Is tip plasty worth it for me? (Photo)

Digital images are not a replacement for an examination, however we have met patients with thick skin and wide nasal tips after rhinoplasty that is completely due to the overlying skin, not the underlying cartilage. An examination by a rhinoplasty specilalist may be helpful for determining what is causing your persistent tip wideness after three rhinoplasties.Hope this helps you.Dr Joseph

It is very difficult if not impossible in some cases to achieve a very well-defined thin nose if the skin is thick to begin with.If work has been done on the nasal tip in the past and all 3 occasions them the risks of a fourth surgery on the nasal tip is high.  She have to take that into consideration before she go for a fourth rhinoplasty on the nasal tip.In your consultation you should specifically ask your surgeon if he or she has had similar patients in the past and if the results were good or not.  That will help to make her decision about proceeding with a tip plasty or leaving it alone.RegardsDr. J

A revision can be done for the tip. However because this would be a fourth revision, it is important to review the details of the past surgeries in order to figure out the best course of action. The cost will vary depending on what needs to be done.

Your nose is a little bulbous on front view. That being said,  the more times you operate on the nose the less the skin can stretch and the more chance that you will see edges of cartilage below the skin. I don't know how well you are breathing but a smaller nose can decrease your ability to breath as well. I would personally avoid synthetic/plastic material in the nose, especially after 3 surgeries, as it tends to show through the skin as you age and has the potential to become infected as long as it is in the nose. You are very pretty and the enemy of good is perfect. Hope you make a good decision.

it depends on:1. what was done/not done during your previous surgeries2. how much of your tip aesthetics are secondary to cartilage issues3. whether your surgery was done open or closed and how much scarring/support your nasal tip hasonce you have gotten up the confidence, an exam with a qualified surgeon ought to shed light on these issues and help you decide whether or not this is worthwhilegood luck

In order to fairly judge the possibility of a fourth rhinoplasty making a more defined tip, I would need to see your initial "before" photo, and the "after" photo for each surgery you had.  It is certainly possible to have a tip-plasty that addresses only the tip of the nose.  As far whether you will get the result you are looking for, it depends on the elasticity of your skin and its thickness.  That being said, you may get the result you are looking for with a medpor implant, even if you have thick skin.  I would be happy to discuss this further in a private consultation in my office.  Best of luck,Dr. Michelle Yagoda

 The photographs demonstrate a very acceptable nose especially since it's been done 3 times in the past. Due to the  complicated and intricate nature of the cartilaginous/ bony anatomy of the nose, and the unpredictability of the healing process, it is best to leave well enough alone.

Remember : the enemy of good is perfections. Sometimes  you have to settle for good and just accept what you have. Another surgery might muck up the good result.

I think that doing a 4th may not make an improvement.  If 3 times didn't correct it, why would you think a 4th time would?  I have reservations.  Some people's tissues limit the kind of refinement that patients sometimes want.

It appears that you have a remaining bulbous tip. This should be addressed with reshaping of the remaining cartilage, and  cartilage possible grafting, NOT more cartilage excision, as it will only create more deformities and not produce the result you want.Your particular case requires finesse and experience, as you have had previous surgery before, which makes subsequent surgery more challenging. Also, most surgeons will  require you to wait at least a year from your last surgery, and at least 6-12 months after accutane treatment.This is a cosmetic procedure, your nose looks good already, whether more surgery is "worth"it,  is a subjective decision, that only you can decide on. I would consult with an experienced rhinoplasty surgeon in your area, if you decide to pursue this.