What to Do About Deformities After Rhinoplasty?

I had Rhinoplasty 5 months ago, open procedure with the osteotomy (shaving of the dorsum), and tip plasty for a bulbous tip. But after five monts, I still think my nose is bulbous and is not straight when it previously was. Also, the tip is shifting as you can see in my picture. There was no cartilage used. I also have a dent on my right nostril with asymmetry. I also think he has left my nose overprojected. Can anyone please point out what are these deformities and what needs to be done?

Doctor Answers 3

Revision rhinoplasty will likely help

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Rhinoplasty is never an easy surgery and the results depend allot on what your nose looked like before the surgery and also how you heal after wards. Having said that from the one frontal view you have provided it appears that you have some persistent deviation of the nose and a bulbous tip. I suspect the bulbous tip may be related to the position of the cartilages that make up your nasal tip. Many people have tip cartilages that are oriented upwards parallel to the middle of the face. We call this cephalically oriented cartilages.

The tip bulbosity is usually corrected in these cases by lowering the position of these cartilages. This will also help support the rim of the nostril where it appears you have some retraction ( more on the right than the left). The bottom line is that it looks like your nose can be improved with revision rhinoplasty. The first step is to return to your surgeon and see what he/ she thinks. Revision surgery should wait at least a year for healing to occur.

Toronto Facial Plastic Surgeon
4.6 out of 5 stars 68 reviews

See a revision rhinoplasty specialist.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 The problems you mention are real and will not subside. See an experienced revision rhinoplasty surgeon who can show you many revisions like yours that he has done.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Difficult problem

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your problem is difficult to assess from just the front view; a side view would help tremendously. However, what is noticeable is fullness in the the supra tip area and an inverted V deformity. The cause and effect are variable. For the fullness of the supra tip your may require more removal of the lower part of your septum and/or a cartilage graft in the upper part of your nose. The inverted V deformity may require spreader grafts to line up the upper bony area with the middle area of the nose. One of these maneuvers or a combination of others may be needed.

I suggest asking your surgeon what he/she thinks has happened and how an improvement can be reached.

Ricardo Izquierdo, MD
Oak Brook Plastic Surgeon

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.