What do I do to reduce nostril length and refine nasal tip size? (Photos)

Question

1) Rasping on right side - May 2022 - In Office Twilight 2) Graft - In Office Twilight - July 2023 | Graft to fix right side, and strut to stop drooping My nostrils look longer, and the tip still droops. Is this a tertiary?

Artur Fahradyan, MD · Answer

A revision rhinoplasty performed by a board-certified plastic surgeon who specializes in revision rhinoplasty can effectively address your concerns.In my opinion, your surgical history suggests that the previous approach was not ideal for a surgeon specializing in rhinoplasty. The goal should always be to perform the procedure once and comprehensively address all concerns. Performing multiple minor procedures and continually adding grafts to correct isolated areas often fails to achieve a balanced, long-term result.In your case, I believe you would benefit from a nasal dorsal reduction, slight tip deprojection, and subtle upward rotation of the nasal tip to correct the tip droopiness and pollybeak appearance.

Eric M. Joseph, MD · Answer

If you feel that your tip is more droopy, and that your nostrils are longer after your procedures, revision rhinoplasty may indeed be necessary to achieve a smaller, less distracting, and more feminine nasal appearance. The complexity of your surgery would require an examination. If your nasal septal cartilage is relatively intact, your surgery may be somewhat straightforward. I hope this helps, and I wish you well moving forward. Sincerely, Dr Joseph

Steven M. Denenberg, MD · Answer

I'm having trouble understanding exactly which photos are the latest. In any event: in my experience, a strut will not change a droopy tip. You can't just jam something in there to raise the tip -- you have to modify the tip cartilages. Then, in my experience, it's really rare that an "in-office" procedure can make a meaningful change in the appearance of the nose. I never ever do them myself.

Having said all that, shortening a nose with a droopy tip ("shortening" means elevating the tip), in expert hands, is one of the most predictable changes to make in a rhinoplasty, even a revision. But you should not have any more in-office procedures. They won't fix the droop or the nostrils, and they will make an eventual revision more difficult.

Alejandro Nogueira, MD · Answer

First of all, get this concept, office or mini procedures rarely end well, they pose a health risk in rhinoplasty and they are terribly limitating technically, hence the outcomes poor or even deforming.

You need a real, complete, structural revision of your nose, under general anesthesia, in a real Hospital (not a clinic) by the hands of a surgeon who knows how to perfrom revisions.

You are correct by wishing to improve your results, they are poor and everything can be refined, the hookedness, the tip definition, the nostrils shape and size, even the dorsum, a full blown "primary" revision is bound here.

Do research well and seek the opinion of a dozen or more surgeons with real talent, experience and passion for revision cases.

What do I do to reduce nostril length and refine nasal tip size? (Photos)

Answers (4)

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