Revision rhinoplasty - How to lengthen the nose so it appears longer when I smile? (Photos)
Doctor Answers 3
Realistic results with a revision rhinoplasty
Since you have already had a rhinoplasty procedure with significant alterations to the normal nasal anatomy, it may be Very difficult, if not impossible to accomplish all of your goals. It is possible to slightly rotate the tip downward. The columellar strut can be removed, but is very difficult to predict what the dynamic action will be of the nose once it is removed. It is also important to make sure that the depressor septi ligament has not been cut during the primary rhinoplasty which pulls the tip down when smiling. It is also very difficult to give added projection to the nose without turning it upwards which is counterproductive. The bridge of the nose could be built up, but it is important to know how much cartilage is left on the inside of the nose for potential grafting purposes. Most importantly is to have realistic expectations about what can and cannot be accomplished with a difficult revision rhinoplasty procedure and look natural. Your current nose looks quite nice, and the risk may outweigh the benefit.
Your pre-operative photos show significant dorsal asymmetry involving both bone and cartilage, a bulbous tip, and hanging columella. In your post-operative photos, each of these is well-corrected, and the nasal tip projection appears quite good. I believe that your surgeon did a fine job in correcting a very difficult nasal shape.
Revision rhinoplasty is always more difficult, and risks causing or accentuating asymmetries. Scar tissue formation is unpredictable, and can defeat our best intentions. As always, I would discuss your concerns at length with your operative surgeon. However, I do not see anything 'glaring' that would warrant or outweigh the risks of revision rhinoplasty.
thank you for your question
I reviewed a your photos from pre and post op it appears that there are dorsum was slightly higher and your nose was slightly more projecting. I would first ask you how long it has been since initial surgery.? It sometimes takes a while for a patient to get used to there "new appearance". Certainly, another procedure can be done . An examination of ear nose would be necessary to determine whether or not a tip graft or removal of the columellar strut would be advisable. Imaging can be done at that time and although this is not a guarantee , it can certainly give you an idea as to whether revision surgery would be advisable. Initially , I would speak with your surgeon . Of course, If you elect to see another surgeon it would be someone with vast experience with revision rhinoplasty.