Is It Possible to Put Cartilage Back into the Tip of my Nose to Lengthen It?

Question

Hello, I had rhinoplasty surgery one month ago to remove a small hump and reduce the tip. I can appreciate that my profile now looks neater but I feel that from the front view the tip of my nose now looks too short and unbalanced for my face. I am so unhappy and feel like I have made a huge mistake. I realise it is too soon for a revision but it would really help me to know whether my nose could be made longer again and what are the chances of it going wrong? Thank you.

Thomas A. Lamperti, MD · Answer

That's too bad that you're not happy with your results thusfar. I would give it time to adjust to your nose, but if need be there are methods to lengthen your nose again. It does require cartilage grafting.

	The exact technique(s) used depends on your anatomy and exact goals (ie, how much lengthening you want).

Raffy Karamanoukian, MD, FACS · Answer

Most people don't appreciate the aesthetic importance of nasal projection.  This could be accomplished during revision with a cartilage graft.

Steven J. Pearlman, MD, FACS · Answer

When I first learned rhinoplasty, it was all about remove, remove, remove. Humps were brought down to fit existing tips and tips brought down to match desired profiles. Current rhinoplasty techniques are more about adding to many areas such as the tip of the nose if it is deficient and might otherwise appear too small or blunted if only treated by a reduction technique. This is even more applicable to revision rhinoplasty where grafts are almost always used to maintain or restore lost structure.

	Although, following previous rhinoplasty you should wait at least one year for healing to be finished before considering any revision surgery.

Russell Kridel, MD · Answer

The post op profile picture you show is not a true profile as is the pre-op picture. You are turned towards the camera and one can see your eyelashes from the other side in the post op picture, so a comparison is not accurate. Even on that view, the nose looks good and proportional. One cannot judge your front view without more pictures. You need to be patient and not so judgmental so soon after surgery. It will be months before most of your swelling has gone down and probably a year before 95% has dissipated. If you do want a revision after giving your nose the time to heal, cartilage is the graft of choice to lengthen your nose.

Samir Shureih, MD · Answer

You only posted the profile pictures before and after. They look excellent.

	You did not post the frontal view???which you are complaining about.

	With the naso-labial angle on profile I dout that your nostrils now excessively show. .

	 

	You are too early after surgery wait one year for final critique.

	I think you have a great results based on the pictures you posted.

	I am sure you will find some one to operate on you, But you will Not get a better result

Shervin Naderi, MD, FACS · Answer

Hi,

	First of all you are only one month out from surgery.  That is very early on and your tip position should drop down over the next 3-4 months so you are unhappy with a half cooked meal.  Let is get a bit more advanced in its healing and then judge it.  This will also give you time to get more used to your new nose and new face.  I am not sure if your surgeon did imaging for you before surgery or not but usually patients who have imaging done do not get so shocked or suprised afterwards. 

	You also said you like your profile but you dont like your front view.  The photo you posted is of your profile so it is hard to judge the front view outcome thus far but again it is early and you need to concentrate on the positive improvements and not focus on the negatives especially since it will all go through lots of changes in the next few months to few years.  Even the profile picture does not cocmpare apples to apples since your after picture is not a true profile and your head is slightly turned to your left.  These subtle photographic nuances make a big difference. 

	 

	Hang in there and be patient and dont go seeking a revision yet!

Francis R. Palmer, III, MD (retired) · Answer

I have performed Rhinoplasty for over 20 years and from the profile picture provided, the nose does not appear to be too short. The tip is rotated at approximately 100 to 105 degrees with a shortened nasal tip defined by 115-120 degrees. I have no photos of the frontal view but doubt it would change that dramatically. IMHO, you should do nothing at this point but you may want to have this discussion with your Rhinoplasty surgeon before deciding on adding cartilage to the tip.

Is It Possible to Put Cartilage Back into the Tip of my Nose to Lengthen It?

Answers (7)

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