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Steven M. Denenberg, M.D.
Steven M. Denenberg, M.D.
rhinoplasty
 
Views of this rhinoplasty patient:

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Let's try to evaluate the surgical changes from this frontal view.  You can see some of the changes from removing the hump: the before picture has two parallel vertical white stripes along the dorsum of his nose.  Those stripes are the return from the flashes in my photo room.  The stripes give you a feel for the position of the dorsum and the presence of the hump, and they are missing in the after picture.

Nasal length: in the after picture, we can see just a glimpse of his nostrils.  That glimpse is our indication that his nose was shortened, because in the before picture, his somewhat droopy tip hung over and obscured our view of the nostrils.

Actually, he has his head tilted down slightly in the before picture, but the analysis is still valid. (You can tell that his head is tilted down a bit by looking at his right eye and his right ear.  In the after picture, his right eye is at the level of the top of his ear.  In the before picture, his right eye sits below the level of the top of the ear.)


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current: Frontal
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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: Is it common after Rhinoplasty the tip of nose to drop?
I got rhinoplasty 3 months ago and 3 weeks post op the tip of my nose dropped loads and is getting worse and which is giving me my bump back again, I'm ment to be getting revision on it but people have went and have got worse so I'm worried, is it normal for it to drop or is there something the surgeons not done right?
(Questioner submitted photos)

Dr. Denenberg's answer: Uh oh, I'd be worried, too.
It's true that three weeks is very early for healing of a nose, but in the next many months, most of the changes have to do with decreasing width: the tip getting smaller, the bridge getting narrower. However, in my experience, if the *length* of the nose is the problem, the length does not shrink as the swelling subsides. The tip does not climb up. In fact, we typically expect a tip to drop with time, so, for example, I'm not unhappy if my patients are nervous because the nose looks *too short* at first, because I know the nose will lengthen a little bit with time.

Still, there's nothing to do right now but wait, and as the water leaves your nose and the overall nose gets smaller, the length may bother you less.

However, one of the most common problems that I see in my revision patients is that the previous surgeon did not shorten the nose enough. It's not easy to do, and most doctors can't get it accomplished well. If you do wind up looking for a revision later, be certain that you've seen before and after photos that show excellent shortening of the nose.

Link to this question on RealSelf.com



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