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This young woman's nose appeared to sit too close to her face. She had
inadequate projection. The goal of her operation was to bring the tip
of her nose farther out from her face.
Her nose has some of the appearance of a cleft lip nose, but her lip is
perfect: she was injured in a jungle gym accident. The nose is reminiscent
of a cleft lip nose because persons with that congenital deformity often have an
associated deformity of the nasal tip cartilages that causes the tip of the nose
to sit too close to the face.
The rhinoplasty surgery tutorial contains a chapter
that discusses the importance of tip projection and how it is maintained or
created surgically (the surgery tutorials contain explicit photographs taken during surgery).
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Questioner:
Do I need a revision rhinoplasty?
I like everything about my new nose but the tip. Im 20 months post op and I'm not thrilled about the tip. It's very round and sort of droopy. Especially in pictures. At my last follow up, my doctor acknowledged that the skin underneath the nose was a little loose but even with the new procedure, there's a chance it'll still look the same way it does now. He claims there's no way to get rid of the skin. Thoughts?
(Questioner submitted photos)
Dr. Denenberg's answer: It doesn't look like loose skin to me.
I have to say, I've never seen a case where drooping at the bottom of the nose there is loose skin hanging down. It's either cartilage or scar tissue.
This far after surgery, if the nose is still too big, you're looking at a revision. There are a couple of pieces of good news for you, though. It appears, from these photos, that the size is the result of strong cartilages under the skin, and a revision where reduction in size is the goal is more predictable than some other changes we try to make.
I would try to elevate the entire tip of your nose -- that's key -- narrow the tip, bring the whole nose back closer to the face, lower the bridge to match the new position of the tip.
Link to this question on RealSelf.com
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