12 years post op and considering rhinoplasty revision. How can I ensure I achieve my desired result? (photos)

Thank you for your question and for providing photos. Choosing an experienced facial plastic surgeon with expertise in rhinoplasty techniques will help ensure that you achieve your desired revision results. During this procedure, the tip can be lifted and the overall nasal symmetry addressed to create a balanced appearance with the rest of your facial features.
Since each subsequent nose surgery becomes more complex due to loss of structural support and scar tissue, the importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with a board-certified facial plastic surgeon with extensive rhinoplasty experience to conduct a more thorough exam and determine the best steps for you.

The drooping of the tip of the nose appears naturally in anyone over long time after tip plasty. This is especially true in cases of conservative surgery. Your nose is showing tip drooping, hanging columella and alar retraction, and you can get good results through revisional surgery, and it is worth the surgery. It can't be exactly the nose you want, but it can have a similar shape.To minimize tip drooping with time, the structural graft using septal or ear cartilage will be performed.

Hello and thank you for your question.
Based on your pictures, it seems like your tip might have loss support over time, making the tip drop. Reshaping and improving tip structure is necessary. This can be achieved with the use of your own rib cartilage grafts.
With the use of computer morphing, you can discuss with your doctor changes you would like and have an idea of how your result can be.

I hear your concerns and see what you are describing in your pictures. An in-person exam would be very helpful to determine which internal anatomical structures are still existent after your original surgery. I see that your tip does indeed plunge, which makes you look older than your stated age, as a plunging tip is indicative of the ageing process. Most important when considering any kind of rhinoplasty surgery is to study the surgeon’s before-and-after photos. Does the surgeon produce unique, natural results, or is the aesthetic more “one nose fits all”? Rhinoplasty surgery is very individualized, and you can evaluate if your aesthetic is in keeping with the surgeon’s by studying the actual results of the surgeon. As a board certified plastic surgeon and member of the Rhinoplasty Society, I like to craft columellar struts to prevent the tip from plunging over time. Just judging from your photos, you appear to be a good candidate for a revisionary surgery.

The Photographs demonstrate droopy nasal tip cartilages, and hanging columella, and your tip droops even more when you smile. A revision rhinoplasty can accomplish not only lifting the tip, refining the nasal tip cartridges, reduction of the hanging columella, and releasing the depressor septi ligament which dynamically pulls your tip down when smiling. Choose your second surgeon very wisely based on extensive experience producing natural results

Hi there! Great questions. Finding a surgeon who performs standardized photography and morphing in my opinion is essential. Morphing allows you and your surgeon to discuss desired changes within reasonable limits on your photos. By doing so, you should get a sense of what the surgeon's "aesthetic" is. Some go for a more operated appearance, while others go for natural. The noses you've shown may be possible, but the best approach is like you said - something that fits your face. Providing a refined, better rotated, and stable tip is definitely possible. I usually elect for an open approach to be the most precise while using structure in the form of cartilage grafting. Hope that helps!