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

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

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