What can be done to an overprojected bridge and tip? (Photo)

Question

A female Asian who wanted a slimmer and smaller nose and ended up with a defined and much bigger nose when viewed from side and 3/4 angle. I prefer the height of my old bridge. What can be done to bring down my protruding nose? Would revising my nose by replacing my current 3mm implant with a smaller one give me back the natural contour of my nose while making it a bit slimmer than my before nose? What would be done to the tip to match a smaller implant? Would an alar plasty be recommended?

Nima Shemirani, MD · Answer

Dear oppsiepoopsie,You can find a nice middle ground between your old nose and your current oneRemoving the implant and deprojecting the tip would be a good startAs a revision surgeon, I would probably replace the implant with temporalis fascia to give some element of projection for the bridge, or else it will be too low againI am not 100% if you would need an alar base reduction, it is something that we would determine in person, my feeling is most likely not.Best regards,
  
Dr. Nima
  
Member, American Academy of Facial Plastic and Reconstructive Surgery
  
Board Certified Facial Plastic Surgeon
  
Board Certified in Head and Neck Surgery

Toby Mayer, MD · Answer

Revision rhinoplasty for overprojected nose with implant? This will be a complex revision based on my 43 years of revision rhinoplasty! It requires an koffice examination off ‘your nose and a discussion of your goals.

Bradley J. Chastant, MD · Answer

Thank you for your inquiry.  Revision Rhinoplasty with removing the implant would be required and placement of a graft would be appropriate.  I recommend you return to your surgeon to discuss options or consult with a board certified facial plastic surgeon specializing in revision rhinoplasty.
Hope this helps and good luck!

William Portuese, MD · Answer

It would be very helpful to have a copy of the operative reports find out what was accomplished in the primary procedure. Obviously the implant can be removed, but it's important to know what size of implant is in place. An alar-plasty can accomplish narrowing wide nostrils.

Richard W. Fleming, MD (retired) · Answer

I am sorry that your not happy with your result because it appears that thee work was well-done but your surgeon did not understand your goals or expectations. I strongly suggest you sit with an experienced surgeon who will respond to your evaluation and explain your options.

Michael Elam, MD (retired) · Answer

Dear OppsiePoopsie, A revision rhinoplasty would be required to provide a better balanced aesthetic.  Most surgeons would remove the implant and replace the implant with grafts that would provide a much more natural appearance and reduce the over projected tip. I am unsure an alarplasty would be needed. An in office consultation and examination will help provide the answers to many of your questions and a surgical plan can be made that will provide you the desired results you are looking for. Best regards, Michael V. Elam, M.D.

What can be done to an overprojected bridge and tip? (Photo)

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