Revision Tip Irregularities-how Common?

I am going to get a revision rhinoplasty because the columella still hangs down too far and the tip is still slightly overprojected. One doctor suggested that I rotate my tip to the front (it is now slightly upturned), shorten it, and lift the columella. Another doctor said that I cant rotate my tip but that he could shorten it and lift columella. However, he said I am at risk for tip irregularities. What does this mean and how common are the risks?

Doctor Answers 7

Non-Surgical Rhinoplasty is Excellent for Revision Cases

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    Non-surgical rhinoplasty, using fillers to contour the nose is a great option for revision cases.  A skilled injector can improve the overall shape and orientation using fillers.

    Non-surgical rhinoplasty is an advanced filler technique and with revision rhinoplasty in particular, it's advised to go to someone who specializes in fillers, and preferably specializes in non-surgical rhinoplasties.

    Sometimes a hanging columella can be treated by adding filler to the bridge and tip, modifying the overall shape and proportions of the nose.

Good luck in your search for information.

Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 156 reviews

Tip irregularities after revision

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Thank you for your question. When it comes to revision rhinoplasty, there is no substitute to direct examination of the nose and face and good photographs. If you are going to a revision you surgeon should prevent or treat any tip irregulars at the time of surgery.You do not want to treat one problem and create another.Open rhinoplasty is probably the best approach.

Moneer Jaibaji, MD
San Diego Plastic Surgeon

Tip Irregularities Following Rhinoplasty

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Tip position and shape can be improved with a revision rhinoplasty. You can also raise the columella. We cannot possibly interpret the comments of another surgeon. Please ask him to explain.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Tip revision

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An open rhinoplasty technique will minimize the risk of more tip asymmetries. it is hard to say what should be done for you without an exam in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision Tip Irregularities-how Common?

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 I have performed Rhinoplasty and Revision Rhinoplasty for over 25 years and in the situation that you describe, it might be best to decrease the tip projection through the columella itself.  Rotating the tip up or down does not change true tip projection and in either case, I don't understand why they'd place you at higher risk of tip asymmetry.  

 I don't have photos of the tip front and side to review but perhaps you may want to get a couple other opinions from experienced Rhinoplasty Surgeons on the matter.


Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Revision Rhinoplasty

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I believe that if you have your revision through an open technique you will have less of a chance for tip irregularities. The collumelar show should be easy to fix and the tip cartilages can then be adjusted to de-project and maintain symmetry. See weblink below that describes this in detail.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Tip irregularities after revision rhino

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I give my revision patients many possible negative outcomes and tip irregularites is not one of them. Pehaps this is a sequella he has seen in his surgeries, I don't get it

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.