Dr. Steven Denenberg's facial plastic surgery before and afters: Rhinoplasty, combination noses #23

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In this frontal view, we can see that the nose was shortened because the after picture shows some of the patients nostrils, invisible in the before picture. In a frontal view, a long, drooping tip will cover the nostrils.

Also, look at the two white dots on the tip of her nose. The white dots are created by the flashes reflecting off of her tip cartilages. The dots are about at the level of her nostrils in the before picture, and they're well above the level of the nostrils in the after picture.

Finally, if you look carefully at the lower edge of the tip of her nose, you'll see that I narrowed her tip and filled in a little dent that existed between her two tip cartilages.

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All views of this rhinoplasty patient:

rhinoplasty 1: Right profile	rhinoplasty current: Frontal

rhinoplasty 3: Left oblique	rhinoplasty 4: Right oblique

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Next: an example of the solid advice Dr. Denenberg gives patients on RealSelf.com.
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Questioner: Can This Bad Revision Rhinoplasty Be Fixed?
It was supposed be simple revision ( I know no such thing) of droopy tip from profile . Front was pretty good. After revision it became worst from every angle. Bridge became crocked, there is a bump from 3/4 view and worst of all tip became longer and pointy. It has been 3 years and I can't get used to this unfamiliar look it gave me. Am I looking for more disappointment with another surgery? Willing to travel Anywhere
(Questioner submitted photos)

Dr. Denenberg's answer: Your nose can likely be improved, much closer to your original goal.
Well, please tell everybody that if a doctor tells you that a revision will be "simple," you should run away at top speed. But going forward, one of your main complaints is that the nose is long, with the tip drooping. Even though we can't accomplish *everything* we want to in a revision, raising the tip of the nose is one of the more predictable changes, even in a revision, in competent hands. See my "Web reference" link for a morph showing your nose with the tip elevated.

The bump on the three-quarter view is caused by your nose being off center from the frontal view. Asymmetries like that are the most difficult features to correct in a revision, or even in a primary rhinoplasty. They can generally be improved, but not eliminated. The goal is to get a nose that you are happier with, more satisfied with, even if there are still some features that bug you or that you wish could be a little better.

Link to this question on RealSelf.com


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