Do I need a revision to improve my nose tip? (Photo)

Question

I had rhinoplasty 2 years ago. I wanted to de-project length and refine/upturn the tip slightly. The before (top) picture was just before the surgery in July 2021 and the after picture is today. I regret the procedure. The tip is still swollen & tender, even after 2 years & is droopier than before. I also still have a runny nose consistency throughout the day, a problem I never had before surgery. Would a cortisone shot still help with the swelling at this stage? Should I consider a revision?

Steven M. Denenberg, MD · Answer

From the photos, it appears that the operation didn't succeed in elevating your tip or deprojecting it. It turns out that those two movements are not "easy" to accomplish, and require quite a bit of expertise to get done well. I don't know why it should still be tender -- does part of it get red, as if there were an infection? In any event, it's highly doubtful that a steroid injection would help anything now, and probably not earlier either, and for sure it wouldn't change the position of the tip of your nose. 
How *much* to elevate the tip, or deproject the nose, 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. 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 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.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. As far as I can see from your photos your nose seems very straight and your nose tip is really droopy. This thing gives your nose a very masculine looking. For gain more feminine and slightly curved dorsum I recommend you revision rhinoplasty surgery. If you can provide photos with better lighting, from the front of your face and 1 meter away I would be able to make a proper evaluation. It would be more convenient to decide with face-to-face consultation. Best Regards!

Andrew Miller, MD · Answer

Based on the photos, it appears that you still need some work on the tip. It needs to be shortened a bit and lifted so that it blends better with the bridge. It appears that it still droops some while the bridge was taken down. Your thickened skin will limit results some, but you can still make an improvement. Be sure to see a rhinoplasty expert for consultation.

Eric M. Joseph, MD · Answer

Based on your photos, your current nasal profile appearance seems to show a somewhat droopy tip appearance with excessive nostril show. This may be associated with an over projection of your lower bridge that is called a pollybeak. In general, when the nasal tip needs to be rotated upward, revision rhinoplasty may be necessary. I hope this is helpful. Sincerely, Dr Joseph

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Thanks for your photos and questions. At 2 years, the nose has likely finalized in large part. The droopiness comes from a lack of support at the tip. This can be addressed by strong cartilage grafting material to anchor the nose into a proper projection and rotation. The runny nose can be treated with nasal sprays such as ipratropium. A cortisone shot perhaps may help the swelling and could be worth a try. If you're unsatisfied with your nose, I would seek multiple opinions to determine what can be done. Hope this helps!

Do I need a revision to improve my nose tip? (Photo)

Answers (7)

Answer: Revision rhinoplasty maybe necessary to repair a poly beak and a hanging columella.

Answer: Revision rhinoplasty maybe necessary to repair a poly beak and a hanging columella.

Answer: Revision for Nasal Tip

Answer: Revision for Nasal Tip

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Do I need a revision to improve my nose tip? (Photo)

Answers (7)

Answer: Revision rhinoplasty maybe necessary to repair a poly beak and a hanging columella.

Answer: Revision rhinoplasty maybe necessary to repair a poly beak and a hanging columella.

Answer: Revision for Nasal Tip

Answer: Revision for Nasal Tip

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.