Pay attention to the white dots on the tip of the nose and to the more subtle
highlights on the nose in between her eyes. Those dots and highlights are
reflections from the flash. The white dots on the tip are
just a bit higher in position in the after picture, indicating that the tip of the nose was
elevated during surgery.
In the after picture, the white highlights on her nose between her eyes flow
down onto the nose a small distance, allowing you to see that her nose is narrow
in the mid-dorsum. In the before picture, you see less of those
highlights flowing down the nose, because the before nose is wider and less
The base view of her nose, view 9,
also illustrates the narrowing of her nose quite well.
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Can this nose be fixed?
I need a seriously talented surgeon to do my third and hopefully final rhinoplasty. I need a grand slam and I will travel anywhere if I can find a surgeon who can perform these multiple techniques. I need someone who can: 1. Decrease nostril width 2. Decrease projection 3. Tip reconstruction using donor cartilage 4. Lengthening of the nose I don't see raising the bridge as the solution to avoiding having to decrease projection. Referrals welcomed also.
(Questioner submitted photos)
Dr. Denenberg's answer: You may not need all of the techniques/changes that you listed
First of all, I agree that, from these photos at least, it's not at all clear that you need to have your bridge raised. The "profile" shot isn't really a profile, because the camera is too high and is looking down at your face, but it appears that the tip of your nose has very strong projection, and bringing the tip substantially back closer to your face will make the relationship between the tip and the bridge much better, without raising the bridge.
Then, a significant de-projection of the tip often can make the nose *appear* longer, so you might not need as much lengthening as you thing you might.
It's also not clear that you'd need donor cartilage to help the tip. Often, even after previous surgery, modifying the cartilage that is still there is all that is needed.
See the attached video and Web reference links for some ideas.
If we had a pure profile, maybe a morph could be make to illustrate how deprojecting the tip also helps both the bridge and the length.
Link to this question on RealSelf.com