Is this tip refinement morph realistic? (photo)

Question

Does my before and after picture show the realistic expectation of my tip refinement or can more be done? I do have thick skin and the doctor said a rhinoplasty refines cartilage not skin so this is what I can expect but I’m wondering if this is true or if I should find another doctor who can give me a less bulbous result? I was to make sure the after is enough change to be worth the money.

Eric M. Joseph, MD · Answer

That said, you should only undergo rhinoplasty surgery if you have severe dissatisfaction with the appearance of your nose. I like your conservative computer Imaging, however, a precise results such as that could not be guaranteed. Wishing you well moving forward. Sincerely, Dr Joseph

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination. It looks like a realistic expectation.

Steven M. Denenberg, MD · Answer

I see how the tip was narrowed, and of course I realize this is just one view, but the nose appears a bit long to me. Was the tip elevated adequately on the 3/4 and profile views? If you're having a rhinoplasty, you must evaluate morphs and confirm an operative goal for all the important views of the nose.

Lucian Ion, FRCS · Answer

Thank you for your inquiry and for sharing your photographs.

The images provided are of relatively low resolution, which does affect the accuracy of the analysis to some extent. However, I can observe a V-shaped shadow at the junction between the bridge and the tip of the nose. This typically suggests medium-thickness skin rather than thick nasal tip skin, as the thickness of the nasal tip skin influences the visibility of the underlying cartilage contours.

Based on this observation, I believe your expectations for contouring the nasal tip are realistic, particularly if the projection of the nasal tip is maintained relatively close to its original position. This can also be achieved even if the length of the nasal tip is reduced.

A consultation using computer imaging and simulation would be helpful to further define the specific characteristics of the changes you are seeking and provide a more accurate prediction of the potential outcomes.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. I highly recommend that my patients focus much more on real longterm before and after photographs rather than 3D imaging.   I encounter so many patients in my practice who see me for revision rhinoplasty who previously had surgery elsewhere who feel like they were mislead into surgery by surgeons who relied heavily on 3D imaging without adequate real before and after pictures to back it up.  Photoshop is easy but real surgery is very different.

I always recommend that you carefully evaluate your surgeon’s online before and after gallery on their website for both quality and quantity of results. Make sure that there are hundreds of real before and after pictures which demonstrate long-term follow up results. If your surgeon is posting mostly on table results without real long-term follow up results, that is usually a major red flag.  If a surgeon is posting mostly just splint removal day videos without longterm follow-up pictures, or all patient selfie’s without real longterm in-office formal pictures that can also be a red flag.   Long-term results are much more meaningful than on table results or 1 week post-op results. Selfie’s can also be fun to look at, but these can often have a filter and do not represent true longterm results because of this and are not as valuable as real longterm in-office before and after photographs on your surgeon’s website.

With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

William Portuese, MD · Answer

An in-person examination determine the thickness of the skin in the tip of the nose is required to make a determination about how much refinement can be accomplished with a rhinoplasty procedure for the bulbous nasal tip

Thomas Spalla, MD · Answer

What you've shown looks very reasonable and achievable. While rhinoplasty rarely involves modification of skin thickness, by modifying the underlying structures of cartilage and bone, the skin molds to that new shape very well.

It is true that very thick skin cannot be expected to show the same delicate refinements as thin skin, but minor abnormalities or asymmetries are able to be camouflaged better with thick skin which can be a nice tradeoff.

Discuss your desires with an experienced rhinoplasty, and bring your pictures as you've shown to communicate goals.

Is this tip refinement morph realistic? (photo)

Answers (7)

More Rhinoplasty Questions

WE SEND PRETTY
EMAILS

Answers (7)

More Rhinoplasty Questions

Can I improve my nose from the front without getting an upturned or "Barbie" nose? (photo)

Prunes and other foods high in salicylates before surgery - when do you recommend to stop eating them?

Is this a mid vault collapse 1 year post-op? (photo)

Nasal Tip Deprojection with Thick Skin (photo)

Rhinoplasty with Uveitis?

Nose never returned to normal post pregnancy (photo)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS