My nose shape is awful at 7 months, are my goals still achievable? (Photo)

Hello,
Thank you for providing these photos. I think the changes you desire are still very possible and it is possible to improve the base asymmetry as well. 3D imaging is a tool that is always incredibly useful so you can get a sense of what each change will do to your nose and overall appearance. I recommend scarless/closed rhinoplasty for all rhinoplasty regardless of whether primary or revision rhinoplasty.
Mark G. Albert, M.D., F.A.C.S.New York, NY

I think your goal is reasonable. Making the tip sharper and correcting polybeak deformity while lowering the slightly upturned nose are achievable. It looks best that you wait till 1 year after surgery.

In the morph you made, you took down the incipient pollybeak nicely, and I see what you did with the columella and the junction of the upper lip and nose, but those changes are really tiny tweaks, and often a revision doesn't work well with tiny tweaks. The problem is, we always miss our optimal goal by some amount, and if we're only looking for changes that are tiny when measured with a ruler, if we miss by a little bit, well then maybe we didn't accomplish anything at all. Also, lowering the columella isn't a very highly predictable change to make, and pushing out the nose/lip junction is really almost impossible. If I were to morph your current nose, I would deproject the tip more (move the tip closer to your face), and elevate the tip more. If you looked at those changes and liked them, it would make you a better candidate for a revision. It would make it more likely that the revision would accomplish some changes that you saw as an improvement.
(Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.