Repair of the pinched nasal tip is one of the most challenging cases in the world of rhinoplasty, or nasal reshaping. Below is a case example of a San Diego patient who had prior unsuccessful rhinoplasty performed by a different rhinoplasty surgeon. She was, unfortunately, left with a severely pinched nasal tip as seen below. In addition to her cosmetic nose concerns, she had a significant problem with breathing through her nose as one might expect. When I first met this patient, I was actually quite concerned about taking her on as a patient despite my extensive experience as a revision rhinoplasty expert. After very careful inspection of her nose and meticulous surgical planning, I decided to perform her revision rhinoplasty using an open approach. In addition, I used a variety of structural cartilage grafts to reshape the nose. Much of this was required to rebuild the structural support of the nasal tip. One of the most difficult aspects of her revision rhinoplasty procedure was elevation of her skin around the actual tip of the nose. As you can imagine from looking at her before photo below, the skin was quite scarred down to the underlying cartilage as a result of the prior rhinoplasty surgery. After very meticulous surgical dissection, I was able to expose her nasal tip sufficiently to place the cartilage grafts. Once this was accomplished, I ended up using temporal fascia grafting to bolster the nasal tip skin and provide a more natural rounded contour. The end result of her secondary rhinoplasty procedure can be seen below. The final result after one year shows a much more natural looking nose. This includes a softer shape from the nasal tip out to the sides of the nose. In addition, her nose functioned much better following the revision rhinoplasty where the support of the nasal tip was reinforced. If you have a pinched nasal tip and are considering revision rhinoplasty, give our office a call today and take advantage of our extensive expertise in revision rhinoplasty.