Based from your front view photo, your bridge appears to have an hour-glass shape. This may be caused by a collapsed middle vault or inadequate infracturing of the nasal bone or both.
The tip that appears relatively big was caused by bifid tip cartilage.
The solutions I can propose for you are:
- revision osteotomy
- revision tipplasty
- graft to the middle vault or permanent fillers
It's hard to really assess your concerns based on the photos alone. I do get a sense of perhaps some asymmetric narrowing of the right middle third of your nose, but that could also be related to your preoperative anatomy.
Your nose is still healing at this point so things may change with time. If you had a large bridge taken down during your rhinoplasty your surgeon may have placed spreader grafts to support your nose in that area. You could ask your surgeon his or her opinion about your concerns as they're best able to assess your situation at this point.
In the meantime you can read about spreader grafts at my web reference link below.
Not quite sure where you are going with your posting and series of after views WITHOUT a before view to compare???
It is difficult to see if you have an open roof deformity from the photos you posted. Valvular collapse is something that is best evaluated in person..
An open roof, inverted-V deformity, and collapsed internal valve can all be quite interrelated. They are secondary to inadequate reconstitution of the middle vault (septum and upper lateral cartilages) and/or inadequate infracture (osteotomies) of the nasal bones after dorsal hump (bump) reduction. The open roof (nasal bones left apart) allows for an inverted-V shadow to be case on the transition point from the nasal bones to the middle vault cartilages so an inverted-V is a visual deformity. Internal valve collapse can manifest itself externally by deformity of the midvault but more importantly by functional symptoms of nasal airway obstruction. From your photos, it is very difficult to see if you have any of these deformities. You should arrange follow-up with your surgeon to discuss your concerns and be examined.
Unfortunately it is impossible to tell from your photos as to whether you have an open roof or an inverted T deformity. A collapsed nasal valve is usually something that has to be diagnosed by an in person examination. Your profile is looks great and it appears that you have a very nice result from your rhinoplasty. Please also remember the nose is constantly changing for up to 12 months after surgery.
I hope that helps. Best regards.
Dear butterfly, It is important when performing rhinoplasty that the function of the nose is addressed as well as the aesthetics. As you state when your nose is much larger you may not have breathing difficulties. However, when it is reduced and function is not addressed then you may develop post operative breathing obstruction. I suggest you see your surgeon for an examination to determine your breathing difficulties and discuss your other concerns. Best regards, Michael V. Elam, M.D.