My tip is still bulbous after Rhinoplasty, can it be refined? (Photo)

Question

I had rhinoplasty 7 months ago now however, I still have a major issue with my tip. It's still very bulbous. What are my options and can it be refined?

Jose Barrera, MD · Answer

Swelling after any rhinoplasty persists for one year or more. Especially after revision rhinoplasty, swelling may take longer. There are other factors that affect swelling such as thickness of skin, use of cartilage grafting, the condition of the nose at the beginning of the procedure, patient propensity for scarring, number of revisions, length of surgery, among other factors. However, if you see significant deformity in the nose, then it's time for a consultation with a facial plastic surgeon.

Julian Rowe-Jones, MBBS, FRCS (Eng), FRCS (ORL) · Answer

You appear to have thick skin over your nasal tip so there is very minimal scope for making it less bulbous.  Certainly you should not judge the final result before a year and your tip may continue to change for longer than this maybe even two years.  Your tip does appear slightly droopy which makes it look a little rounder from the side.  Your tip could be lifted and projected out more but you would need a very careful discussion about this, with image manipulation before considering revision.

Holger Gassner, MD, FACS · Answer

Your nasal tip does look large, round and turned downward on the photo. Some of this may still be edema. If you have phases with less swelling, this would be an indicator that your tip may still become smaller. A thorough evaluation can be done after about 10 months. Revision of your tip may include turning it slightly up, making it appear less round and less wide. This can be done through an endonasal approach. For now I would advise to be patient and re-assess in 3 - 4 months.

Richard Bloom, MBBS (Hons), FRACS · Answer

Hi there,At 7 months it is too early to be considering a revision rhinoplasty. The swelling can take over a year or even longer.It also depends on what your nose shape was like before your surgery. You appear to have quite thick skin so a very refined tip may not be possible.At this stage though you need to be patient. Everything about your nose looks reasonable in the photo, so I would just wait at this point.RegardsRichard

Edward Farrior, MD · Answer

Seven months after a rhinoplasty is too early to consider a revision. Especially since you have thicker skin anyway. I would recommend that at this time you ask your surgeon about measures that can be taken to reduce swelling. This might include taping of the nose, massage and steroid injections. Ask your surgeon about his recommendations, allow another 6 months before becoming discouraged and considering surgical intervention.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. You may be a candidate for a revision rhinoplasty. Of course, you will need an in-person consultation to evaluate you for this procedure. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!
 
 Best,
Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

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