Nose base feels still & worried nose tip is overprojected, could this be swelling? (Photos)

Generally, the projection of the nasal tip should be equal to or slightly less than the length of your upper lip. You appear to have a pleasing nasal tip appearance on front and profile view. You may have somewhat of a deep Radix. If the top of your bridge is a bit too low, the part in between your eyes, it can give the illusion that the lower third of your nose is over projected. If this is the case, adding volume to your Radix may be achieved with either a temporary or permanent injectable filler, depending on your examination. I hope this is helpful! Sincerely, Dr Joseph

Hello! It could be swelling. Even at this time, there's room for reduction in the tip structures. Steroids and taping are options to improve this. As for the crease, it can occur if there is too much stiffness at the base of the nose. That could be due to cartilage or scar tissue present. It may continue to improve, but it doesn't always. Hope this helps.

Was it this over-projecting *before* the 2nd operation? If the surgeon only put in a "tiny bit" of cartilage, you wouldn't think it would make a huge difference in the projection. I'd love to see some pre-2nd-surgery photos. The contours of the tip of your nose seem to indicate that you've already lost the great majority of your swelling, so I'm not so sure that any more deprojection will happen with more time. Could there have been a big graft that was placed all along the base of the nose? If there is a firm area where the nose meets the lip that definitely wasn't there before surgery, that might be a clue. Getting ahold of the operation report would be another huge clue!

In case you eventually decide that you need a third operation: how *much* to deproject the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.