Is it worth getting a revision for a caved in nose tip? (photos)

Hello and thank you for your question.

Although an exam in person is ideal, from your photographs alone it appears that you can benefit from a formal revision rhinoplasty where the nasal tip cartilage is modified for a more refined, symmetric look without the caved in and prominent areas you mentioned. It also appears that your nasal tip is over-rotated (turned up) and, if this is indeed the case, I would recommend de-rotation with extended spreader grafts secured to a columellar strut. I would also place a mastoid fascia tip graft between the reconstructed tip complex and your skin to reduce the risk of cartilage prominence (tenting up of the nasal tip skin by cartilage), Also important, if your septum is deviated and you have breathing difficulty, a revision septoplasty may benefit you as well -- insurance can cover this and reduce the price of your surgery☝️

The next step for you is to pursue the right aesthetic plastic surgeon for your rhinoplasty. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, IN PERSON, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. I also think a key component of your consultation is to establish a good connection with your plastic surgeon. This is difficulty to do without seeing your surgeon in the office, in person. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Hello and thank you for your question. Based on your photographs, you are a great candidate for a revision rhinoplasty. The tip asymmetry can be greatly improved with a combination of nasal tip deprojection, placement of a mastoid fascia tip graft, placement of extended alar contour grafts, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon