Two cartilages form the tip of the nose, a left tip cartilage and a right
cartilage. In the before picture, you can see the depression, or dent,
between her two tip cartilages. They are quite prominent, and decreasing
their strength was an integral part of obtaining this result.
If you don't mind looking at photos taken during surgery, the
of the rhinoplasty surgery tutorial gives a good introduction to the anatomy of
the tip cartilages,
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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