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The lateral view of my nose is annoying me, because the cartilaginous part of the nose looks protruded.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 30 August 2012


I have done an open tip rhinoplasty 5 months ago.

The reason for the surgery was that I had a mid-line shadow in my nose tip, and I wanted it just to disappear. Otherwise, I don't want any change in my nose.

My plastic surgeon told me that all I may need is an inter-domal suture, and after he has done the surgery he told me that the two cartilages were positioned apart and he needed to approximate them by almost 4 mm.

Now I'm 5 months post-op and my front view is very acceptable (although there become a little upward direction of the tip that I didn't prefer, but I accepted it and it's ok).

But the lateral view of my nose is annoying me, because the cartilaginous part of the nose looks protruded as a whole compared to the upper osseous part of my nose.

It looks like that the whole cartilaginous part is moved anteriorly and slightly superiorly, with the columellar part also moved a little inferiorly.

I would like to know what possibly caused this in your opinion doctor. Is it over-correction or let's say over-tightening of the inter-domal suture, or could it be the position of the suture was seated too anterior or something like that, or the vertical extent of the suture was elongated more than it should be, or may be I just must wait another five months to judge.

Before the surgery I asked my surgeon not to cut any part of the cartilages, neither to add any type of sutures other than the suture between the two domes.

I told him that I only want the vertical shadowing line to disappear, I want no other change in my nose at all, is it this request that limited my surgeon ability to do a goad tip refinement surgery, or my request was logical but the surgery wasn't done well enough. In other words, dr. Lucian do you recommend for me to keep following up with my surgeon or to look for another one.

I really don't know what to do, and I am afraid that the surgery which I have done will lead to a series of problems.


It is impossible to give detailed advice on the basis of descriptions of the shape of the nose, as opposed to the examination during the consultation. Photographic information can help a little bit more, but ultimately nothing is as accurate as the consultation.

In order to plan for further surgery, certainly you would be looking at a longer period of time to allow suitable time for healing, and I normally suggest a preparation using computer simulation, for more structured management plan that integrates several of the concerns that you have.

I cannot advise you regarding maintaining or changing your surgeon, this would be unethical on my part.

Lucian Ion Cosmetic Surgeon Mr Lucian Ion FRCS(Plast)
129 Harley Street

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