Tip / top of nostril rim collapse

Question

I had rhinoplasty 16 years ago but recently noticed my nostrils getting higher so showing like a pig. My tip was always sticking up but I learnt to live with it. However it feels like the edge of the nostril / tip of my nose has dipped in and I think this is why the nostril is more on show. Side on you can see fully into my nose and cthe scar from the rhinoplasty. Help please

Guray Yesiladali, MD, FEBOPRAS · Answer

It sounds like you're experiencing changes in the shape and appearance of your nose many years after your rhinoplasty. This is not uncommon, as the nose can continue to change subtly over time due to aging, changes in skin elasticity, or other factors. 
The issues you're describing, such as the nostrils appearing higher and more exposed, as well as the tip of your nose dipping in, could be related to a few potential causes:
1. **Cartilage Weakening**: Over time, the cartilage in your nose can weaken, which might cause the tip to droop slightly, leading to more of your nostrils being visible. 2. **Skin and Soft Tissue Changes**: Aging can cause the skin and soft tissues to lose some of their elasticity and volume, which might result in the nostrils and tip looking different than they did right after surgery.
3. **Scar Contraction**: Sometimes, scar tissue from the original surgery can contract or change over time, affecting the shape of the nose.
Given that these changes are causing you concern, the best course of action would be to consult with a board-certified plastic surgeon, preferably one with experience in revision rhinoplasty. They can assess your nose in detail and discuss the options available to correct these issues. Revision surgery may be an option if the changes are significant and affecting your satisfaction with your appearance.
In the meantime, avoiding any trauma or pressure on the nose and possibly considering non-surgical treatments like dermal fillers (if appropriate) could provide temporary improvement until a more permanent solution is decided upon.

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have very thin nasal skin and nostril retraction with a hanging columella. Depending on your examination, microdroplet Silikon-1000 injections maybe considered for adding lost volume to your nasal tip and for lowering your nostril margins for a less operated nasal tip appearance. I hope this helps! Sincerely, Dr Joseph

Gianfranco Frojo, MD · Answer

This is alar retraction classically seen in the more aggressive open rhinoplasty approaches of the past. I would recommend a revision rhinoplasty that would include alar contour grafts to help address the alar retraction.

Tip / top of nostril rim collapse

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Tip / top of nostril rim collapse

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Everything you need to know about Rhinoplasty

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