I had rhinoplasty last year. I'm happy with my new bridge and reduced drooping, but the supratip and dorsum look wide and "fat." This is also true for the columella. Looking back at pictures, I've noticed that it's a bit smaller/more defined than it was just six months ago. When I push down on the tip, it feels balloon-like. Is it possible to have such swelling after 17 months? Also, the skin around the tip hasn't completely contracted. Could this be causing the problem?
Nasal Tip/dorsum Still Wide over Year After Rhinoplasty? (photo)
Doctor Answers 3
At 17 months after rhinoplasty your swelling should be all gone. The tip may look full because of a thick skin envelope or inadequate suturing of the tip.
Wide nasal tip 18 months following primary rhinoplasty.
At 1.5 years following rhinoplasty, essentially all of the soft tissue swelling has completely resolved. Any changes going forward from this point will be related to structural changes that may occur in the underlying bone-cartilage framework.
After reviewing your photos I agree that the tip and supratip complex are still somewhat full and the tip defining points are wider than they could be. This will likely not improve. Otherwise, the result appears to be cosmetically good. A well-executed revision rhinoplasty can help you achieve your goals.
Tip revision surgery can be done using both a closed or open rhinoplasty approach depending on the unique situation and desired goals. Commonly techniques to improve definition include:
· Cephalic strip excision of the lateral crus of the lower lateral cartilage.
· Intradomal and interdomal suture shaping maneuvers.
· Cartilage grafts.
Seek out an experienced revision rhinoplasty surgeon. Good Luck.
Mario J. Imola, MD, DDS, FRCSC
Wide Tip 18 Months after Rhinoplasty
It is unlikely that your tip will change now that you have waited for 18 months after your rhinoplasty. The tip can be narrowed and the slight supra-tip fullness can be reduced. Talk to your surgeon or an individual who specializes in revision work. This refinement should give you an excellent result.