Revision Rhinoplasty. Can my nose still be made smaller, and the tip lifted considerably?

Question

I had rhinoplasty a year ago, mostly to reduce the size of my nose, and I'm unhappy with the results. My nose is still fairly large, but my surgeon said he removed as much cartilage as he felt comfortable with. The tip of my nose is very low, and dips even lower when I smile, and my nostrils spread out pretty wide. Can my nose still be made smaller, and the tip lifted considerably? I'm hoping I can still have the significant transformation I was looking for. Thank you.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. As far as I can understand from your question, without the photos I cannot make a proper evaluation because these kind of things might change due to your skin and nose type. If you can provide photos from front of your face, from the side of your face and 1 meter away I would be able to make a proper evaluation. It would be more convenient to decide with face-to-face consultation. Best Regards!

Steven M. Denenberg, MD · Answer

Over the years, I've learned that inexperienced rhinoplasty surgeons think that shortening a long nose is an "easy" task to accomplish, but actually it can be very demanding technically. It's not a matter of removing cartilage, but rather re-arranging cartilage, and yes, unless you have something rather unusual going on, you should be able to get the shorter nose that you originally wanted.
How *much* to elevate the tip, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision.

Mark G. Albert, MD, FACS · Answer

Hello,
I don't see any photos so it's difficult to comment on your case. Usually, further reduction/improvement is possible except in cases where the skin is extremely thick. Doing 3D imaging with your surgeon is a tool that is always incredibly useful so you can get a sense of what each change will do to your nose and overall appearance. I recommend scarless/closed rhinoplasty for all rhinoplasty regardless of whether primary or revision rhinoplasty.
Mark G. Albert, M.D., F.A.C.S.New York, NY

Andrew Miller, MD · Answer

While it's difficult to say without photos, if your tip is quite droopy then it probably lacks support which would need a revision to improve. If the tip is lifted, it will make the nose look shorter. Be sure to see a rhinoplasty expert for consultation.

Stephen J. Pincus, MD · Answer

I am sorry for your unfortunate results. It's hard to respond to your question without seeing any photos. However, in general, there are many approaches that a more experienced surgeon may have to help you obtain your objective. You should seek opinions from surgeons who specialize in revision rhinoplasty.

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