Pinching in the Nose? (photo)

Im about 14 months post-op and my nose is starting to look worse and I'm a bit worried. Is there anything that can be done? My surgeon has offered further resection in the tip instead of grafts and Im not sure this is a good idea. Would it be best to leave it how it is?

Doctor Answers 4

Pinched nose after rhinoplasty

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At 14 months the swelling has resolved the changes will require revisional surgery.  The pinched look combined with a bulbous tip indicates two problems:  scar tissue or cartilage centrally, and inadequate cartilage support laterally causing the pinching. I am concerned that your original surgeon does not fully understand the problem or is not explaining it well, but revisional surgery with cartilage grafting as well as dealing with the central bulbous appearance are both important. I would absolutely us an open rhinoplasty approach.

Bulbous Tip and Nasal valve Collapse

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It looks like you have a persistant bulbous tip and the begingings of a nasal valve collapse. Revision rhinoplasty is probably what you are going to need but I would be cautious on going back to the original surgeon that created the problem.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Pinched tip after Rhinoplasty

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Tip surgery is often the most complex part of rhinoplasty, especially when the tip cartilages are convex (rounded instead of flat) and when they point upward  instead of to the sides. In these cases, trimming the cartilage in an attempt to make the tip smaller can lead to a ball shape with collapse of alae(sides of the nostrils). Correction may involve repositioining the cartilages and flattening them with grafts. Good Luck!

Roy A. David, MD
San Diego Facial Plastic Surgeon

The appearance of your nose after Rhinoplasty Surgery may be improved.

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I reviewed your concerns and your photos.

Your tip did not likely get wider after your nose job. You appear to have indentations just behind your tip which is making your tip appear bulbous. Your mid bridge appears a bit narrow as well.

You may require a revision rhinoplasty to improve your nose, but you may be a candidate for a Non-Surgical Rhinoplasty to add volume, improve symmetry and improve the appearance of your nose. In properly selected patients, I prefer to use Silikon-1000, an off-label filler for permanent results. I would not be able to judge your candidacy for silicone nasal injections without examining you.

It is my practice philosophy to leave a revision rhinoplasty as a last resort.

Hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 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.