15 years post rhinoplasty - What are my options to fix the tip of my nose? (Photos)

Question

I had a rhinoplasty surgery done almost 15 years ago. Initially, I was really happy with my results, but I feel like the tip has changed a lot over time. From the front as well as from below, it skews to one side. It also appears more bulbous than previously, while the nostrils feel more pronounced in profile, especially when I smile. What could be reasonably be achieved with a revision? I don’t want a dramatic change, but my nose has started to feel “off.”

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. 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. FACS
Harvard-trained board certified plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D. FACS
Harvard-trained board certified plastic surgeon

Jeffrey H. Spiegel, MD · Answer

It looks like the tip has started to tilt to the left. We should be able to support the tip of your nose with a cartilage graft to keep it straighter and more secure.

Yasemin Aydinli, MD · Answer

Changes 15 years after rhinoplasty are common. The tip cartilages that were weakened during the first surgery slowly lose support, so the tip drifts to one side, looks broader and the nostrils become more visible, especially when you smile. Looking at your photos, I also think the tip projects a little too far forward for your face, and that over projection is part of why the nose feels off to you now. What I would suggest is a revision that focuses on the tip: reducing the projection slightly, restoring support with cartilage grafts from the septum or ear, straightening the deviation and refining the width, all planned in proportion to your facial features rather than as a dramatic change. The bony part of your nose looks reasonable, so it does not need to be touched much, which makes this a more limited surgery with an easier recovery. Expect the tip to take up to a year to fully settle, as is usual after a revision.

15 years post rhinoplasty - What are my options to fix the tip of my nose? (Photos)

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