is it possible to build my bridge higher and de-rotate the tip downward? (Photos)

In the photos, you seem to have tape on your nose. Depending on exactly how the surgery was done, it's extremely common for the tip to drop in the weeks and months after surgery. Also, even if the tip stays too high, it's important to wait about a year after one operation before attempting another, because the scar tissue that naturally forms after any operation, in any part of the body, start out being firm and then it shrinks and softens, and if the scar tissue is firm it can greatly hamper the revision. But waiting very well might allow the tip to drop some. Even if it doesn't drop *all the way* to where you want it, it might get close enough that you think the risk of another operation wouldn't be worth it to get just another one or two millimeters of additional length to the nose. This make any sense? Also, if the tape is being placed to hold the tip up, stop taping.

Hello and thank you for your question. Based on your photographs, it is possible to perform top derotation. A surgeon can accomplish this by fully releasing scar tissue followed by placement of extended spreader grafts. 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