What Can A Revisional Rhinoplasty Do To Improve My Nose?
Q: Dr. Eppley, I had a rhinoplasty two years ago of which I am not happy with the result. My nose now looks too feminine. It is upturned rather than long like I wanted it and the bridge of my nose seems too low now. The tip of my nose is still too wide and I see too much nostril now. I know that revisional rhinoplasty is difficult and my option are limited at this point. But what do you recommend as I trust your judgment. I have attached some pictures for your review and comments.
A: While I do not have the advantage of see what your nose looked like before, I can tell that you had a rhinoplasty and I see several improveable problems. First, the tip is overrotated superiorly, making the nose look short and giving it the false impression that the nasal bridge is low. Secondly there is alar rim retraction probably caused by lack of support from the lower alar cartilages from too much cephalic trim and/or as part of the tip overrotation. These conditions could all be improved by a secondary rhinoplasty which will require septal cartilage grafts to support tip derotation/lengthening, batten grafts for lower alar cartrilage support as well as alar rim grafts for nostril rim lowering. With your thick nasal skin, there is a limit as to how much tip narrowing you can achieve and you may have already reached the best that you can do.
Dr. Barry Eppley