Q: Dr. Eppley, I am interested in a revision rhinoplasty. I did my first rhinoplasty surgery because I didn’t like my nose tip it was a little bit to large for my nose, but that was the only aspect of my nose that I disliked and wanted changed. The doctor said that he could make the tip a little bit less large but he also said that he would need to take 1 mm of my nose bridge to take the hump out (that I didn’t have too much) and with that my tip would be raised 1 mm too because he would change my hump I asked him to just do the tip but he said that it would be better. So I agreed, but after my surgery I noticed that he took way more then 1mm of my bridge and raised way too much my tip. Now my nose has a C shape and my tip is too high. I want my bridge raised again to the previous shape and to add more length to my nose as it was before the surgery. Would that be possible? I don’t think that my tip needs anymore change I was want it to look less upturned.Thank you so much in advance. Please see the pictures attached.
A: Thank you for sending your pictures and providing your rhinoplasty history. If I understand your goals now, you would like some bridge augmentation and the nasal tip brought back down. (derotated) Both of these can be achieved by onlay cartilage grafting of the bridge and the infralobular tip area. Assuming your septum was not harvested during your initial rhinoplasty you have adequate graft material to accomplish both nose reshaping goals.
Dr. Barry Eppley