Revision rhinoplasty for tip worth it? (Photos)

Question

I had my initial rhinoplasty 9 years ago for a bulbous tip, and although I am about 90% satisfied with result, I do feel that there could be more tip definition, more refinement with more of the underlying cartilage showing, and maybe also a bit thinner. Since I am still overall pretty satisfied with my result, I am a little bit hesitant to go through a whole second procedure in case I actually end up making things worse. Would appreciate any input and advice, thank you so much!

Eric M. Joseph, MD · Answer

Unfortunately, rhinoplasty surgery is the surgery of millimeters. We do not recommend revision rhinoplasty Unless if there is severe dissatisfaction, and a nasal deformity that is repairable. Thank you for posting your question and photographs. I hope it's helpful. Sincerely, Dr Joseph

Kyle Kimura, MD · Answer

Great question and thank you for the photos!
This is a really tough question and I think you touched on the biggest concern, whether doing another surgery could potentially make things worse rather than better. Making changes to the tip is also one of the more challenging aspects of rhinoplasty as there are many factors that influence the final results including skin thickness, soft tissue thickness, overall shape and orientation of the cartilages, how the patient will heal, scar tissue, etc. 
Frankly, I feel you have a really nice looking nose that fits your face. Is there some room to refine or narrow the tip? Certainly, but I do not know if it could be significantly smaller to justify another surgery unless this is something that really bothers you. If you ultimately decide to proceed, make sure you see someone who specializes in rhinoplasty and most importantly, somone you feel confident in, because I think the margins are quite thin to get a great result from a nose that already looks quite good.
Hope this helps and best of luck!Kyle Kimura, MD

Guray Yesiladali, MD, FEBOPRAS · Answer

It’s completely valid to feel cautious about revision surgery&mdash;especially when you’re mostly satisfied with your current result. Wanting more tip definition and refinement, particularly after 9 years, is a common and understandable motivation for patients who had their initial surgery to correct a bulbous tip.
At this stage, subtle concerns like:
-Mild lack of tip definition
-Desire for more cartilage visibility or sculpting
-A slightly thick or rounded appearance
can potentially be improved&mdash;but only through surgical revision, as fillers or non-surgical options are not suited for refining the nasal tip.
That said, revision rhinoplasty is inherently more complex than primary surgery due to scar tissue, altered anatomy, and the unpredictability of healing. A key consideration is risk vs reward&mdash;since you’re 90% happy, any revision should be approached very conservatively and only by a surgeon with extensive experience in delicate tip work and secondary cases.
In the right hands, subtle structural adjustments (such as cartilage reshaping or grafting) can enhance definition without overcorrecting. But your hesitancy is wise&mdash;any revision should have a clearly defined goal and realistic expectations.
I hope this helps you weigh your options thoughtfully. A consultation with a revision rhinoplasty specialist would help clarify what’s possible with your current anatomy.
&mdash; Güray Yeşiladalı, MD

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. You are a great candidate for rhinoplasty. Other Maneuvers for your surgery would include tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. 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.
Harvard-trained plastic surgeon

Best wishes and good luck.

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

Philip Michael, MBBCh, FRACS, FRCS(Ed) · Answer

Many thanks for your enquiry
Revision cases can always be performed. They can be challenging owing to the presence of issues such as scar tissue and do have the potential for correcting one issue but generating another. Revision cases carry a lower success rate than primary cases. Hence, a balance should be considered. If there were significant concerns, revision would be a reasonable avenue but if you are 90% satisfied, the risks entailed may outweigh the incremental benefit that you are wishing for.
Best wishes

Revision rhinoplasty for tip worth it? (Photos)

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