Wide/thick columella, swollen/bulbous tip, flared nostrils, nostril show in profile. How can thsi be fixed?

Do seek better opinions asap, you should NOT get alar or nostril reduction AT ALL, this will botch your nose irreversibly!!!You have a very poor nasal work in need of full revision, but never nostrils reduction (in your case); your problems:-very high tip, poor septal support, upturned tip-pinched nasal valve-no tip definition-alar rim retraction: this is the cause of the overexposure of your nostrils and the visibility of your septum, in other words... the cause of your septal exposure is NOT the excess of flare or the excess of nostrils / alae, to the contrary, it is cause by TOO SHORT and retracted alae, requiring batten caudal extension grafts to lower the alaeIf you wish better grounded opinion please do post or send privately well lit, focused and standard images: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Dear Rhinoquestion1,I would advise against having your third surgery done five months after your revision rhinoplasty. Post-op swelling can last up to one year and even longer for revision rhinoplasty. I recommend waiting at least one year before going through with another surgery. In addition, I would recommend getting another opinion before making any other decisions. Best regards,Nima Shemirani

Thank you for sharing your question and photographs.  In general, it takes at least 1 full year for all of the swelling to resolve after primary rhinoplasty. It takes even longer, 18–24 months, for swelling to resolve after revision rhinoplasty. In fact, the tip and nasal base takes the longest to heal. At only 3-4 months postop from revision rhinoplasty you have a lot of healing ahead of you. For this reason, you might even consider delaying the alar base reduction for a few months- consider discussing this with your surgeon. Try to remain patient and maintain close follow up with your rhinoplasty surgeon during this lengthy healing period. Good luck! Dr. Harmych

Having had 2 rhinoplasties within the last 16 months and already planning your third you are headed for dangerous territory. Be very careful about having 3rd, 4th etc. rhinoplasties because the enemy of good is better and you could end up with irrepairable damage at this rate.

Obtaining your previous operative note and consulting with a rhinoplasty specialist would be helpful. Good luck!

 You should get a second opinion before having any further surgery. There are a large number of very experienced rhinoplasty surgeon's in Beverly Hills.

Hi there,I am not sure I agree with your assessment that your columella looks wide or unnatural. Everyone's nasal structure is different. The desire on your part to pursue a third rhinoplasty in a 2 year timeframe is concerning - you may be chasing an unrealistic final outcome. Obviously, an in-person consultation with a revision rhinoplasty specialist is probably in order but you should expect some reticence on the part of a different surgeon to want to pursue a third-time rhinoplasty for you unless your goals are VERY clear and your expectations can be set VERY reasonably. The only way to assess this is with thorough in-person communication. Best of luck to you!

it appears you have very thick skin, but I could be wrong because of the blurry pictures. Your columella width really isn't a big issue with your overall tip appearance. I think what you're noticing is your tip transition to your columella from the front view hangs a bit. This can be rotated upward. Now, the thick skin means you will have less dramatic changes than someone with moderate skin. I think your nostril width is fine once the tip is brought into better relationship with the rest of your nose. Your nostrils should be just lateral to the inside of your eyes, which they appear to be. I don't think they are too wide. It's the hanging tip. Your tip could also be narrowed to help.