Polly beak or supratip on thick skin? (Photo)

Question

I have ethnic thick skin I think. I had a rhino 2 years ago. I hate it and want the results to look like the second picture. Is that possible?

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, thank you for question and provided photos, a Revision Rhinoplasty can be performed  totaly healed from first operation. A better, balanced and natural looking nose can be improved by Closed and Atraumatic technique and it will provide maximal healing, minimal edema and eliminate a scar on your columella.Best Regards,

Steven M. Denenberg, MD · Answer

It's not a polly beak, and it's not thick skin. Your tip sits very low, and it's strong in its forward projection from your face.
When you made those morphs for a previous post, you adjusted the profile but you didn't elevate the tip. Even the model whose photo you posted had a very short nose. I think it would look nice on you, but it requires lots of elevation of the tip. That's where we use the morphs to figure these things out *before* attempting a revision!
The woman in the short video that I posted with this answer had the tip of her nose substantially elevated (and narrowed, too) in a revision operation.
I'm afraid that if someone agrees to revise your nose, but doesn't have the length as a key factor, you'll wind up hating your nose again.
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes I described above require advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. For those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.
Your nose is also a perfect 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. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! 
But remember, you're not the surgeon 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.

Jeffrey Jumaily, MD · Answer

I see the part that bothers you. It's hard to tell if this is skin or cartilage without an exam. If it's possible to have an inperson consultation, that would be ideal to give you the best advice. Best wishes

William Portuese, MD · Answer

The wish Picture should be attainable, but a thorough examination be required to determine the extent of the thickness of the skin in the nasal tip. Try steroid shots first by  your original surgeon to see if you get enough definition in that area when there's thick skin, scar tissue, and fluid retention present.

Michael Elam, MD (retired) · Answer

Dear Dsghh, Seek some consultations with experts in the field and after an examination a prioper surgical plan can be put into place. Have imaging performed to show you the proposed changes and review the surgeons before and after photographs to ensure expertise. If you have your previous operative report that is always helpful during secondary opinions. Best regards, Michael V. Elam, M.D.

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