Rhinoplasty Result. Possible to Make it Thin Again Without Grafts? (photo)

I have already posted my question asking your opinions of my rhinoplasty result.Here are more pictures of my nose for your examination.If there any possibility to make it look as thin as it used to be without graft involved?And I would be glad to hear your comments.Surgeon did rhinoplasty with septoplasty and conchotomy.the last three photos are before the surgery.

Doctor Answers 5

Narrowing the nose and refining the tip in revision rhinoplasty

You have a few issues which seem to be present in your nose. Obviously, I would need to examine you in person to fully assess your situation, but based on these photos, here are some of my thoughts regarding your need for a revision rhinoplasty:

First, your nasal bones are still a bit on the wide side. These could be narrowed with lateral osteotomies, which are controlled fractures made from the inside, extending along the sides of the nose, where the nose meets the cheeks. Medial osteotomies, which are little fractures made from the bridge extending obliquely towards the inside corner of the eye, may also be needed to fully mobilize the nasal bones. 

Your second issue has to do with the position and shape of your tip cartilages (lower lateral cartilages). The cartilages are malpositioned cephalically, meaning that the ends of the cartilages are pointing towards your forehead, rather than out towards your cheeks. This is sometimes called the "parentheses deformity". The cartilages are convex and possibly wide, causing your tip to appear bulbous. This can be corrected with repositioning of your lateral crura, flattening the lateral crura with sutures, and a conservative cephalic trim.

The final issue I can see is on the left tip cartilage, where you have a bossa. This means a bit of the cartilage is poking upwards towards the skin. This requires a reconstruction of this left tip cartilage, possibly with a strut graft.

Your issues may require a small amount of cartilage, which ideally could be taken from your septum. This cartilage graft harvest is very routine and straightforward for revision rhinoplasty experts and should not dissuade you from pursuing a correction of your nose. 

Best regards,

Dr. Mehta

Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Increased dorsal width following primary rhinoplasty.

From your photos it would appear that the dorsum is wider postop than it was preop.  This is most likely due to inadequate narrowing of the nasal bones following dorsal hump reduction.  In addition, there is persistent excess width and fullness of the nasal tip.  Both of these issues can be addressed with a revision rhinoplasty to be performed no sooner than 1 year following your initial surgery.

Mario J. Imola, MD, DDS, FRCSC.


Mario J. Imola, MD, DDS
Denver Facial Plastic Surgeon
4.8 out of 5 stars 116 reviews

Rhinoplasty Result. Possible to Make it Thin Again Without Grafts?

 Aside from further thinning, of the nasal tip, I wonder if you don't have a partial open roof deformity from the dorsal hump removal and the previous Rhinoplasty.  The nasal bridge, on profile, is aesthetically correct which means that the nasal bones would need to be broken and moved inward making the bones more narrow and closing the open roof.  An examination of the nose would be required to verify that diagnosis and treatment with a Revision Rhinoplasty.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Rhinoplasty Result. Possible to Make it Thin Again Without Grafts?

You still have a boxy tip that contribute to your nose appearing wide. In fact your nose looks thinner before surgery since the tip was wider. If your nasal tip is narrowed then further osteotomies will narrow your nose.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Rhinoplasty Result. Possible to Make it Thin Again Without Grafts? (photo)

It depends on how long ago you had your rhinoplasty. If it's been less than a year, you might want to wait a little longer. If you are a year or more, the only way to narrow you bridge is to perform osteotomies and/or put in a dorsal graft.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 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.