Revision - Tip, nostrils. What are the best options for an overall more natural look? (Photos)

Based on your photos, I can appreciate an overly narrowed nasal tip appearance, along with nostril asymmetry. Microdroplet Silikon-1000 nasal injections may be considered for achieving a more natural nasal appearance, and improved nasal symmetry, without the inconvenience, expense, and uncertainties associated with revision rhinoplasty surgery. I hope this helps!

Thank you for sharing your question and photos. It looks like quite a bit of cartilage was removed from your nasal tip, which may be contributing to your concerns. A revision rhinoplasty would likely be the best option to restore a more natural, balanced look. In most cases, cartilage grafts—taken from the septum, ear, or rib—are needed to rebuild tip support and improve overall shape.

I recommend consulting with a facial plastic surgeon who has extensive experience in revision rhinoplasty. These surgeons are first board-certified in Otolaryngology (ENT), so they not only focus on the cosmetic appearance of the nose but also ensure that nasal function and breathing are preserved. In addition, I recommend obtaining a copy of your operative report to present to at your consultations.

Needless to say, you were a candidate for an ethnic rhinoplasty of afroamerican type, no way around, no minimally invasive techniques, no tiny touch up at the tip, not for the faint of hear and lacking skills, it is long hard procedure for the surgeon, involving rib cartilage harvesting and no less then 5-6 hours.

What I see from your pre/postop images is you got just an aggressive reduction of tip and alar cartilages, aggravating your features and makin you look, you're right, evidently artificial.

African and asian noses are very simlar internally, they are not beautiful or ugly, they are only lacking great part of the structure of other ethnical groups, up to 80% might be missing, therefore they don't need reshaping, re-structuring, plasties, partial grafting, etc, needless to say any reduction maneuver over the skeleton is a big error, the required technique closely equals to a large extent to a skeletal reconstruction of the missing parts: dorsum bridge, tip projection, nasal length, nostril support, etc; only the alar flare may be candidate to reduction.

With that said, seek the help of a surgeon actually and masterfully experienced in afroamerican and asian rhinoplasties, stay away from tempting offers made of smal revisions, just a touch up, fillers, short procedures, etc.

It appears that you need some type of alar support (articulated alar rim grafts, specifically). As the nose heals, there is always some element of alar retraction/notching. In thicker skinned individuals, this is particularly important to support the very heavy soft tissue envelope because that will contract/change over time. I would also recommend an alar base reduction to narrow the ala (nostrils).

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include placement of a mastoid fascia tip graft, possible nasal tip deprojection, 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

This is a particular area of expertise for us. Your nose is very narrow, especially at the tip, and looks "done". The surgeon removed a lot of cartilage. I would not be surprised if you have trouble breathing as well. We can work to recreate a more natural appearance by using cartilage grafts to reconstruct the natural support.