Is rib cartilage best way to correct over projected tip 7 years post-op? (Photos)

You appear to have thin nasal skin which tends to show more irregularities after rhinoplasty. It may be true, that you might benefit from cartilage grafting from both a functional and cosmetic standpoint. Deprojection unto itself does not alway require grafting. We use ear cartilage when it is absent in the nasal septum, and the nasal valves and the nasal tip may require reconstruction. Hope this helps! Dr Joseph

Hello and thank you for your question. Although an exam in person is ideal, from your photographs alone it appears that you can benefit from de-projection of your nasal tip. I would perform this via medial crural resection. Further tip refinement may also be performed where the nasal tip cartilage is modified. Due to your prior rhinoplasty, the cartilage in your septum was likely harvested and so you will likely require MTF (cadaver) cartilage. The modification of your nasal cartilage can be done with trimming, stitching or grafting. If your septum is deviated and you have breathing difficulty, a septoplasty may benefit you as well.

The next step for you is to find the right aesthetic plastic surgeon. In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course. Also, be sure to see plenty of before-and-after pictures in men who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon. It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS
Harvard-trained Board Certified Aesthetic Plastic Surgeon

The projection of your nose is just fine, you have a small residual dorsal hump, and a significant hanging columella. Choose your second surgeon wisely based on extensive experience, You do not need rib cartilage grafting.