Is this a chance to get this stub on nose straight with a more defined feminine nasal tip? (Photo)

Second Rhinoplasty, nasal tip always ends up rounded. 2 years 4 months since last revision

Doctor Answers 5

Poorly Defined Deviated/Asymmetrical Tip

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If you select a rhinoplasty surgeon who specializes in revision work you should be able to improve definition and correct the deviation or asymmetry of your tip. 

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nasal tip definition

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I believe what you are asking for can be accomplished. Without an in-person exam, it is difficult to say what can be done 100%, but I think the tip definition can be improved. From the photo, it appears that you have slightly thicker skin, which is always a limiting factor when trying to define the tip. Basically with thick skin, no matter how much you narrow the underlying structure, you are covering it with a 'down comforter' and this can obscure the definition. I would recommend seeing someone who specializes in revision rhinoplasty so they can discuss your options.

Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon

Tip definition in revision rhinoplasty

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Dear Lola,

Sorry to hear that you have not had a satisfying result from your previous rhinoplasties. As you have noted, your nose does appear to still be crooked and undefined in the photos. There is no reason to lose hope, though. In the hands of an experienced revision rhinoplasty specialist, there are techniques available to create a more structured and symmetric look to your tip. You should visit with a revision specialist in person so that he or she can examine your nose to assess your remaining cartilage support, skin thickness, presence of scar tissue, and other factors that will help determine the techniques necessary to achieve your desired result. You can also have computer imaging done to give you an honest and realistic sense of what is possible to hopefully make this your last revision. All the best in your search. 

Jason Litner, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 52 reviews

Revision rhinoplasty with a crooked middle third.

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Hello and thanks for sharing your photos.

I do think that this is an appropriate time to consider revision work.

I would recommend you acquire all of your medical surgical reports from your previous physicians as well as post operative notes if steroid injections were utilized.  Before and after photos are always nice but are really unnecessary.

We really would have to physically examine your nose for any real helpful information.  However, your photos would suggest that tip refinement is possible and likely to be helpful.  We need to discuss your skin type to make any real judgements.

The middle third continues to appear shifted.  Standard photos might be a little more helpful.  Regardless I have to say that the middle third is a tricky area that really needs significant attention to achieve a balanced result.  I would guess you might require a supportive graft based on the position of the septum currently.  

One challenge you may face is availability for cartilage with your past surgeries.   Operative notes may shed some light on this. 

Your best bet is to find a physician specializing in revision rhinoplasty that can meet you and give you some solid advice.

Best wishes.
Dr. Hobgood

Todd Christopher Hobgood, MD
Phoenix Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Revision rhinoplasty candidate for crooked nose and bulbus tip

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 To reduce the bulbous tip of the nose, suture techniques are applied to the lower lateral cartilages of the tip, and sometimes conservative cartilage removal is performed when  cartilages of the tip are excessively wide. Thick skin will be an impediment to seeing a very refined result. The photographs also demonstrates a concave upper lateral cartilage, for which a cartilaginous spreader graft will be required to straighten the nose. For many examples of hump reduction and straightening the nose, please see the link low

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.