Question: Should my nasal bone be rasped down or do I need an osteotomy since I can feel the bone protruding?
Answer: It is very difficult to tell from the photographs what needs to be accomplished for the revision rhinoplasty procedure. If there’s a small dorsal hump, this can be shaved down. If the bone itself is drifted outwards, then an osteotomy is going to be performed. This can be accomplished with a closed rhinoplasty approach with all incisions placed on the inside of the nose. Revision rhinoplasty is more difficult than a primary rhinoplasty, therefore an in-person examination going to be required.

Question: Is there any way to lift the bottom of my nose (septum) as it hangs really low?
Answer: A full set of facial/nasal photographs are required from all angles to make a determination about how best to proceed. If you’re talking about a hanging caudal septum, this can be reduced with a columella-plasty. It’s also important to release the depressor septi ligament which pulls the tip down when smiling. For before and after rhinoplasty many examples, please see the link and the video below.

Question: Rhinoplasty or chin implant? What do you think would make the most positive impact?
Answer: The photographs demonstrate an overly projecting nose with the dorsal hump, and a recessive chin profile. A closed rhinoplasty procedure can accomplish Shaving down the dorsal hump, refining the nasal tip, and narrowing the bridge line with all the incisions placed on the inside of the nose. Consider placement of a chin implant to augment the chin forward for better facial balance and proportions, especially from the side profile with respect to the overly projecting nose. Both procedures can be performed together or separately. Perform the procedure for the issue that’s bothering you the most, whether it’s the chin or the nose.

Question: One year after rhinoplasty supratip is still puffy and right side of nose is more defined then the other. How can I tighten it?
Answer: From the photographs presented, it appears that there’s thick skin in the tip and the supratip area of the nose. Consider going back to your original surgeon for steroid shots to be placed in the supratip area for better refinement. Try taping at night as well.

Question: Is it possible to get my nose similar to the picture posted?
Answer: Revision rhinoplasty is more difficult than a primary rhinoplasty, due to the fact that there’s been previous alterations the normal anatomy and scar tissue formation. It is very important to have realistic expectations about what can and cannot be accomplished with the procedure. The small dorsal hump it’s present can be shaved down, and the hanging columella reduced. And in-person examination is going be required to make a determination about how much de-rotation can be accomplished with the procedure. Consider a chin implant to augment the chin forward to help with facial balance and proportions, especially with respect to the projection of the nose from the side profile.

Question: What procedures are best to enhance my overall looks? I certainly want sharper and slimmer face.
Answer: The photographs from the side profile demonstrate an overly projecting nose, and an under projecting chin. Consider the combination of rhinoplasty performed with a chin implant for better facial balance and proportions.

Question: How can I correct my bulbous tip without creating a more upward turned nose?
Answer: Suture techniques and conservative cartilage reduction can accomplish reduction in the bulbous nasal tip. Rhinoplasty is a very difficult endeavor, so choose your surgeon wisely based on extensive experience.

Question: What kind of surgery can make my face look better?
Answer: In the plastic surgery business, we usually ask the patient what is bothering them the most. From the limited photographs presented, there appears to be a nose that’s slightly out of proportion for the rest of your facial features. Consider a closed rhinoplasty approach to refine the wide tip and the bridge line. A full set of pictures and all angles of the face are going to be required to make a determination about how best to proceed.

Question: Nasal implant (gore tex) extrusion, will it happen again with the revision?
Answer: In our practice, we do not recommend Gore-Tex implant to the nose due to the fact that it has a high propensity for infection and extrusion. It is probably best to wait at least 1 year before undergoing a revision rhinoplasty with cartilage grafting to build up the bridge of her nose. Cartilage grafting techniques have a much lower incidence of infection, and also best to be on antibiotics for a revision rhinoplasty.

Question: One of my side of nose is indented and weaker, is it fixable and how?
Answer: The area that you’re describing on the nose is an inverted upper lateral cartilage is best treated with a spreader graft composed of the patient’s own cartilage. An onlay graft may also be required for the inverted concave cartilage in the tip area. The dorsal hump can also be removed and that bridge line straightened and narrowed with osteotomy’s. All this can be accomplished with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required. For many before-and-after examples, please see the link and the video below.