When performed judiciously, alar base modification should have no effect on breathing. Typically the sensation of nasal obstruction or flow is most easily affected at an area referred to as the “nasal valve”, which should not be affected by alar base modification. Another way to explain this is that since the inlet of the nostrils – where the alar base modification occurs – is not the bottleneck to airflow, judicious narrowing of it will not compromise breathing.
The amount of swelling (edema) that develops post-operatively is rarely symmetric. Give yourself and your eyes time to heal and for the swelling to resolve, and try not to over-analyze things until you reach your final result.
A number of different surgical techniques are available to increase the projection and the refinement (pointiness) of your tip. Conservative excision of cartilage in the tip of your nose, and suture techniques can be used to increase the refinement in your tip. In addition, cartilage grafts (pieces of cartilage from your own body carved into specific shapes) can be used to increase the projection of your tip and change the shape of it.
Changing the projection and shape of the tip can alter the proportions of the nostrils and the base of the nostrils, and sometimes modification or narrowing of the bases is necessary to restore the appropriate balance.
For an entire year after your surgery, your nose is continuing to heal and take on its final appearance. During that period of healing, it’s not unusual to see your nose fluctuate in size and the amount of swelling. You manipulated your nose quite vigorously, so that is the most likely explanation for the sudden increase in swelling. It’s unlikely that at 4 months out cartilage would have been displaced, but also a possibility. Give the swelling some time to settle down before you start worrying about cartilage shifting, and try to be more gentle blowing and picking your nose.
L-shaped silicone implants are a quick and easy way to get a more projected (taller), more refined nose. The problem that you are starting to encounter is a common one for many patients that have rhinoplasty with an L-shaped implant. Unfortunately there is a risk of extrusion and infection of the implant. When the skin overlying the implant thins to the point of extrusion, it must be removed asap. In your situation, there’s no need to panic since that has not happened, but the best option is to replace the silicone implant with your own tissue. You will be able to achieve the shape you want, without people noticing you had work done.
The way to ensure the safety of any surgical procedure, especially an elective cosmetic one, is to make sure you have an appropriate medical clearance and/or cardiology clearance, and that your surgeon operates at an AAAHC accredited surgery center with experienced, board-certified anesthesiologists. Your BMI alone does not preclude you from having a safe surgery and normal post-operative recovery.
Alcohol, strenuous activity, flying, high altitudes, hot weather – basically anything that increases the blood supply to your nose, can increase the amount it swells. Don’t worry though, no permanent damage done. Your nose took a step back in terms of how long it will take the edema (swelling) to resolve, but it eventually will.
Q: Hi I had a rhinoplasty done with rib cartilage to lengthen my nose as well as to sharpen the nose tip. I feel my nose tip can be slightly sharper. Is it possible to use more rib cartilage to sharpen it?
A: Are you 2 years out from your rhinoplasty with rib cartilage? If not, give it a full two years to see if the tip becomes “sharper” as it heals.
If you are more than 2 years out, then certainly things can be done to create more tip definition. You may or may not need rib cartilage as there may be sufficient cartilage in your septum or ear to provide graft material for your tip. Keep in mind also, that the thickness of your skin may also limit the degree of definition you will be able to achieve.
Q: My surgeon reduced my tip making my profile smaller, and thinned the bridge of my nose a little bit, I had internal and external splints, a little after 2 weeks I began to feel a bump on the right side of my bridge, below my eye. I do not understand, I never even had one their before, it doesn’t go when pressed carefully. When I feel it, their is more prominence on my right side however I can feel its slightly raised nearly to the other side. Will it get bigger and will it go? I feel so anxious 🙁
A: It could be cartilage or bone, but unfortunately without examining you it is impossible to guess which. In this situation your surgeon will be in the best position to provide you with an accurate answer.
Q: First Rhinoplasty: 10 months ago. Main concern: hump but bridge was narrowed, cartilage removed from tip and lifted. Had to go back in March as I developed a huge hump on the side where original hump was removed – nose looked crooked. After second surgery still a hump – it feels like cartilage and not happy with tip. Also have a lot of scar tissue. Afraid to go back to original surgeon. Rhinoplasty revision specialist here in SA doesn’t want to operate ever – What to I do? – Can’t accept my nose!
A: Seek other revisions rhinoplasty specialists and get another opinion. Many offer Skype consults to make it easier for you to have an initial visit.
