Post Rhinoplasty: Nose Sits Too High on Face

Question

I had open rhinoplasty two weeks ago. Bump was removed and the tip was narrowed and tilted. Now my nose sets too high from my face . Too much space between my my nose and mouth. Is it fixable. I am really bothered by it.

Sam Naficy, MD, FACS · Answer

Some of what you are bothered by at this point will improve over time - 2 weeks is obviously very early in the course

Peter E. Johnson, MD · Answer

Though the nose has not moved any higher, rotation of the tip will show more of the upper lip and reduce the shadow on the upper lip with overhead lighting. Normally the angle between the lip and nose should be slightly open, 95 to 110 degrees. Early swelling can push the tip upward as this is the 'mobile' part of the nose, and the tip often will settle over several weeks. If the tip is terribly over-rotated early revision can adjust things, though if the balance is not too bad it can pay to wait six months, and revise later if needed. Your before pictures and computer simulations can also help give perspective as to where you are at this point in healing.
	Best of luck,
	peterejohnsonmd

Mohsen Tavoussi, MD, DO · Answer

Swelling under your upper lip close to the surgical site is pushing the nose out at this stage. This will improve with time. Your nose will look different in another 2-4 weeks and there after.

Kamran Khoobehi, MD · Answer

You just had surgery and have a lot of swelling. Please discuss your concerns with your surgeon. You need to let the swelling to resolve before discussing revision.

Michel Siegel, MD · Answer

Dear kako:

	You still have a lot of swelling 2 wks after your surgery, this will affect the position of the tip, in your case it is over-rotated. If this is the final position, or a temporary position due to the swelling is hard to tell without knowing what was done. If it is swelling related, then it should come down as the swelling decreases, if not you may need another procedure to fix this.

	It may take at least 6 months for the tip position to settle. You may want to take pictures monthly and asses any changes.

	 

	Michel Siegel, MD

Richard W. Fleming, MD (retired) · Answer

Thank you for submitting a picture, but I will not comment on your result because you're only 2 weeks post-op. Your appearance will change dramatically over the next several weeks. With most inquiries re short-term results, the appearance does change and revisions are possible if the patient is not ultimately stisfied.

Francis R. Palmer, III, MD (retired) · Answer

I think that the tip rotation after the hump was removed seems odd and extreme to you now but IMHO, from the photo the tip is rotated at ~ 110 degrees which is the proper aesthetic angle for the nose. It looks good so give it a little time to get used to it. It's likely to fall a few degrees in the next 4-6 months as you heal from your Rhinoplasty.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi Kako,

	Since your only 2 weeks post -op you probably have allot of swelling. However, if your nose had that height before surgery then you may have further reduction of your bridge in future.

	Best,

	Dr. S.

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