Tip Projection After Rhinoplasty

Hello, I had a rhinoplasty with rib cartilage (bridge and columellar strut) 2.5 weeks ago and I'm feeling weird about how my tip looks. Aside from being bulbous, it seems to be over-projected and a bit up-turned ( it kinda pulls my upper lip forward and makes a larger nasolabial angle). Also, I'm worried about how noticeable my nostrils look from the front and 3/4 angle view. Should I be worried or will they go away as the swelling go down? thanks, NateL

Doctor Answers 8

Tip at 3 weeks

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Three weeks post surgery is still very early for you to judge the results of your surgery - especially after rib grafts

Worried about nose appearance after rib grafts during rhinoplasty

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I have performed Rhinoplasty for over 20 years and I have no idea how much is swelling and how much is the shaped, carved rib cartilage or bone that was placed during your Rhinoplasty.  You will have to ask your Rhinoplasty surgeon who should be able to answer that question. 

Tip is overprojected after rhinoplasty

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A rib graft is a very strong maneuver in rhinoplasty as as the bridge is raised strongly the tip can go up with it. It is possible that the graft and columellar strut are too large and the aesthetics are out of balance. Your nose is likely to settle a  bit and at this point is makes sense to let the tissue recover. As the grafts are healed in, they can be trimmed and reduced after several months if needed.

Best of luck,


Upturned after rhionplasty with grafts

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at 2-3 weeks the final result is far from finished. take pictures every week and I bet you'll see steady improvement. this type of swelling can take a long time to resolve so serial photos will help convince you of your progress.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Rhinoplasty with rib grafting and lots of swelling

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It is difficult to render a professional opinion without examining your nose or having a picture to visualize it. According to your description, your nose appears “up-turned” and nasal tip is bulbous, after rhinoplasty with rib grafting 2.5 weeks ago. Considering the extend of the operation you had, it will take at least 8 weeks to see significant reduction in swelling. Therefore you must wait. The best person to talk to is your surgeon. Good luck and good healing. Dr. Kevin Sadati

Tip too high after rhinoplasty

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It is too early to get worried,.  The nose can lengthen for at least 6 months after surgery.  If the columellar strut is too long, it could produce the effect you are seeing, but if an experienced surgeon operated on you, chances are very high that you are just seeing swelling.

Try to be  patient.  Worst case, the problem can be repaired.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon

Rib graft

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You had a big procedure done. Your concerns are justified. You had a very stiff material placed and the projection may be too much. However, you must wait until the swelling goes down to make a final decision.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon

Tip Results After Rhinoplasty and Rib Graft

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Rhinoplasty and any rhinoplasty with a rib graft is a major surgery.  There is associated swelling and significant changes that routinely result from the procedure and the addition of the grafting material.  The swelling of the nose at 2.5 weeks is still significant, and it is very difficult to make a judgment on your situation from this point.  If the nose is too "turned up" or structurally "off" - you may get a hint of what is to come, but without photos we cannot give you an opinion.

Stay in contact with your surgeon and follow this closely, but patience is necessary with any rhinoplasty procedure.

Best of luck

Vincent Marin, MD

San Diego Plastic Surgeon

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.