Do nose jobs usually need to be tweaked later? My nose has changed since my rhinoplasty 14 years ago. (photos)

We state that the nose is fully healed at a year. This is not true. You see 95 to 98% of the healing. However noses may change for years after surgery. Part may be due to scar contracture, skin shrinkage and cartilage settling. Some may be from natural aging. We also tend to leave more support to combat these long term changes in modern rhinoplasty than we did 14 years ago. Lastly, we always tell patients that rhinoplasty may need tweaks in the future to get the best result. 

As the years go by, the skin continues to tighten down over the cartilage and bony structure of the nose which can cause changes in the shape if the support weakens some. Callous formation of the bone can also occur over time. These things can be improved with a revision procedure. Be sure to see a rhinoplasty specialist for consultation.

The shape of a nose can change over the whole life time. It is unpredictable and that is what makes rhinoplasty so challenging. You can have a great nose after surgery for many years but over time mild trauma to the cartilage or just the scar tissues pulling in certain directions can change the nose completely. It does not happen overnight but over years. RegardsDr. J

The "bunnying" that you mention might be the way the tip cartilages are a little prominent, and especially, asymmetrical. They make the tip of the nose look wide, and make it look like it hangs a bit low as well. I hope I'm seeing it the same way you are. Profile views would probably help with a nose like yours.
The tip can be made more narrow, and elevated, and probably made more symmetric, too, in a revision operation. The woman in the short video that I posted with this answer had the tip of her nose elevated and narrowed in her revision. 
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 I described above require advanced techniques, requiring 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. For those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.
Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

Hello, thank you for your question and provided photos, A rhinoplasty procedure requires at least one year to heal then it is the final shape and do not change generally. However, some deformities might occur years later. First you need to have a detailed physical examination then discussing with your exprienced PS you can undergo a revision rhinoplasty to improve your nose for well-proportioned, natural  and beautiful.Best Regards,

Usually rhinoplasty is a one time operation and late changes don’t happen but occasionally the nose does change.  The best solution is a revision rhinoplasty but it should be straightforward.

Thank you for the questions
The nose continue to evolve over many years following rhinoplasty. If the cartilage structures of the nose have been weakened even years after surgery deviations can occur and the nasal tip and dorsum can develop irregularities. Scarring and contractile forces can twist the nose.
Dorsal irregularities are normally easily corrected while nasal deviation may require a full revision procedure.
I hope this helps.
Dr. Callum Faris

If you desire further improvements- you appear to be a candidate for Revision Rhinoplasty preferably performed through a closed technique- no scar across columella. I suggest that you seek an experienced Board Certified PS for in person exam

Skin, bone, and cartilage are all living tissue, so minor little irregularities can show up years later. These are usually treated with a small touch-up procedure by your previous operative surgeon. A small hump can be simply rasped under local or general anesthesia.

A common misconception is that once noses are operated on they need no further work. Ideally you don't need a revision but it is rare that a nose is perfect whether you've had surgery or not.  A rhinoplasty result may hold up for years but noses age as do every other structure in the body.  Hopefully they do so in a graceful way but, frequently the nose begins to descend (the rumor that noses continue to grow) and new anatomic abnormalities may become evident over time.  If the changes are subtle you may be a candidate for a non-invasive rhinoplasty using a filler.  In more profound cases, a surgical revision, or primary rhinoplasty at an older age may be warranted.  As revision rhinoplasties are often very challenging it is best you seek the opinion of a board certified facial plastic surgeon to review your individual cases.  I hope that helps.