Possible Tip Collapse 18 Months Post Rhino? (photo)

Hi,

Delayed tip collapse happens when the structural integrity of the nose is violated; sometimes it takes place as a delayed reaction when nasal parts/grafts settle (cartilage absorption may take place if used).

Fillers are a temporary fix and cannot reflect the same results a corrective surgery can have over your nose hence your entire face.

It is perfectly normal that a patient feels uncomfortable and not ready for a corrective survey when he/she had their first one soon; fillers can be used to give the patient an idea of what a corrective surgery will provide.

In other words, the fillers could work as a try-out approach so the patient is comfortable with the change and if they decide to make it permanent without having to rely on the fillers as a repetitive solution, a corrective surgery will be the logical choice to pick.

That being said please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.

I hope this helps.
Thank you for your inquiry.
The best of luck to you.

 

Dr. Sajjadian

This type of delayed tip collapse is something that can happen after rhinoplasty. This is one reason why we must focus on the structural integrity of the nose during surgery.

I don't recommend placing fillers in the tip of the nose. It would only give you a temporary improvement and there are risks of permanent damage to the skin which is ultimately very difficult to treat.

I can understand not wanting another surgery, though. If it is something that bothers you it may be worth talking to a revision rhinoplasty specialist to see what options you have.

Your surgeon has the best idea as to what may be causing the tip asymmetry.  The possibilities are directly related to the various maneuvers performed to the initial surgery and can include one or more of the following:


Asymmetric cephalic strip resection.

Asymmetric domal sutures.

Asymmetric lateral crura setback procedures.

Asymmetric cartilage grafts.


Fillers can improve things but not give the best possible result.  Furthermore, they are temporary.

Mario J. Imola, MD, DDS, FRCSC.

 

Tip collapse can happen.  I am not a big fan of fillers for nasal rejuvenation, it will only be temporary.

To answer your question YES tip collapse can occur anytime. But your posted photos are of no help. 

It is not uncommon to see some tip changes a year or even longer after a rhinoplasty.  Unfortunately, your photos are very difficult to comment on.  It is possible to use fillers (wether temporary or permanent) to correct small defects or asymmetries after rhinoplasty.  Fillers are more commonly used on the dorsum though, although can be used on the tip as well.  They need to be used on the tip with more caution, since the skin there is tighter and blood supply may be slightly diminished after surgery thus making filler placement in this area more prone to complications (infection, skin necrosis, etc). Some postoperative problems, however, are not possible to correct with fillers and they do require a revision surgery, wether minor or major.  

 It's more likely that there were tip grafts, perhaps crushed cartilage, that dissolved at 12-18 months after the Rhinoplasty.  These were most likely placed to soften the nasal tip after resection of the tip cartilages.  You'd most likely be better off having a few consultation with Rhinoplasty Surgeons to explore your options.

In my practice I have very limited indications for a revision with fillers . Fillers will correct the asymmetry of the tip cartilages but will do nothing for the nostril asymmetry. I suggest you consider a revision of the tip including the nostrils which will be much easier than the original surgery. This can be done with just local anesthesia.

Yes although I am not a fan of fillers this can be achieved with fillers.I particularly like that you do not want surgery and this fits for you