Q: Dr. Eppley, My rhinoplasty questions are the following :

-Would my case be done with open or closed rhinoplasty?

-I think the tip is a very prominent part of the face and Im scared about the tip looking stitched or asymmetric. Is it possible to deproject the nose  without touching the tip with the surgical knife? With tip I mean the part that is colored in pink in the photo “tip photo”.

-Which are the chances that a second surgery would be needed?

-Is it possible to achieve a reduction like the modified photo compared to the original photo?

-Would it be necessary in my case a graft in the tip or in another part?In which part? 

A: Thank you for your inquiry. Unfortunately all of your pictures dd not come through so I can not make an assessment of how realistic an imaging or ideal goals are. But to answer your specific rhinoplasty questions:

1) Am open rhinoplasty approach is needed. Deprojecting any nose is not a rhinoplasty technique that lends itself to favorable closed rhinoplasty results.

2) I do not know what you mean by ‘deprojecting the tip without touching it with a knife’. That statement is an oxymoron as only surgery can change the projection of the tip of the nose.

3) With most forms of tip modification it is almost always best to at least place a columellar strut graft to maintain the shape and projection of the reshaped tip.

4) The general revision rate in rhinoplasty averages around 15% but that number is influenced by what type of rhinoplasty or nasal shape changes are being done.

Dr. Barry Eppley

Indianapolis, Indiana