I want my nose tip raised and defined. How can I choose the right procedure/surgeon? (Photo)

Hello, and thank you for the question. If you are looking to raise the nasal tip, I would recommend seeking the advice of a board certified revision rhinoplasty specialist. He/she may use computer imaging software to morph a photo of you, which will give you an idea of how the final result of surgery may appear. When choosing a surgeon, it is important to keep the following in mind:1) Credentials2) A great deal of experience performing revision rhinoplasty3) Great patient testimonials 4) A good amount of before and after photos showcasing the surgeon's workDuring a consultation, he/she will discuss any specific techniques that will give you the desired result. I hope this information helps, and I wish you the best of luck. 

   There are many ways to raise a tip, so I am not sure why there has been an issue. Kenneth Hughes, MDLos Angeles, CA

No recommendation can be made without seeing your nose in the context of the rest of your face.  The nose must fit the face not just be of the proper relationships within itself. In choosing a surgeon you should have several consults identifying for the surgeon what you are most concerned with.  I would discourage you from telling the surgeon how you think the operation should be done.  I would not operate on such a patient. you need to be able to relate what bothers you about the appearance of your nose to the surgeon and allow them to explain how they would correct that problem.

Lifting the tip of the nose can be accomplished with several different maneuvers  during the rhinoplasty procedure. These include shortening the caudal septum, excess cartilage removal in the tip and suture techniques applied to the lower lateral cartilages. After 4 rhinoplasties, you must have realistic expectations due to extensive scar tissue that is present. For many examples of lifting the droopy tip with rhinoplasty, please see the link below

Raising the nasal tip is a fairly simple procedure and may be accomplished with revision rhinoplasty. If you have had all four procedures done by the same primary surgeon then perhaps your vision and his/hers are on different pages and it is time to consult with other surgeons. See an expert in the field of rhinoplasty and make sure you and your surgeon are on the same page as what your proposed results should be. Digital imaging during consultation will help confirm that you and your surgeon agree to your desired result and that is is attainable. Best regards, Michael V. Elam, M.D.

After seeing the pictures submitted I agree that your nose would be improved by raising the tip. If you have to tell your surgeon how to accomplish this, you need a new surgeon. The best way to accomplish your goals is to work with an experienced rhinoplasty surgeon who specializes in revision work.