Post Rhinoplasty Tip Projection - is it too high? (Photo)

Question

I had my first rhinoplasty / septoplasty in 2021 to reduce a small hump on my nose and bulbous tip. Bridge of my nose was quite narrow and when I breathed hard my nostils would close. After the surgery my nose was shaped like a banana and nostils still closing when breathing in. Surgeon told me it would settle once healed, it didnt. In 2022 he did a revision using rib cartelige for additional grafts, noting one side of nostril still closes when breathing. The tip is still extremely hard and I feel it projects quite far off my face and rotated too high. Does my tip seem too high, and are there an options if I have already had two surgeries.

Alejandro Nogueira, MD · Answer

You're right, photo is not very good, a complete set of images would be needed for a complete assessment, however here we can see a totally upturned or piggy nose, over shortened nose and septum, a saddle nose problem, over projected tip, etc.

Proceed to carry out a thorough research and consultations with different experts in revision rhinoplasty; your case is now of very high difficulty, 9/10 in challenge scale of revisions; surgical time 5-6 hours and many grafting needed (eventually rib too).

Eric M. Joseph, MD · Answer

If your bridge were a bit higher, your nasal tip would appear less projected, I think. Additionally, adding a bit of chin volume, with either filler or an implant, would also lead to a less projected nasal appearance on profile. I would consider either of these options before a third rhinoplasty. Thank you so much for your question, and I hope you find it helpful. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a a revision rhinoplasty with nasal tip, deptojection and tip derotation. This will dramatically help the overall appearance of your nose. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

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