Do I need a revision rhinoplasty? What is wrong with my nose? (Photo)

Question

Hi all! I had a primary rhinoplasty 7 years ago and really loved it until recently. I can't quite pinpoint the problem but I know something is not right - especially in pictures with flash. I'm not sure if its a plundging tip or the bridge isn't blended in well? Am I being knit pickey or do you all see what I see? I'm going to see a surgeon who specialized in revisions but I just want to know how to describe the problem w

Andrew Miller, MD · Answer

It is difficult to tell from one photo, but the tip appears a bit long and droopy and possibly a little pinched. The best thing to do would be to see an expert rhinoplasty surgeon to fully examine you and perform computer imaging. That way you could see if the changes that are made are to your liking.

Eric M. Joseph, MD · Answer

If your issue with your nose is that your nasal tip droop down too far with smiling, that is what I see in your singular photo. If you are going to visit a Rhinoplasty specialist for a consultation, it might be helpful if you could bring a copy of your operative report and preoperative photos to the visit, I hope this helps and I wish you well moving forward. Sincerely, Dr. Joseph.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you are a great candidate for a Revision Rhinoplasty. Maneuvers would include tip refinement, tip elevation, and Nasal Tip Deprojection, anmong other maneuvers. 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

Steven M. Denenberg, MD · Answer

It does also appear that there is some lack of definition in the central part of the bridge, but that may be a lighting thing, and the tip position seems to be the most important.

How *much* to elevate 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 better identify 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.

Steven Schuster, MD, FACS · Answer

Unfortunately it is very difficult to evaluate a non medical style photo like this.  a side view and straight on view would help.  In looking at your nose you seem to have tip droop and this is combined with a collapse of the right side which probably affects your breathing.  The tip seems to tilt to the right side but this may be photo artifact.  I would consult with an experienced rhinoplasty surgeon as you may or probably will need an open rhinoplasty with cartilage graft to support the nose.  Good luck, Dr. Schuster in Boca Raton Florida

Do I need a revision rhinoplasty? What is wrong with my nose? (Photo)

Answers (5)

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