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Steven M. Denenberg, M.D.
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Whenever a hump is taken down, the upper part of the nose, where it's made of bone, often needs to be narrowed as well.  The reasons for that are discussed in detail in the rhinoplasty surgery tutorial's chapter on removing humps (the surgery tutorials contain explicit photographs taken during surgery).


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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: Rounded tip, pollybeak and over-projection? Is it swelling or should I consider a revision?
I'm 4 months post op. My tip is very rounded and my nose appears to be over projected on three quarter view. Is this swelling, a pollybeak forming or just not a nice result? Should I consult with revision surgeons?
(Questioner submitted photos)

Dr. Denenberg's answer: Excess projection and fullness after rhinoplasty
Hi,
I'll try to be helpful, but for some reason I can't see the posted photos.

I suppose the rounded tip could be, as you said, swelling or a pollybeak or just not a nice result. Sometimes, if it's swelling, a steroid injection can help, but it's unlikely to help hugely. I don't see how projected your nose is, but probably the projection won' change much now.

De-projecting a nose involves advanced techniques on the tip cartilages, and most plastic surgeons don't have the training to make the changes with accuracy and predictability. Especially in a revision. If you consider a revision, you *must* see before and after photos of the doctor's other patients, with noses similar somehow to yours, so that you can see if he was able to accomplish for someone else what you want for yourself.

If you re-post the photos, I'd be happy to give you advice based on your specific situation. See the attached video and Web reference link for examples of changes that can be made in the right hands.

Link to this question on RealSelf.com