Nose bulbous 9 months after rhinoplasty, especially when smiling? (photo)

Rhinoplasty should be about improvement, and it would be helpful to see preoperative photos for comparison. The nose
can be swollen for up to a year or more. Swelling will depend upon the
nature of maneuvers employed, presence of grafts or implants, thickness
of skin, open vs closed, revision vs primary, etc. Kenneth Hughes, MD Los Angeles, CA

Thank you for posting your photos. Your photos show that you have creases lateral to your tip, separating the tip from the alae (nostrils) and creating straight line shadows between bridge and tip. The photos also show a somewhat droopy infratip lobule (area just below tip and above columella). These are findings are sometimes seen when an endonasal procedure is performed and the dome sutures create narrowing in the tip, but also pull the lateral parts of your tip cartilages inwards and force the medial portions of the tip cartilages down. As a result, the shadows that you do not like lateral to your tip may form. Another reason for this is cephalic malposition of your tip cartilages (something that you would have had before surgery, not that your surgeon created, but surgery can make it look worse).Rhinoplasty is a very challenging surgery and it is never possible to get a perfect result. Overall your nose is most likely improved from before surgery, but not perfect. Instead of looking for perfection, decide if you can live with the things that bother you or not. Keep in mind that if you decide to have another surgery, revision is always more complicated than primary rhinoplasty. Discuss your concerns with your surgeon and wait for your nose to completely heal from your surgery before making any quick decisions about having another surgery. Hope that helps.Minas Constantinides, MD

NO before photos in all those views were posted??? Why??? We need to compare in order to respond to your issues!

The goal of rhinoplasty is to improve the nose and if needed improve breathing. If you are happy with the improvement then the procedure is a success. It is not possible to create the 'perfect' nose.