Too-Straight Nose After Rhinoplasty

Question

Basically I had rhinoplasty a year ago,to remove a bump and reduce my nose in size.My problem is that now my nose in my opinion looks too straight almost like a slope ,but not a ski slope where it goes up more ,rather a slope that goes too much into a straight line.I was wondering ,if there is any way to make the nose naturally curve more and maybe add a small bump to the nose ,so it looks more natural.I know alot of people ask for a perfect straight nose ,so is what I want out of the ordinary?

Edward J. Gross, MD · Answer

I have seen good results worsen after attempts at revision Rhinoplasty. Without a deformity or complication, I would learn to accept the results and see how you feel about it in a year. Many patients find more acceptance over time. Be cautious. Dr. G.

Michael A. Persky, MD · Answer

Hi Lily,

	Speak with your rhinoplasty surgeon about your concerns.  There are some things that can be done to help you achieve your goals.  Judiciously injected filler may be the answer or revision surgery.  Good luck and be well.

	Dr. P

Richard H. Tholen, MD, FACS · Answer

Actually, the answer can in some cases be "yes!" But when it is virtually impossible for any surgeon, however experienced or capable, to guarantee exactly how every patient will swell, scar, and ultimately heal and settle into a final result, how can it be your doctor's fault that it is "too perfect?" Most of my colleagues' answers include useful information, and the most important is that none of us can comment or answer as accurately and honestly as your own surgeon. After a year of healing, your nose has reached it's "final" appearance post-op, so anyone who advises that you should wait and see is only deferring having to actually assess your concern.

	What I "hear" as I read your question is that you do not like the fact that your nose somehow has an "operated" look, or that "people 'know'" you have undergone cosmetic rhinoplasty. Or is this your own self-awareness that you unconsciously "telegraph" to someone you might notice admiring your nose? As in--OMG, does he/she know I've had a nose job!?

	The short answer to can changes be made to make your nose less "perfect" is: yes. In fact, you may get your wish--it could look absolutely terrible! The long answer is still relatively short: relax, and ask your surgeon about a temporary filler such as one of the HAs (Restylane, Juvederm, etc.), a longer-acting filler such as Radiesse, or even hydroxyapatite granules (this requires a small, local-anesthesia procedure). If you love these results, then a small cartilage graft can be placed for a "permanent" result. But beware; asking for a change can end up giving an unanticipated disaster that neither you or your surgeon will like, especially given your present "perfectly straight" nose.

	Remember: the enemy of good enough is better!

Thomas A. Lamperti, MD · Answer

There is a way to place a bump back onto your bridge if that is what you desire. Having a consultation where computer imaging (and morphing) is done would be very helpful. This would allow your surgeon to best determine what outcome you're looking to achieve.

	A hump could be added back by grafting some of your own tissue such as cartilage or perichondrium (the natural covering found on cartilage). A temporary effect could be achieved with a soft tissue filler injection such as restylane or juvederm.

	Another way to break up the straight line of a perfectly straight nose would be to create what is called a "supratip break". This is basically a subtle concave area on the bridge above the nasal tip. Computer imaging would allow you to see how your nose would look with this done as well.

Otto Joseph Placik, MD · Answer

Before you embark on another surgical procedure you may want to consider using a filler to simulate a nasal hump. IF you like this result, you could consider a long term result with a cartilage graft.

Rod J. Rohrich, MD · Answer

I have never done a perfect rhinoplasty nor have I ever had a patient tell me her nose is too straight.   We really need to see photos of our face and nose  , at least a frontal and a side view so we can see what you are telling us .  One of the key elements in performing a modern rhinoplasty today is to make your nose match or be in balance with the rest of your face. 

	   If you have a straight narrow nose and your face is long and narrow, this may be OK, however, if you have this with a short wide face, it may be a problem.    It is all about balance and making your nose look natural.  Send us some photos so we can help you .

Theda C. Kontis, MD · Answer

Most all patients who come in for a rhinoplasty consultation request a straighter nasal dorsum on profile view. I have had a few patients ask that the hump be left alone so that it looks more natural. This is where computer imaging helps. In the initial consultation, I learn from the patient what they want from surgery and I discuss what can be achieved, realistically.

	You can have revision surgery, it would not be too hard to give you your bump back. You may consider trying a little dermal filler in that area to be sure that is what you want, or use video imaging to help explain to the surgeon the look you desire. Best of luck!

Srdjan Ostric, MD · Answer

Yes it is possible to correct this without a doubt with some type of graft. That being said, people generally love the so-called aquiline nose, and it is hard to achieve. Most surgeons are conservative and leave a bit of a bump. Most say it looks more natural, and it generally does, in the sense it is more common. But people don't always want to hae a common look so to speak. Also, surgeons are conservative in regards to the bump because over resection causes the so-called saddle nose deformity, which is really unsightly and depressing for most patients to deal with. It's something, I would say, you should have a frank conversation about with your surgeon, but keeping your mind open in regards to the process and what can be done and what was done and achieved. It's not easy to work with the human body, especially noses--they are living tissue and not clay.

William Portuese, MD · Answer

It is possible to create a bump on the bridge of the nose by adding a cartilage graft harvested from the internal portion of the nose and placed along the bridge line. This will add a slight hump to the side profile.

Ryan Greene, MD, PhD · Answer

This is a complex question, as evidenced by the wide range of answers you have already received. It is difficult to provide you with a good answer without seeing some photos, so these would be helpful. But I will tell you that patients will sometimes tell me that they want to maintain a subtle bump on the bridge of their nose, for fear of having an operated look. Others will actually want a 'perfectly straight' nose. It just depends on the patient. This is where preoperative imaging can really help, so that patient can communicate their desires more effectively to the surgeon.

	I agree with some of the other answers. First of all, be very cautious if you decide you want a revision. Discuss this in great detail with your surgeon to make sure that you are on the same page. Revision surgery tends to have a higher complication rate, and it requires much more surgical planning and skill. I agree with the surgeon who mentioned that 'the enemy of good is better.' Understand that there is no possible way to guarantee a rhinoplasty result, and there is no such thing as a 'perfect' result. Striving for perfection can be a dangerous road in rhinoplasty. If, on the other hand, you are very dissatisfied with the result, then you can discuss this with your surgeon and inquire about the possibility of a revision.

Too-Straight Nose After Rhinoplasty

Answers (20)