4 months post Rhinoplasty. Cartilage in tip showing worse, what would the experts do at the year mark? (photo)

When I smile I can literally see all the white edges of the cartilage form in the tip of my nose. It's getting worse as time passes, what can be done when I hit a year mark? Will my nose look bigger by adding crushed cartilage or soft tissue and will this have to be an open procedure? My nose feels very tight and stretched when I smile. Dr knew going into this I had very thin skin. Very disappointed, thank you in advance.

Doctor Answers 6

Post op rhinoplasty

Because your skin is thin, I would recommend fat grafting of the tip. You just need a small amount to provide more padding over the cartilage. This can be done without opening your nose and will provide stable coverage for years.

San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

Cartilage showing through the skin

Dear gigigirl14,
  • Placing a piece of soft tissue (fascia) will help camouflage the tip cartilages
  • It would add about 1mm of projection depending on the piece placed
  • You can adjust for that by removing just a slight amount of cartilage
  • It is best to see your surgeon or a second opinion where you can be examined
  • From there we can address your concerns 

Best,Dr. Nima

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 74 reviews

Revision Rhinoplasty

Obtaining your previous operative note and consulting with a rhinoplasty specialist would be helpful in determining if your diagnosis is indeed correct. If it is in fact a piece of cartilage or cartilage graft that has shifted over time, then a removing it through a closed approach would not result in a significant amount of downtime. Sometimes sharp contour irregularities can result from twisted or deviated cartilage, and if that is the case you may require a more extensive revision to achieve a nice result.

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Revision rhinoplasty

Thank you for your question and photos. Based on the pictures, you would be a candidate for a revision rhinoplasty with placement of a tip graft to soften the contour. Alternatively, we have had good success with soft tissue fillers in the nose. These do not require surgery, but are temporary. Interestingly, we find that fillers last longer in the nose than they do other areas of the face, some as long as 2-3 years. See an experienced plastic surgeon to discuss this option further. Good luck.

Tamir Mosharrafa, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 8 reviews

Tip graft showing

It is a tough question to answer without seeing you in person. In general, it is much better to re-build the underlying structure rather than just place soft tissue or crushed cartilage over the top of a problem. There are many solutions and the exact method would require a further discussion and an examination. If the graft was placed to give you a bit of projection, we can re-shape the tip cartilages and project them a bit which will give the same result of tip placement without a graft. Meet with a few revision rhinoplasty surgeons and they can give you more specifics.
Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Tip cartilages showing after rhinoplasty.

Tip cartilages showing after rhinoplasty. This is often seen in natural noses. However, if it bothers you it can be softened with soft tissue at 9-12 months by a very experienced revision rhinoplasty surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 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.