Dr. Steven Denenberg's facial plastic surgery before and afters: Rhinoplasty, large tip noses #11

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The frontal view is always the hardest to evaluate, but we'll try. Look at the two white dots in the tip of the nose. They are reflections from the flashes, just as there are two white dots in each of her eyes. Now compare the position of those dots with the position of her nostrils in the before and after photos. You'll find that the dots are higher in the after picture, indicating that I succeeded in elevating the tip of her nose.

It's harder to tell what was done to the dorsum from this view, but check out the two vertical parallel white stripes in the dorsum in her after picture. They are more even and uniform than the stripes in her before picture, indicating that her dorsum was narrowed and straightened. See what you can tell if you know what clues to look for?

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All views of this rhinoplasty patient:

rhinoplasty 1: Right oblique	rhinoplasty 2: Right profile	rhinoplasty 3: Left oblique

rhinoplasty current: Frontal	rhinoplasty 5: Right oblique	rhinoplasty 6: Left profile

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Questioner: Uneven nostrils after 2 rhinoplasties. What can be done?
After two rhinoplasty surgeries. my daughter's nostrils are uneven, and she is self conscious. Her nostrils were not uneven prior to rhinoplasties. To correct them, would she require a third rhinoplasty with general anesthesia? Would it be as hard a recovery? What can be done to fix them?
(Questioner submitted photos)

Dr. Denenberg's answer: Maybe, maybe, she could have a revision of only the columellar scar
In general, that view, the bottom view, is the least important view after a rhinoplasty (or before), because it's a view that people generally don't see. Achieving excellent symmetry in that view is unrealistic, and unnecessary.

Having said that, however, it seems that much of the asymmetry is caused by a bulge of scar tissue on her left side, at the location where perhaps the incision was made for an open rhinoplasty. Maybe revising that scar would help meaningfully, with no risk to the entire rest of her nose.

Link to this question on RealSelf.com


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