What Kind Of Revision Surgery Could I Get To Round The Square Tip of My Nose?

Looking at your photos provided, I would agree that your tip appears more angular and sharp than it should be. For your face, it would be more appropriate to have a more convex, slightly rounded nasal tip instead. This type of problem is encountered in some cases of rhinoplasty where the tip cartilage has been reshaped and the nasal skin shrink wraps down to reveal unwanted cartilage angles and corners. This is usually corrected with revision rhinoplasty surgery with use of cartilage grafts to reshape the tip. The goal would be to add cartilage to the tip so that a more convex contour is created - which translates into a more rounded looking tip. With the degree of skin shrinkage that you experienced, it may also be recommended that you have temporal fascia grafting over the cartilage to provide a thicker soft tissue covering. Make sure you consult with an experienced revision rhinoplasty expert who has specialization in managing this type of nose.

I can see what you mean when you note the more angular tip. This can likely be improved with a revision procedure, though your nose is tricky given how thin your skin is. This thin skin is what allow the edges of the cartilage of your tip show through and give the sharp appearance.

You may have had cartilage grafting placed in the tip to give it definition. Revision surgery could address this in addition to the notching that you can see to the sides of you tip itself. This isolates the tip and accentuates the pointiness. Rim grafts can help improve the transition from the tip to the ala. There are ways of thickening your tip using perichondrium (the thin tissue covering found on cartilage) or fascia (tissue that covers muscle).

Consulting with an expert revision rhinoplasty surgeon would be recommended for you to get a better idea of your options.

Rhinoplasty in persons with thick cartilages and thin skin can ocasionally result in bossae. This occurs when the soft bend in the tip cartilages tighten and become more visible through the skin. Correction of this type of appearance generally requires open revision rhinoplasty with reconstruction of the tip cartilages and possibly temporal fascia grafting to help thicken the skin.

Making the tip more round can be done by a combination of grafts, such as alar rim grafts, alar baton grafts, and spreader grafts.  The important thing to know is whether or not there is enough cartilage inside the nose for grafting material.  

The prominence of your nasal cartilages may be the occurrence of the skin shrinking around your cartilages. Fillers can camouflage this a bit, but they will get absorbed. Sometimes revising the rhinoplasty by adjusting the cartilages or adding temporal fascia as a blanket( thickening layer may help.

You have experienced what is sometimes called the "shrink wrap" effect. As the skin swelling reduces the skin contracts around the narrowed cartilage and if it is not strong enough to resist this contracture there is pinching and angular points. Fillers willonly camouflage the problem. You need to have the tip resupported and sometimes the skin as well if yours is very thin.