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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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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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