At 8 month post rhinoplasty I feel my tip is very pointy and or sharp. Can this still change? (Photo)

I tried zooming in as much as my computer would allow, and you appear to have a pleasing nasal appearance. If you have a small and pinched nasal tip appearance, sometimes we can improve upon this with a few droplets of Silikon 1000. This adds permanent volume to the tip of somebody's nose if it looks too pointy. That said, I cannot determine this from your photos. Thank you so much for your question and I wish you well moving forward. Sincerely, Dr. Joseph

Your big gorgeous smile in the photos makes some things harder to tell, but it seems that your nose is still very strong in its forward projection away from your face. Is that right? Is that something you notice? Perhaps you have some kind of grafting that is holding the tip out away from your face, which grafting is contributing to the tip feeling hard, and appearing pointy. If I'm off base here, well, I tried.

We say that it takes close to a year for 95% of the changes to happen after surgery, but boy, after 8 months, you would know a lot of what's going on.

If the problem *is* the projection, and even if it's not, it's likely that your issues can be addressed in a revision operation, much as that's a pain in the bee-hind. You'd have to figure out everything that you don't like about the nose, so everything can be addressed if you have another operation.

How *much* to bring the tip back closer to the face, or what other changes to make and by how much? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, 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 that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. 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. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. Basically, you'd have to re-evaluate how much care you took in selecting your surgeon, and by how much he missed your goals. Those are two of the elements that are important to consider.

Hello and thank you for your question. At eight months you are still swollen but this type of issue usually worsens with time rather than improving. Based on your photographs, you may benefit from nasal tip deprojection to shorten the elongated and pointy appearance of your tip. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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