Revision of Curved Nose Profile: Underproject Nasal Tip

I want a revision surgery now. I got my surgery 2 months ago, a week after I saw a curved profile (that i never had). Now it's looking more curved, outside looks a little uneven but inside i can tell that one side doesn't have any cartilage its just skin and the other side there's like a 3/4 cm of cartilage almost covering the air flow i really care most for the esthetic part but every part is coming wrong!

Doctor Answers 7

Your nose may benefit from a revision

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The "Party Line" is to tell people they need to wait 6-12 months before you can tell what the final results of rhinoplasty will be. This is not always the case. Your photo looks like you may benefit from more tip support. 2 months is not too early to get another opinion.

Denver Plastic Surgeon
4.9 out of 5 stars 82 reviews

Give it time

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Before the idea of any revisional nasal surgery is entertained, one year must occur to allow all settling and healing to occur in the nose. If there is a slight amount of cartilage on the internal portion of the nose herniating down into the airway, this can be trimmed at three to four months if it is creating just an airflow issue.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Too early to tell Rhinoplasty results

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Your rhinoplasty surgery was only two months ago, so you will still be very swollen especially at the tip and the nostril areas. Go speak with your surgeon and explain your concerns. Sometimes, taping and massage can be effective to get the swelling to resolve a little faster.

However, before any revisions can be done, you will have to wait until the swelling is gone, and that typically takes one year. Make sure you are not having nasal allergies or other medical problems that could be contributing to what you see. If after a year you are still unhappy, you can safely seek a revision. If you are unhappy with what your surgeon recommends, there is no harm in seeking a second opinion.

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

It is best for you to wait to judge this.

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I know you must be very disappointed with the result. However, it is best to wait since the nose is still swollen. If a surgeon does the surgery at this point he would only be guessing as to where to place your final tip projection, etc. You can find a surgeon who will operate on you now and tell you what you want to hear, but that is not what a good surgeon would do.

See an experienced revision rhinoplasty specialist and he can evaluate your nose and tell you when is the soonest it could be done.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Rhinoplasty Revision

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Hi L,

I am sorry that you are unhappy after your rhinoplasty. It is very important to wait at least 6 months before having revision rhinoplasty for many reasons.

Use the time to speak with your surgeon and even to get second opinions from other rhinoplasty revisions specialists.

I hope that your revision goes well and that you have the nose that you desire. Be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

2 months after Rhinoplasty is early

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2 months is early and only your doctor will know if there is going to be any asymmetry. A lot of times, even when things are straight when you finish the procedure, contraction can lead to asymmetry several months or years later.

An operative report could help, but even that does not tell you everything that was done. It really depends on how much you trust your doctor in terms of what he accomplished. If there is obvious asymmetry now, it could be just swelling. If it is significantly hard / firm, it may indicate that things have shifted.

Sometimes, if your cartilage is inherently weaker, techniques done during the procedure may not maintain their shape or position. In these situations, you need to bolster your cartilage with sutures and stronger cartilage from within your nose (septum), ear or rib cartilage. Don't worry, things can always be done to improve the situation. I'm sure your doctor will hold your hand through this like I try to do with my patients.

Consulting a Board Certified Facial Plastic Surgeon would be something that I would recommend. We specialize in the face and are highly qualified to help you with this.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Need to give Rhinoplasty results more time

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Based on your picture you have something called a pollybeak deformity. It occurs when you have too much fullness in the area just above your tip. This can be from either swelling, scarring, or unresected cartilage. I also think your radix, the top part of your dorsum, is underprojected.

The first step is to give it more time, swelling after rhinoplasty can take 6-12 months to resolve. That being said, I have to about 20% of the time inject a minimal amount of steroid into the supratip area to reduce swelling. If you have cartilage there and no swelling then you will need a revision.

Your nasal tip is not underprojected; it actually is in the right spot. Your supratip is overprojected thus making you look like your tip is underprojected.

Another solution would be to build up the upper dorsum and radix to give you a more pleasing profile with maybe a touch of cartilage off of the lower dorsum.

Hopefully, your pollybeak deformity is from swelling and will resolve with time. I would talk to your surgeon.

Samson Lee, MD
Seattle Facial 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.