Tip Refinement or full Revision Rhinoplasty? Costs? (photos)

I had primary rhinoplasty that I believed was underdone in the tip/supra tip region. It was not left with proper support causing my columella to hang. I have seen three rhinoplasty surgeons for a consultation on revision. They all want to charge me between 10k & 15k. When I press upward on the tip/columella my nose looks exactly as I'd wish it to look. I'm not making the connection as to why I have yet to be presented with a tip-plasty option.

Doctor Answers 7

Tip rhinoplasty

A tip rhinoplasty may be all that you need, but an exam in person evaluating all aspects of your nose would be essential.


New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Tip Refinement or Full Revision Rhinoplasty?

Lifting your hanging columella and increasing tip rotation does improve your appearance as demonstrated in these pictures but you have not shown me your entire nose. I get the feeling that you want to do a tip-plasty so you don't let me see anything else. I don't know if there is any advantage to doing a full revision rhinoplasty.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Tip refinement or full revision rhinoplasty? Costs?

Revision rhinoplasty is much more difficult than a primary rhinoplasty, so of full rhinoplasty is required to make sure  all of the components of the nose balance with themselves, and the new nose balances with the patient's facial features. The nasal tip cartilages, the columella, and  the nasal dorsum will also need to be adjusted. It's also important to release the depressor septi ligament also if it's present, which pulls down with animation and smiling. For more information, many before and after examples, and our current price list, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Revision rhinoplasty

It appears from your photos that rotation of the tip would be helpful in achieving the result you desire.  This can sometimes be done by just rotating the tip complex but sometimes additional grafting such as to the tip or to the columella area for tip support as necessary.  the exact extent of the surgery can only be to determine by an in office examination. This should be fairly straightforward by someone experienced an revision rhinoplasty.

David F. LaPatka, MD
Santa Barbara Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Revision rhinoplasty

From your photos I can see what you are looking for and I agree that tip elevation would be appropriate for improved aesthetics.  My recommendation would be for revised tip rhinoplasty using an open approach with ear cartilage grafting for improved structural support.  Costs will vary with surgeons; be sure to consult a surgeon certified by the American Board of Plastic Surgery who has a great deal of experience with this type of revision.  A comprehensive portfolio of his/her pre- and post-op pictures will help you assess his/her expertise.


For comparison, in my practice, the total cost for revision rhinoplasty is $6000-8500 depending on how much time is needed in the OR

Revision Rhinoplasty

The photos show an over-projected and ptotic tip.  Since you have already had a Rhinoplasty, I recommend that you see someone who is experienced in Rhinoplasty and most specifically revisions, or don't do anything.  Rhinoplasty is far more complicated than most people think and achieving the result you are depicting is not a quick fix.  Secondly, Rhinoplasty by an experienced Rhinoplasty Surgeon who can produce results that make you feel like it was worth your while will not be cheap.  Choose carefully. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 reviews

Tip Refinement or full Revision Rhinoplasty? Costs?

I agree with your assessment. It  may be possible to rotate your tip upward as you have indicated you desire. This can only be determined after physical exam to evaluate all of the components that create this tip position.

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.