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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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This nose was shortened, and it had a small hump reduced.  There are many factors that must be considered in deciding how short to make a nose.  The rhinoplasty surgery tutorials contain an entire chapter on how a nose is made shorter during surgery, as well as a discussion of how to decide how short the nose should be (the surgery tutorials contain explicit photographs taken during surgery).


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Questioner: I am considering a revision rhinoplasty. I am not sure if it is even an option for me.
First surgery in 1988. Closed procedure. Left me looking deformed, cartilage collapsed. Second surgery, different surgeon tried to repair with closed procedure. Nothing changed. He agreed needed to be a bit more aggressive. Did a third surgery with some grafting. Open procedure. Made changes, but I still feel as though I look deformed. This was all done in 1992-1993. Now I am 48. (notice assymetry, bulbous tip, and dent in the middle.) Want to find out if ever possible to fix.
(Questioner submitted photos)

Dr. Denenberg's answer: Meaningful improvement is likely in expert hands
Hi,
From the information available in the photos, it does seem as though you should be able to get more improvement in your nose. What I notice: the upper part of your nose, where it's made of bone, is still a little wide, making an irregularity on the frontal view; the tip is still wider than it needs to be; from the front, the tip seems to droop down between your nostrils more than average; from the profile, the tip can still be elevated a little.
These are all changes that should be possible, even in a multiple revision. The problems relate to the size and position of bone and cartilage, and changing those elements of the nasal anatomy is very possible in revision surgery.

Link to this question on RealSelf.com