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

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.

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.