I had a rhino. done over a year ago and I hate it. She told me the skin was very thick and I couldn't have a smaller nose. My original issue was that it was bulbous, wide and lacked shape. Even though my bridge was high she put in an implant. Now it's too high and still huge. What are my options? Is she telling me the truth when she says my nose can't be smaller? It was a closed-rhino. I attached photos.
Rhinoplasty Re-vision for Asian Nose?
Doctor Answers 7
Revision Asian Rhinoplasty for Smaller Tip
Thank you for your question. Yes a revision is possible. Techniques to be considered may include:
- Open Rhinoplasty technique to better visualize the structures beneath the wide tip
- Removal of excess fibro-fatty tissue on top of the cartilages so supporting structure more visible through skin
- Narrowing of the two cartilages beneath the skin of the tip
- Cartilage "strut graft" to support and elevate the nasal tip
- Cartilage "tip graft" to refine and create a narrow nasal tip
You need to find a board certified Plastic Surgeon who is experienced in revision Rhinoplasty. This is not a procedure that a novice should attempt.
Your concern is very common among ethnic noses. Is is possible to give you a smaller nose with thick skin.
The answer is no, but yes. Rhinoplasty is an illusion. The skin cannot be made thinner to shrink the nose, but reshaping the cartilage underneath the skin can make the nose more defined giving the illusion that the nose is smaller.
Hope that helps,
Michel Siegel, MD
Wide nose in Asian patient
Although thick skin is a limiting factor there are a few techniques that will allow more aggressive sculpting of the tip. These include structural grafting with strong cartilage grafts, removal of soft tissue form the tip, and post-operative steroid injections.
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Making nose smaller and more refined in Asian revision rhinoplasty
The issue of whether one could make the nose smaller is complicated. Thick skin is a limiting factor, but certainly one can often defat the tip somewhat to help refine it. Your supratip does seem a bit full, but I can't tell if this is due to your implant, residual swelling or scar.
The width of the nostrils can often be improved using alar base excision techniques.
Look at patient #10 on my rhinoplasty gallery. She has similar problems to your concerns that were addressed via an open rhinoplasty approach using her own septal cartilage. I also defatted her tip which helped with the fullness there. I also increased her tip projection which help refine the tip further.
Asian Revision Rhinoplasty
A revision cannot make your nose actually 'smaller" but it can narrow your nose and improve shape and definition. Choose a surgeon experienced in revision and ethnic rhinoplasties.
From your lateral picture, it looks as though the implant is causing a polly beak deformity. This happens when the implant is placed over the nasal tip cartilages. The implant has to come out or repositioned. The skin needs to be carefully and aggressively defatted in order to achieve better draping over teh tip cartilages.