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Along the dorsum, you can see parallel vertical white lines that are the reflections of the
flashes. The linear reflections are prominent, and a bit crooked; they softened and
straightened after the hump was removed.
Look at the tip of her nose. In the after picture, there are two white
dots, also reflections from the flashes. The white dots are small and symmetric, closer
together than in the before picture, more distinct than in the before picture,
and positioned higher above the nostrils than in the before picture. Those
findings are our indications that the tip of the nose was narrowed and elevated
during the operation. Also, we get to see just a little bit more of her
nostrils after surgery, another indication that the tip of the nose was
elevated.
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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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