What exactly is causing my pinched look and how to fix it? (Photo)

Question

I had a revision rhinoplasty 10 years ago and I'm still dissatisfied with my nose tip. I miss my rounded, more soft look. 2 mm lateral steal . With 5/0 PDS, bilateral dome-spanning sutures were passed. 1 to the Keystone area, one to each two medial oblique osteotomy line, two to supratip field, very crushed onlay cartilage graft was placed. To the Pre Columela to the region, shield graft was placed. 4 cap grefts to enhance tip projection. What is causing my tip to look like this?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It is difficult to give detailed advice based on this single picture. Generally speaking nasal tip deprojection and a mastoid fascia tip graft  would potentially solve the issues you are describing.  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

Eric M. Joseph, MD · Answer

Based on your photo, which is somewhat limited to evaluate, you appear to have very thin nasal skin. Additionally, you have had a lot of grafting done to the tip of your nose. Many people with thin nasal skin experience what is called: shrink wrap phenomenon. Is a situation where thin nasal skin shrinks down to the underlying nasal tip structure and subsequent irregularities may be seen years after surgery. In our experience over 20 years, microdroplet Silikon-1000 injections may be considered for adding permanent volume to the tip of your nose for a less pinched and less operated nasal tip appearance. I hope this helps and thank you for your question! Sincerely, Dr Joseph

What exactly is causing my pinched look and how to fix it? (Photo)

Answers (2)

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

What exactly is causing my pinched look and how to fix it? (Photo)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.