Revision rhinoplasty for upturned nose issues or non surgical filler? (Photo)

Question

Broke my nose in an accident at school which left me with a sharp one sided hump. I had a rhinoplasty at age 17 then 18 - first 2 were just rasping of the hump no tip work, was unsuccessful and at age 20 my 3rd (with a different doctor) hump gone, tip way too rotated. Now after 10 years of psychological upset I want to revisit this but I’m absolutely petrified. I know this is a difficult fix. Please advise if non surgical methods could work and if suggested over another rhinoplasty?

Steven M. Denenberg, MD · Answer

Your tip does indeed look too short, pointing up, in some of the views, but the tip is also distorted, projecting far forward from your face and standing out from the line of the bridge of the nose. Those features make the tip look higher than it actually is. You've already suspected something non-obvious is going on, the way the nose doesn't look too terribly short in some of the views.
When the tip of a nose is brought back closer to the face, it tends to make the nose *look* longer, which would be good for your nose, so I think one of the first things to consider would be to bring the tip back much closer to your face.
Probably would lower the height of the bridge a bit, too, to match the new position of the tip, especially up high, in front of your eyes -- some of the views make your bridge look strong in that location. Then, make the tip cartilages less prominent, narrow the nasal bones, see if everything can blend together, so no feature draws unwanted attention. I like noses that are ignorable because they look natural.
I'd really love for you to see some well-positioned morphs of your nose, so you can see whether these changes fit with what you want. Your nose is complicated enough that exactly what to do isn't obvious until we learn it from the morphs.
But definitely no filler. It wouldn't do anything good for your nose, and would complicate a revision unnecessarily
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, requiring skill that most plastic surgeons don't possess with expertise. For most noses, 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 for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.
Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, thank you for the question and provided photos, based on them you seem to have asymmtry issue as well. Nonsurgical treatments such as fillers are temporary solutions. If you would like to achieve natural looking, well propertioned nose, a revision rhinoplasty will improve your nose to desired look. Graft material can be needed either rib or ear cartilage. You need to seek a professional, innovative and exprienced Surgeon.Best Regards,

Richard Mark Winters, MD · Answer

I'm sure that many of the rhinoplasty experts reading your post are saddened on many levels.... unfortunately, not all rhinoplasty surgery goes as planned or delivers on patient expectations but your results are simply the result of lack of expertise.... the good news is that although your dorsum has been over-resected leaving you shortened and with an over-rotated tip while leaving the tip over-projected, you can likely be helped significantly.... while lengthening and de-rotating your nose is tricky, its doable in combination with de-projecting your tiplimit your consults to rhinoplasty experts with many years of experience, a practice focused on rhinoplasty and a predilection towards difficult revisionsgood luck

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