I had rhinoplasty 2 months ago. The naso-labial angle is well above 90-95 degrees. I attached before and after images. If it does not come down significantly, would it be more worth my money to get that fixed or do a chin implant? I only want to do one or the other. A revision would likely include adding to tip, deprojection, and alar base. Could a revision this complicated possibly lead to disaster? Should I just leave it alone so I don't get an over-worked nose w/ alar scars,stiff tip etc?
Unhappy With Naso-labial Angle Post Rhinoplasty. Would a Revision or Chin Implant Be My Best Bet To Correct This Look? (photo)
Doctor Answers 6
Improving naso-labial angle or chin
Your nasolabial angle will likely evolve further over the next several months. Overall (from profile view) your nose looks pretty good overall. It looks like your excessive columellar show that we can see in your preop photo was improved but there is still some columellar show evident.
The perceived naso-labial angle could be improved by addressing the hanging columellar aspect of this depending on how you ultimately heal after about a year. It's hard to comment on the need for the other revision nose work you mention without seeing additional views of your nose. Chiin augmentation is also an option. It may be easier for you to decide what route is best after giving yourself time to heal so you have a better idea of your new baseline.
Not happy with nasolabial angle and chin projection?
Your nasolabial angle is very slightly rotated. When dealing with slight changes there is a degree of unpredictability and whoever may be advising you should discuss the fact that you are not guaranteed the nasolabial angle you want and I would really be concerned about this. I think you look pretty good and I would suggest leaving it alone. The same goes for your chin. The chin ideally should come out to a perpendicular line dropped from the lip. You are minimally understated. Putting a chin implant in you might make you minimally over projected. It certainly won't change the appearance of your nasolabial angle.
Unhappy With Naso-labial Angle and Chin Projection
I don't understand why you only want to fix one problem. Your surgeon may not charge a significant fee to revise your nose which can be improved without fear of leading to a disaster. The nose can be lengthened but I cannot comment on alar adjustments without a picture of the nasal base. I'm sure you know that your nose, especially the tip, will change over the next 8-10 months. The chin implant will improve chin projection and improve the proportions of your profile.
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Chin augmentation versus revision rhinoplasty.
Please bear in mind that you are only 2 months following surgery, so there will be some change going forward. That being said, however, I agree that at this point the columella-labial (naso-labial) angle is too high for a male. I took the liberty of using a protractor to measure the preoperative and postoperative naso-labial angles you provided. The preop photo measured out at 110 degrees and the second from the left postoperative photo measured out at 99 degrees, so there has been significant improvement. Your surgeon has done a good job of decreasing the bony prominence in the region of the anterior nasal spine and improving the inclination of your upper lip.
The way things stand now I agree that your facial profile is better, but still too convex, i.e. the midface (nose) is still too projected relative to the chin. In order to acheive the ideal result, I would recommend changes to both the nose and the midface. The nose revision would include further resection of the anterior nasal spine, further reduction of the nostril-columellar show and a little more deprojection of the tip and supratip. These changes could be achieved relatively safely and easily through a closed approach. If I had to choose between nose revision and chin augmentation, I would go with increased chin projection.
Best of luck in achieving your goals and I hope this helps.
Mario J. Imola, MD, DDS, FRCSC.
Unhappy With Naso-labial Angle Post Rhinoplasty. Would a Revision or Chin Implant Be My Best Bet To Correct This Look?
Aesthetically speaking, your chin is weak and could be augmented with a Chin Implant to create a more balanced profile.