Do I have a pinched tip? (Photo)

Question

I had rhinoplasty 6 months ago. My surgeon and I had agreed that the front view won’t change but the side would as he deprojected. I love the side view but the front now looks like the tip is lower than before. It looks like I have a pinched tip which gives an impression of pointed down nose and flared nostrils. I worry my surgeon has accidentally taken too much of the tip away and I’m worried it looks much worse that before. Please can someone advise me on if this is a pinched tip or not?

Ronald J. Edelson, MD · Answer

The main problem I see is that the tip was left too long. It’s simple to lift the tip but not all surgeons know how. That’s why I see so many long noses after rhinoplasty. Raising your tip will help a lot

Yannis Alexandrides, MD, FACS · Answer

From the single view I have, it is possible you have a pinched tip but I cannot confirm that given the sole front-facing image you've shared. In order to confirm, I would need view from the bottom of the nose, preferably both on inspiration and expiration.

Whether or not the external value collapses when you breath out could be a sign you have a Pinched Tip. You may have to speak to your surgeon to see if they can perform a Revision.

Stephen Kleid, MBBS, FRACS · Answer

The photos you sent are inadequate to make any assessment of your nose.In fact, it is impossible in to give an opinion on what is required in a Revision Rhinoplasty, based on photos alone.The assessment requires the surgeon seeing, and feeling the nose. We need to feel what cartilage3 and bone has been removed, to assess what is supporting the nose (holding it in place).Ideally, I like to get copies of pre-operative photos, operation notes and operative diagrams - although in 50% cases I cannot get that information, and in half of the patients where I get information it is of no value to me.
Cartilage grafts are often required in revision Rhinoplasty, preferably taken from the patient's nasal septum, sometimes from the patient's ear (from the concha), occasionally from a rib graft (taken from the patient, or from a cadaver donor).

Eric M. Joseph, MD · Answer

Your photos are a bit difficult to interpret, but you may have some tip narrowing and enhanced supra-alar creases. In our experience, microdroplet Silikon-1000 may be helpful for adding volume to your tip for a less operated nasal tip appearance. Hope this helps! Dr Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.I have tried to evaluate your case from the photos you provided but they're not really clear. I would need better photos from your face from front and side to make an appropriate evaluation.Anyway, you are right it looks like your nose tip is pinched. To correct this I can recommend you a revision surgery with rib cartilage reconstruction to support and elevate the tip.Best regards!

Do I have a pinched tip? (Photo)

Answers (5)