Why do I have bumps on both nose sides & why the revision did not fix the issue? (Photos)

Hi, Sorry to see that you went down this road and still do not have the results that make you happy. Although it's hard to say for sure why your results came out this way, there are some potential explanations. For the tip droop, it seems like there is little to no support of the tip at the columella. The bottom of the columella where it meet the upper lip seems to be a little receded. This in itself can give the appearance of a more drooped tip (relative proportions), plus it is where the main tip support resides. Press on your nasal tip, if it drops easily, there is probably inadequate support. The bumps on the sides are likely from a higher osteotomy or incomplete osteotomy, but this is very difficult to say from pictures only. The bump on the bridge is your nasal bones being slightly higher at the "rhinion" compared to the cartilage below. It can be either from not enough reduction of bone, or too much reduction of cartilage. Check out the video on nasal anatomy, which might help make more sense out of this explanation. In the end, a formal consolation with someone who specializes in rhinoplasty, including revisions, is the best way to get the most accurate answers. ... and even with this, we do not always know the exact reasons or issues until we go into the nose for surgery. If you rule out surgery completely, these issues can be mitigated with filler via liquid rhinoplasty. Some filler at the columella base can rotate the tip and some filler below the bridge bump can help smooth out the dorsum. Hope this helps. Good luck!

Hello and thank you for your question. Based on your photographs, you may benefit from a a Revision Rhinoplasty in order to address these issues and others. Spreader grafts can be placed in order to address the asymmetric dorsal aesthetic lines which you are describing. Additionally, slight tip elevation, Nasal Tip Deprojection, tip refinement, among other maneuvers could be performed for improvements. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon