Revision Rhinoplasty Experts in Beverly Hills

A scooped-out profile is probably one of the most common problems we see after rhinoplasty. It usually occurs after routine reduction rhinoplasty when there was a bump on the bridge that was shaved down too much. This is particularly problematic when this occurs in men, as it is a feminizing feature.

A pollybeak deformity refers to a nose in which the area just above the tip is too full. When it is very full, it can make the nose look down-turned like a parrot’s beak, thus the name. Normally, there should be a little dip or depression just above your nasal tip that defines the transition from your bridge to your tip on profile. In a woman, that little dip is a feminizing feature.

A frequent problem after an overaggressive rhinoplasty is a tip that becomes distorted and lacking in support. This usually happens when too much of the tip cartilages are removed in trying to narrow and refine the tip. Instead, you just end up with a tip that is unstable. We have lumped these 3 rhinoplasty surgery problems together because they often occur together after a rhinoplasty in which the tip cartilages collapsed.

A frequent mistake seen after primary rhinoplasty surgery is a persistently over-projected tip. This means that the nasal tip still appears to stick out too far from your face. There are two reasons that this mistake is so common:

The first reason is that many rhinoplasty surgery patients are initially more concerned about their bump than anything else and are happy if the bump is all that is removed. Afterward, many patients realize that the tip still appears too prominent. The second reason is that technical maneuvers to reduce the nasal tip’s projection are more sophisticated. Many rhinoplasty surgeons were never trained in these maneuvers and simply do not perform them. Many surgeons have tried in the past but have experienced problems and now choose to avoid deprojecting the tip.

Think of the tip cartilages like a pair of wings. You can get an idea of what these look like from the rhinoplasty photos below. The cartilages are like a bent spring that hold the nostril’s shape, keeping it open to allow for normal breathing.

In many poorly done rhinoplasty surgeries, this cartilage is aggressively cut or removed so that it loses this natural spring. Over time, whatever cartilage is left starts to bend and twist under the weight of the skin. As the cartilage twists on itself, the weak points at the ‘joints’ of this cartilage can start to form bumps or knuckles, called bossae, that are very noticeable through the skin. Check out the diagram below to see what we mean.

There are two types of nasal valve collapses. The collapse of the tip cartilages described above can cause external valve collapse where the blockage is just past the nostril. However, when most rhinoplasty surgeons discuss valve collapse they are talking about internal valve collapse. This occurs when the upper lateral cartilages in the middle of the nose have been too narrowed. Take a look at the attached diagram to see where these are. This problem happens when a nasal bump is taken down too much and when the

The nasal bones are not so much like a pyramid but more like an arched covered bridge or tunnel. When a bump is made smaller, the top of the bones is shaved or cut shorter to reduce the bump. This leaves an opening in the roof of the bridge. That’s one of the reasons why we have to cut the base of the bones during rhinoplasty surgery (called osteotomies). We perform osteotomies in order to push the bones inward towards each other so that this opening can be closed.

The final rhinoplasty surgery mistake and problem we discuss is the twisted nose. A twist in the nose can happen anywhere from the nasal bones to the middle third of the nose and down to the tip. Getting a nose completely and perfectly straight is one of the hardest things to do in rhinoplasty and is especially hard in revision rhinoplasty. That is why you need to see an experienced rhinoplasty specialist like the Los Angeles rhinoplasty surgeons at Beverly Hills PROFILES.