Uk cost for tip refinement? (photo)

Question

I had primary surgery in 2011. My results were good at first but then my tip started to droop and from the front it looks wonky and bulbous. I hate having my picture taken so much. There is only one angle my nose looks alright in and thats at a tilted diagonal position :( I would like the tip to be lifted and slimmed. Would this cost less than having a whole nose job? I am hoping to start going on consultations soon after research. Thanks :)

Alejandro Nogueira, MD · Answer

I am afraid I don't have very good news for you, reading me can be distressing so, if you are emotional and sensitive do not go on reading my answer, because your case is not, at all, for a mere and simple tip refinement.To begin with better images to illustrate your case are necessary, however the work is so obvious that a frontal looks tells a few things; as far as visible you might have issues including but not limited to the following:-open roof deformity: your surgeon failed to perform the mandatory and state-of-the-art essential step of osteotomies or infracturing the "open roof" caused by hump shaving; this is non-optional, non-negotiable, failing to (at least trying to) fracture the nasal pyramid in association with dorsal shaving leads to: open roof deformity + inverted V deformity + pinched middle vault + broad nasal base + undefined and broad nasal dorsum; since Dr. Joseph and disciples invention of basic rhinoplasty and the surgical instruments for it in the first decade of 19th century (yes, 19th century, first decade, do google the history of rhinoplasty) us, the surgeons, we do, we should know that osteotomies are-a-must; does performing them bring swelling and bruising to patients? true... does performing them specific training and good skills to avoid accidents? true... and? this is our work as surgeons of faces: assuming risks and achieving safe and successful rhinoplasties; whoever does not feel ready to perform osteotomies in noses should not to any single rhinoplasty in his career; solution for your open roof: performing osteotomies; which not only close the nasal dorsum, they also provide definition of the dorsum, narrow the dorsum and narrow the nasal base-inverted V deformity: due to failing to infracture the nasal bones a peculiar phenomenon happens: the surgeon aggressively pushes the upper lateral cartilages (soft cartilagenous lower nasal wall) towards the midline, therefore dislocating and separating them from the nasal bones, nasal bones which are unable to move to midline (unless fractured, obviously) whilst the upper lateral cartilages have a natural hinge with the maxilla allowing their forced mobility to the center of the nose... as consequence the bony dorsum stays open and the middle vault too much closed (pinched), ending with a visible slot between nasal bones and the upper lateral cartilages which can be easily detected at your nasal wall; the solution is, besides performing osteotomies at the bones, rebuilding the soft dorsum with sutures and eventually inserting carefully planned, suitably sized and properly fixed spreader or spacer grafts (donor site: septum)-broad dorsum, undefined dorsum, broad nasal base, pinched middle vault: already touched above-better images are needed, but from the frontal view you have an excess of soft caudal septum making a prominence and also massive fibrosis, this is called "polly beak deformity", associated with poor tip support; may this be a real situation the solution is dorsal regularization and tip supporting (strut at columella)-biphid or cleft tip, seems not much work was done on your tip, you can benefit with high-end tip surgery, plications, plasties and eventually Sheen's graft-slight alar rim retraction, probably pre-existant to surgeryYou are, therefore, a case for a full revision rhinoplasty of high difficulty, 8 out of 10 in revision cases, surgical time 4-5 hours. Do research well the skills and capacitation of the revision surgeron, revision rhinoplasties are technical ordeals, not accessible to any rhinoplasty surgeon, they require lots of experience, passion, skills, open structure rhinoplasty training and a loads of perfectionism and patience.If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Uk cost for tip refinement? (photo)

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Everything you need to know about Revision Rhinoplasty

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Uk cost for tip refinement? (photo)

Answers (1)

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.