Will a tip rhinoplasty (only) help my issue? (photos)

The rhinoplasty result that you currently have is not unattractive but I feel it can be improved quite a bit. A "tip rhinoplasty" is not really a procedure. You would like to see changes to your tip and this needs to be evaluated in the context of the rest of your nose. You are a good candidate for revision rhinoplasty as you have a hanging columella, bulbous tip, poor alar support, and an inverted V deformity. My suggestion is to make a consultation with a reputable revision rhinoplasty specialist, virtual or in person, and have an open conversation about how you would like your nose to appear and I suspect that surgeon can deliver those results.

Yes, a tip-plasty could certainly improve the shape of your tip and the overall proportions of how your nose fits your face. Based on the views you provide, this would be a reasonable plan to minimize the extent of a revision surgery while still addressing your concerns.

Your bulbous tip makes the nose look very long, it makes the tip look like it's drooping. You can see it in the second-to-last submitted photo, and the one before that. In the frontal views, we see it in the way the bottom of the tip droops down to try to cover part of your upper lip, but as is typical, it's the 3/4 view that show best if a nose looks long-ish.
The good news is that, in expert hands, narrowing and elevating the tip of the nose is one of the more predictable changes to make in a rhinoplasty, even a third-time operation.


How *much* to elevate the tip, or narrow the nose, or make other changes? 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 -- especially after previous surgery -- 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.

Hello. Yes it is possible to address the tip only. Every (good) rhinoplasty is very specific to the person's desires, nasal anatomy, and the facial aesthetics. Issues occur when noses are treated with the same "generic" techniques across the board. From the pictures it looks like the main issue is the tip cartialge orientation, specifically that they are cephalically mispositioned and bowed down below the tip. I see these in revision cases very frequently and they are often due to over resection of the "lateral crus" of the tip cartilages, and inadequate support overall. In many of these the approach is to change the shape and orientation of these cartilages, while also adding adequate support. Rhinoplasty isn't about majors changes or drastic changes, but rather about the right changes. It's sometimes a hard concept to explain without morphing images and showing how those changes have to occur to get that ideal result. Go to several consultations with surgeons that truly specialize in rhinoplasty. Have them explain and show what changes they propose and how they plan to accomplish them. Of course it would be hard for you to know what the right answers are, but you can at least compare their answers and decide which make the most sense. That's the best advice that I have found for patients short of learning how to perform rhinoplasty and judging your surgeons answers. Also get a feel for whether or not the surgeons are genuinely interested in getting you the best results. I hope this helps, good luck!