision to correct any of this?

Doctor Answers 8

Revision rhinoplasty issues

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


You should be thrilled with rhinoplasty results, so if you are not, you need to continue your conversation with your surgeon.  But you will hear a couple of constants when it comes to rhinoplasty. One, it takes a year for full recovery. So results may be in evolution.  We don't know how long ago your surgery was. Two, surgeons can often modify your results as you heal with steroid injections.  So continue to discuss your concerns with your surgeon to see if that is an option.  Three despite effective planning, surgical execution, and diligent patient care the revision rate on rhinoplasty is still between 5-15%.  So if you are still unhappy with your results at the end of the healing period, revisit this with your surgeon.  If you don't get the information you seek, you might have to get a second opinion.  Good luck!

Madison Facial Plastic Surgeon
4.7 out of 5 stars 15 reviews

Rhinoplasty concerns, drooping tip, nostril dents

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thanks for your question. First, there are several potential options for a revision rhinoplasty that will benefit you. Certainly raising your tip would make a big difference. An in person consultation with someone who specializes in rhinoplasty, and does a lot of revisions, may ease your concerns or offer solutions.  I agree with the comments below in that a lot depends on how long ago was your rhinoplasty. It seems you still have some swelling left over after surgery and this may resolve some but likely not all of the issues. Hope this helps. 

Taha Shipchandler, MD
Indianapolis Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Post Rhinoplasty Concerns

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I am sorry that you did not achieve the rhinoplasty results that you envisioned. I share your concerns about tip ptosis, nasal length, indentations and nostril support. Fortunately, an experienced rhinoplasty specialist may offer you the opportunity for correction via a revision rhinoplasty through an open approach. You may likely need cartilage grafts for strut and alar battens to address support and indentions. Additionally, the overall length and rotation of your tip should be improved. This may require advanced tip modification techniques to repair or reposition your lower lateral cartilages, achieving a smaller and more balanced result. "Taking in your nostrils" via an alar base reduction is probably not indicated, as revision changes described within this reply should improve overall nostril size and width too. Discuss your concerns with your surgeon and ask for recommendations. If necessary, seek another Rhinoplasty Specialists' opinion before agreeing to another surgery. Best wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon

Concerns after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I understand your concerns about the tip of your nose. From the picture it looks like you are in the first 3 months after surgery. Some people will have excess swelling in the tip of the nose. Some patients will require injections into the tip of the nose to help reduce this issue. At this point, it is too soon to say if a revision will be needed. Go see your surgeon and tell him/her your concerns and hopefully you can find a resolution for it.

Arash Moradzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 15 reviews

Healing after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I am sorry to hear about your rhinoplasty healing.  If you are fairly early in your recovery from rhinoplasty it may be that swelling is still a big component to your overall nose shape.  Swelling is often worst in the tip and nostril area following rhinoplasty and it is the location that retains swelling the longest, meaning it will be the last for the swelling to go down.  If you are in the six to twelve month range after your rhinoplasty you can start discussing revision since some swelling is still present but most of the swelling will have subsided.

Good luck with the rest of your nose shaping journey.

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Minor revisions for the nose are possible

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There may be some residual swelling. If there are elements you want to change, a minor revision or perhaps some filler can help.


Dr. Karamanoukian

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Postoperative Rhinoplasty vs Preoperative Imaging

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Chelsea, you don't mention in your soliloquy how far postop you are. Regardless, you eye is good as your surgeon has lost control of the tip of your nose which has "drooped" as you say. In many cases imaging creates false expectations and implies a certain result. In your particular case the imaging is fair and "could" be accurate.

Lifting the tip of your nose is frequent postop request and is reasonable. Do realize lifting the tip may require an adjustment to your supratip area and dorsum. Whenever one lowers the tip by contouring it, it causes some flaring of the alar bases. Many surgeons don't like to do alar wedges to make the base of the nose smaller. 

Finally, the dents appear to be the inferior outline of your strong alar cartilages. These cartilages can be reduced in size and morcelized to weaken them. 

Your complaints are legitimate and easily addressed by a plastic surgeon with a decent rhinoplasty experience and training. My only suggestion is to throw away the imaging. I think you can  actually do better than what I see on the computer.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

Troubled by my nostrils and tip after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I concur with your assessment. It would be helpful to see the frontal and sub-mental views also before and after .. More can be done to more closely approximate the previewed image. I would seek a second opinion by a very experienced Rhinoplasty Surgeon.

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.