I had rhinoplasty 10 years ago, unhappy w results

I want a narrower tip More refined And not so wide when I smile Is it achievable? Who is best surgeon for this U.K. Or Usa My surgery was closed and making nose very slightly narrower, difference is minute! Thank you

Doctor Answers 5

Rhinoplasty revision

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I would agree that more tip definition should certainly  be attainable with a revision rhinoplasty.  Of course, it depends on the thickness of your skin .   An open approach may be necessary to achieve the results but this could only be ascertained after you are examined.

Santa Barbara Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Your nose likely can have some good improvement. See my morph.

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Click on the "Web reference" link, just below my response, or go here:


I made a computer morph of your nose, and an animation of the morph, to show the changes that are possible for your nose in truly expert hands. I narrowed the tip of your nose, although not as much as the models whose photos your submitted. It's probably possible to get the tip of your nose a little narrower than what I drew, but I didn't want to go too far at first. 

Besides narrowing the tip, I elevated the tip significantly; it looks like the tip is drooping. I'd love to see some profile views, because I'll just bet that your nose is long, the tip hanging down, and shortening the nose would be a great change to make. The short video above is a revision rhinoplasty where the tip was elevated significantly. And certainly the two models' noses are very short! On the "Web reference" link page, at the *very* bottom of that page, is a link to instructions on taking photos that are most useful for online consultations like this.

You should understand that the changes I demonstrated in the morph require very advanced techniques, techniques that most plastic surgeons cannot handle.  Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

Your nose is also a good example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 42 reviews

Revision nose

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Elody76, revision rhinoplasty is a difficult procedure and should be done by surgeons that specialize in "only faces" and have done so for decades. Search the Internet and see the video. Cannot give surgical advice without an exam! Good luck!

M. Sean Freeman, MD
Charlotte Facial Plastic Surgeon
4.7 out of 5 stars 55 reviews

I had rhinoplasty 10 years ago, unhappy w results

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Hello Elody76 - Thanks for your question. There looks to be room to further finesse your nasal tip. The procedure can be performed either as a closed operation (endonasal) or an open one with a little scar across the fleshy divider of your nostrils (columella). Depending on the thickness of your nasal tip skin, you might benefit from cartilage grafting to the tip to further enhance the contour. Finally, rotating your tip up slightly would help you get closer to your wish pics. Be careful how narrow you go as you have full lips and wide, high cheek projection. Too narrow of a nasal tip won't match the look of these other facial structures. 

In London, I would recommend Dr. Rowe-Jones as the man to see about this minor adjustment. There are too many fantastic rhinoplasty surgeons in the U.S. to create a list for you. 

Good luck, 

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Revision rhinoplasty candidate

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A full set of facial photographs and and in-person examination is required to make a determination about being a candidate for a very difficult procedure known as revision rhinoplasty. Depending upon what was done in the past, further narrowing and bulbous tip can be accomplished. Thick skin in the tip of the nose will prevent refinement in that area. Look for a surgeon with extensive experience for best results.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 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.