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World’s Best Rhinoplasty Q and A by Dr Francis Palmer

Dr Francis Palmer, world renowned Beverly Hills Plastic and Cosmetic Surgeon, voted one of the “World’s Best” plastic and cosmetic surgeons by Tatler Magazine answers Rhinoplasty Questions. Rhinoplasty Question: I had rhinoplasty 10 days ago, performed elsewhere to have my nose straightened, the tip raised and fix the hanging columella. During the Rhinoplasty, the alar base reduction was was also done. After surgery I was told my septum was broken so that section was removed. Right after the splint removal I noticed my asymmetric nostrils and my columella was short, felt tight, and pulled to the left. I know I’m swollen so I’m trying to be patient, but could the improvement over time be dramatic enough to make a difference? Dr Francis Palmer’s Answer: While 10 days post Rhinoplasty is incredibly early to evaluate the results of a Rhinoplasty, it’s unusual for a pulled nostril to change that shape during the post op healing phase without intervention.  This could be as simple as daily manipulation of the nostril to stop the stretching laterally (to the side).  This should only be undertaken with the express consent of your Rhinoplasty Surgeon as you are under his/her post Rhinoplasty care at this early post Rhinoplasty stage.  Hope this helps. Rhinoplasty Question: Hi I am considering revision rhinoplasty to lengthen an overly shortened nose. My concerns are whether in the experience of the Doctor’s on Realself this is a realistically succesful procedure. For instance I’ve had consults and done as much of my own research as I can and what seems evident to me is that even in the hands of the most experienced surgeon that this is a challenging corrective surgery. My fear is that something I’m already unhappy with will be made worse. Dr Francis Palmer’s Answer: You have made the correct assessment of the situation.  Photos, of your nose would help in the evaluation but lengthening the nose is indeed more complicated than shortening it with Revision Rhinoplasty.  Conchal ear cartilage placed along the nasal tip makes the nose appear longer/tip less over-rotated but this often needs to be combined with tucking of the columella.  Rib cartilage grafts are way to stiff for this region of the nose in my opinion.