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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
rhinoplasty
 
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She doesn't really have a ball on the end of her nose, even if that's the cliché.  The cartilages that form the tip of her nose are wide, and they overlap each other, giving the impression of a ball.

A wide tip will appear to be a bulge on an oblique view of the nose.  If you put your finger on her nose where it begins, next to the inner corner of her left eye, and run your finger down the edge of her nose, your finger will have to bump out to your right as it follows the bulge around the tip of her nose in this view.  In the after picture, with a narrower tip, that bulge is gone, and your finger would trace a straight line from where her nose begins down to the tip.

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All views of this rhinoplasty patient:
rhinoplasty
rhinoplasty
current: Right oblique
rhinoplasty
rhinoplasty
rhinoplasty
rhinoplasty

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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: Unhappy with Nasal Tip After Rhinoplasty? Will Secondary Revision Cost?
I had rhinoplasty in 2012 and was dissatisfied with the nasal tip. I noticed a few months after surgery the deformed tip, spoke with the surgeon and he said it was still healing. Well, it's a year and a half later and I am still unhappy with the results. From the front of the face you can see where the nose looks slightly crooked. The tip slants to the right of the face, making it somehow look larger from the side view on the left. I have attached pictures if you want to look.
(Questioner submitted photos)

Dr. Denenberg's answer: More work on the tip of your nose would make a big difference
Hi. The problem is not so much the asymmetry. It's that inadequate work was done on the tip of your nose. The tip of your nose is drooping down, and it projects strongly forward off of your face. See my "Web reference" link for a morph showing what your nose could look like with a revision rhinoplasty. In the morph, I brought your nose back toward your face, raised the tip, so it doesn't look so long, and I also tucked up the columella, which is the little piece of skin that separates the left nostril from the right nostril.

Small asymmetries are difficult to correct, but often, when a nose is deprojected, which means brought back closer to the face, some of the asymmetries go away, because asymmetries are frequently more noticeable when the nose projects strongly.

In selecting a surgeon, you need to see before and after photos of his work in revision rhinoplasty, and especially work on the tip of the nose. Tip work is the hardest part of the rhinoplasty operation to teach and to learn, and many doctors don't do it well enough.

The good news for you is that, in capable hands, deprojecting and elevating the tip of the nose are two of the most predictable parts of a revision operation.

Link to this question on RealSelf.com



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