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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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Questioner:
Is There Hope for Another Revision Rhinoplasty?
I had a revision rhinoplasty to fix my deviated septum. I wanted to keep the shape and size and only fix the deviation. A graft was placed (not from my body) but I was surprised that now my nose appears to have bad scar tissue, resulting in a "no shape" and bulbous nose. Could another revision fix my nose, for the last time? Or, will scar tissue keep forming? Can my nose be slimmed and defined? I live in Saudi, but I'm considering a revision in the states. Is there any surgeon you recommend?
(Questioner submitted photos)
Dr. Denenberg's answer: Removing scar tissue to give definition to the nose can be difficult
While it's true that some scar tissue will always form after any operation, the question is whether your scar tissue can be carved enough to give a meaningful improvement despite the new scar that can form. Sometimes the cartilages can still be modified to help with narrowing and defining, or adjusting or removing the graft could help. Could you post larger photos, taken from many angles, and also let us know where the graft sits? That would help.
Link to this question on RealSelf.com
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