Nose Revision for Round Asian Tip Elaboration, Please?

2 months ago, I had surgery to heighten my bridge and refine the tip but, it looks the same. I have some definition at my bridge, but only slightly suggested and my tip is still round. My nostrils are uneven because (I think) the tip of my nose is crooked! You can kind of tell at certain angles. I know I should wait a year, but how will the procedure be like. Do I have to undergo open surgery? Because I prefer closed. The picture on top is my normal nose and the bottom is my nose when I smile.

Doctor Answers 6

2 months post-op

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Two months post surgery is still very early for you to judge the results of your surgery - the tip will reduce in size more with time.  The nostril asymmetry may be improved with a relatively minor closed revision under light Iv sedation

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Asian rhinoplasty revision

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it is important to wait at least 6 months to truly evaluate your results, however having extensive experience with nasal surgery and asian noses I doubt (looking at your photos) if you are going to have the well demarcated tip definition you desire. In order to achieve this in the typical asian nose, you need to do aggressive cartilage grafting to the nasal tip and possible nasal dorsal implant work. The stantard westernized approach to rhinoplasty which usually involves removing excess tissue tends to weaken support for asian noses and works against promoting definition

Asian Nose Revision

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You are correct in assuming you need to wait about one year for a revision. It is difficult to evaluate your nose 2 months after  your initial surgery. Whether a closed or open technique is used will depend on what was done previously and your needs at the time of revision. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Asian tip revision rhinoplasty (nose job)

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Typically, to achieve a defined tip in an Asian nose, additional grafting of the tip is required. This is often taken from inside the nose or the ears. IF your nose is crooked, it may best be treated with an open approach to achieve maximal visualization of the structures. Any further bridge enhancement may require a larger graft such as the rib. However, silicone implants are more commonly utilized in Asia for this purpose.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Revision Rhinoplasty for Round Tip on Asian Nose

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One of the important aspects of your end results is how was the tip enhanced.  The use of a cartilage graft or a silicone implant with or without alteration of the lower lateral cartilages or alar cartilages will ultimately determine the changes in your appearance as the swelling subsides and the skin re drapes over the underlying framework.  It is common to use a silicone implant to enhance the tip in Korea.  Although it can give a quick result, there are some potential issues related to the material with time.  It  is very important that you wait as your nose will continue to change for more than the recommended one year.  Many people prefer the closed technique for the lack of a visible scar.  But in my opinion, the most precise way of altering the tip is by an open approach.  It is similar to working on the engine of a car with the hood up and out of the way vs. the limited view of the same area with a chain preventing the hood from lifting more than a foot.  Techniques involving the placement of sutures between and within the lower lateral cartilages are very powerful way of improving the tip.  The best thing to do at this point is wait as you are currently at the start of your experience.  I can see the improvement.  Your nose is "crooked" before the surgery and smiling in the photo does make it harder to compare.

Dennis J. Bang, MD
Beverly Hills Plastic Surgeon

Round Asian Tip

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Your outcome will depend on what exactly was done to refine the tip. If the tip was treated then you will need to wait until a year or so to see what the final result will look like.  At two months, there is still going to be a significant amount of swelling, especially with your thicker skin.  It is best to wait and see and then make a decision if further refinement is need.  At this stage it would not be recommended to go back in regardless of the approach taken. 

Amir M. Karam, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 124 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.