Unless the nose is built strong at the time of rhinoplasty, it can slowly change over time. The effects of gravity and minor knocks and bumps can, but not necessarily, cause very slow shifting of the cartilages. This is one of the reasons Columellar struts have become so popular that they are almost added routinely and without thinking. Similar to the way the bridge was over curved (ski slope) a generation of surgeons ago. Even without surgery many noses change as people age. Commonly the tip drops and a second bump appears just above the tip. In your case, the Columella has become angled instead of having a nice flowing curve to it. I would venture to guess the medial crura cartilages which make the the support of the columella have bent over the last 2 years. And I wouldn't be surprised if no columellar strut was used or it has migrated to where it no longer give added support. This isn't a case of something 'wrong' happening at surgery. Surgeon have to make judgements and act on these decisions. Surgeons do make the wrong decision at times (in fact its possible the correct decisions were made and this still happened!), but this is far from malpractice.
Thank you for your question and photos, After evaluatin your photos i would request that you post some before photos to see the differance. your nose however looks very good and well healed.
It appears that you have some fullness in the infra tip region. It is unclear what was done in your first surgery and would be helpful to now in coming up with a surgical plan to correct your concerns.
Thank you for your question. I am sorry that you are having concerns about the tip of your nose after surgery. I have reviewed the photos you posted, and I would need to see your pre-operative photographs to know exactly how the tip has changed. In general though, I think your nose has healed very well and you have a good result.
What you are describing in your question possibly could be some infratip (below the tip) fullness which you are not not happy with. Also, you may have some columellar show that you would like to be reduced, as well. I would discuss your concerns with a board certified, fellowship-trained facial plastic or general plastic surgeon, who specializes in rhinoplasty. He/She will be able to perform an examination and help you with your concerns.
I hope that this helps!-David Gilpin