Need Post-rhinoplasty Soft Tissue Adjustment in Tip of Nose, What Can Be Done? (Photos)

Question

I had an open rhinoplasty 7 years ago to narrow my broad/poorly defined nose. No complaint with profile but doctor used a tip graft to create upturned look. Not happy with result, but I believe the problem is one of soft tissue dynamics. The problem starts south of the bridge where tissue is barely connected to the center cartilage (adhesion is 1mm wide max). The skin is otherwise loose from septum to cheek, so the nose lacks form and is very subject to facial movements. What can be done?

Michel Siegel, MD · Answer

In my opinion your after photos look better than your before photos. You appear to have thick skin, which would limit the definition of your nose.

	In my opinion, revision rhinoplasty may get you "some" improvement on your present result. Are your expectations appropriate? That will really determine how happy you are if you undergo a revision rhinoplasty. Even the best rhinoplasty surgeon cannot counteract the limitations posed by the anatomy off some patient's nose/skin.

William Portuese, MD · Answer

Revision tip rhinoplasty requires different views of the nose in 3 dimensions and different angles.  It is impossible to give an opinion based on one  frontal photograph. Make sure you seek out very experienced revision rhinoplasty specialist prior to embarking on any further surgery.

Tae Ho Kim, MD · Answer

I think I like the nose before the operation better.  There is a little asymmetry of the nose in the postop photos.  You still have poor nasal tip definition.  It seems that you have thick skin and this is one of the reasons that you don't have good tip definition.  

	Based on the photos here, I would recommend the following in a revision open rhinoplasty:  improve nasal tip definition, re-establish alar dome (depends on what the anatomy looks like), probably need to remove some soft tissues but conservatively so as not to disturb blood supply, possible lateral crural cartilage struts, refracture the bones, and consider alar base (Weir) excision on both sides.  

	I definitely think your nose can look better with another operation, but I would advise you to find an experienced plastic surgeon in rhinoplasty.  Good luck.

Need Post-rhinoplasty Soft Tissue Adjustment in Tip of Nose, What Can Be Done? (Photos)

Answers (3)

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Need Post-rhinoplasty Soft Tissue Adjustment in Tip of Nose, What Can Be Done? (Photos)

Answers (3)

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.