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Steven M. Denenberg, M.D.
Dr. Denenberg's articles on Medium.com.
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Views of this rhinoplasty patient:

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In these photos we see another clue, that his nose is over-projecting.  In the after photo, draw these two imaginary lines: a mostly-horizontal line drawn along the base of his nose, and a line drawn along the skin from the base of his nose down to his upper lip.  Those two lines meet at a sharp angle.  In the before picture, however, they don't.  The line that traces the skin of his upper lip curves forward to meet the bottom of his nose in the before photo.

If you grab the tip of your nose and pull it forward, making your nose more projecting, your upper lip skin will do the same thing.  When the upper lip skin pulls forward like that, we call it "tethering of the upper lip," and it's usually an indication that the nose is a projecting nose.

The rhinoplasty section of the Surgery tutorials contains a chapter that discusses the phenomenon of upper lip tethering (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.
Get that advice for your own situation by emailing your photos to Dr. Denenberg.

Questioner: I 100% Have a Pollybeak Def from Going on 4 Rhinoplastys, Should I Go Through with the 4th?
first rhinoplasty almost 2 years ago now, the results were horrible & my nose looked twice the size as it naturally did. Since then my surgeon suggested another 2 closed rhinplasty to fix that and a twisted look from not enough taken off one side of my bridge. Since the 3rd still very unhappy, I have a pollybeak he says and is now soon booking me for an OPEN rhinoplasty which i am worried about because I dont want my nose to collapse or anything and he said nothing about grafting, what to do, help
(Questioner submitted photos)

Dr. Denenberg's answer: A reasonable revision operation might help your nose significantly.
I'm sorry to hear about your experiences.  It could be possible to make improvements in your nose. If the bridge of your nose can be built up just a small amount, and the polly beak taken down just a small amount, it can make a huge difference in how natural your nose looks. Click on the Web reference link to see a digital modification that I made of your nose.
You should not have the same doctor operate. Revision rhinoplasty is extremely difficult operation, and your surgeon has probably proven satisfactorily that he might not be up to this job.  Also, you must have realistic expectations. It's too late to end up with a stunning gorgeous nose -- you should be seeking a nose that looks natural and does not draw attention, and then leave it alone forever!

Link to this question on RealSelf.com