I Had Rhinoplasty 3 Months Ago...Nose Looks Much Longer now!

Question

I had rhinoplasty about 3 months ago. Overall I just had a nose that needed to be shaved down a few millimeters. my nose was a little down turned and that wasn't supposed to change but now when I take pictures I hate how long my nose looks, I think its because my tip was raised a bit and my hump overly shaved down. Is it possible to de-project my tip and slightly turn it down? Also my columella shows much too much I'd like to reduce that as it contributes to drooping when I smile.

Umang Mehta, MD · Answer

Thanks for the question and for sharing your photo. The first point is that at 3 months, you still have some ways to go before your nose is a "finished product" so I would encourage you to wait it out for ~9 more months before even considering revision surgery. Your tip may appear less projected and rotated with time.

	That being said, I can certainly appreciate your concerns. Deprojecting and counterrotating the nose can be achieved by shortening the medial crura of the lower lateral cartilages. These crura are the portions of the cartilages which sit behind your columella, between the nostrils. In rhinoplasty, a well described methodology for addressing the tip is to think of it as a tripod. If you shorten this lower leg of the tripod, the tip will deproject and counterrotate. It is difficult to assess your columellar show in the photo you have submitted but this is an issue which can be addressed with rim grafts if the nostril rims are too high. Alternatively, it may be a matter of changing the shape of your columella. Seeing standardized photos of your nose would certainly help in this analysis. 

	Best of luck,

	Dr. Mehta

Toby Mayer, MD · Answer

Yes, the nose can be deprojected and the columella repaired, etc. I would wait at least 3 more months before doing this since the nose will continue to change for at least that amount of time.

Kamran Khoobehi, MD · Answer

The best thing would be to wait at least six months and let the tissue to heal and the swelling to resolve. Please let your surgeon help you and do not rush into revision.

I Had Rhinoplasty 3 Months Ago...Nose Looks Much Longer now!

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