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Are There Less Possible Complications with Tiplasty Vs. Full Rhinoplasty?

If I just want to upturn the tip and all I need is a graft to add support to tip, is there less chance for complicatoins (crooked tip, uneven nostrils) vs. having to reshape tip and lessen the size through a full rhinoplasty?

I dont want to change the shape or size of tip only want to rotate the tip upwards because I have read some horror stories on this site! Also what are the pros and cons of cutting the depressor nasi septi muscle?

Doctor Answers (18)

Complications with tiplasty vs. full rhinoplasty

+2

Frank,

A "FULL" rhinoplasty is more involved than a "TIP" rhinoplasty and as such there are potentially more things that "can go wrong". (Similar to the difference between painting a room over an existing coat of paint VS. installing new Sheetrock walls, plastering them and then painting..)

That being said - rhinoplasty is the MOST individually customized operation in plastic surgery where YOU need to determine what bothers you, just how much does it bother you and then discuss and plan with your plastic surgeon what surgical options (and potential complications) may need to be done and accepted.

If ALL you want is a tip procedure - by all means, ask your surgeon if he/she thinks a tip procedure by itself would get you what you need. Sometimes it is possible, in other cases, depending on the nose, a more involved procedure may be needed.

Good Luck.


Memphis Plastic Surgeon
5.0 out of 5 stars 62 reviews

Tip only versus full rhinoplasty

+2
I would suggest choosing a surgeon with whom you are comfortable. Explain to the rhinoplasty surgeon what issues you have with your nose and which features you are entirely comfortable with. The surgeon should be able to show you, possibly with computer imaging software, the changes you are seeking to your nose and how they will impact the rest of your nose. You may decide that other changes would also look nice.

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Tip vs full rhinoplasty

+2

I wish I could tell you that there was a big difference between the tip vs the full rhinoplasty but there really isn't. They are both very involved. You seem to want to minimize the technical difficulty of what you want (ie. "all I need is...) and you shouldn't underestimate the technical steps involved in a tip rhinoplasty. Make sure you go to a surgeon with extensive rhinoplasty experience. Dr. Cochran in Dallas who answers many rhinoplasty questions on RealSelf is an outstanding surgeon who specializes in this kind of work. You might do very well by visiting him.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 49 reviews

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Rhinoplasty, Beverly Hills Rhinoplasty, Nasal Refinement, Nose Job, Closed Rhinoplasty, Open Rhinoplasty.

+1

 I have performed Rhinoplasty and Tip Plasty Surgery for over 20 years.  The nasal tip can be rotated upward by trimming the superior (top) aspect of the anterior septal angle and placing a permanent suture to rotate the tip.  This is a simple, yet highly effective, procedure that I have performed many times.  If all you want is the same shaped tip just rotated up, that would be my recommendation.  If however, you would like the nasal tip more refined, you could combine the aforementioned technique with a Closed Tip Plasty.

  Closed , not Open, Tip Plasty is a limited procedure with less tissue dissection, bruising and swelling than a full Rhinoplasty so the healing and recovery time should be less.  I have performed Closed Tip Plasty using a retrograde tip technique where the patients have returned to work ( some actors) several days later due to the limited dissection with this technique.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Tip plasty and full rhinoplasty

+1

The cutting of the nasi septi muscle is of no consequence other than to prevent the tip of the nose from drooping down when smiling. We cut that muscle frequently when needed. It is important if you are only having the tip plasty performed that it is going to balance with the remainder of the nose. Very few noses fall into this category, most of the time a full rhinoplasty has to be entertained.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Rhinoplasty complications

+1

Complications can occur with all surgeries. However, the procedures you asked about: full rhinoplasty vs tip plasty, historically have very low complication rates.

Depending on how severe your problem is, you might not even need tip cartilage grafts which you mentioned. Frequently, a minor trim and loosening of the skin around the tip is all that may be needed.

Remember, the most important part of getting a good result from plastic surgery, is the surgeon that you choose. Fees vary depending on the level of expertise, so choose wisely.

Darrick E. Antell, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Complication risks may be lower with tiplasty

+1

Just adding a columellar strut or plumping grafts adds less complications than a full rhinoplasty. The less you do, the less risk of complications. I rarely cut the depressor nasi septi muscle unless the patient and I discuss the risks first since it can lower the upper lip and show less teeth especially when smiling. Thank you.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 32 reviews

Complication rates are low...

+1

for both surgeries. However, in general, the more invasive and prolonged a surgery, the greater risks. So in that sense, a tip plasty would carry less risk than a full rhinoplasty. The specific risks that you cite, crooked tip and uneven nostrils, are probably the same for both procedures since a tip plasty alone still involves dissection, suturing and scarring around the tip.

The depressor septi muscle can indeed be surgically defunctionalized. There is no con to losing the function of this muscle, as it probably represents a vestigial remnant of a muscle that we used to shake insects off our noses in neanderthal days. However (again), to cut the muscle requires surgical dissection at the base of the nose with its attendant risks, e.g. scarring. You can experience the effect by having Botox or Dysport injected into the muscle to paralyze it (off FDA label use). Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

Tip only or full rhinoplasty, complications are few

+1

Certainly when considering rhinoplasty or nasal shaping, changes are only made where necessary, and for some a tip only rhinoplasty will produce very nice results. For a majority of patients however a full rhinoplasty will be needed to keep the whole result in balance. Any change in the tip as far as projection, rotation, or width, can affect the appearance of the rest of the nose and may limit the overall result. It is best to work closely with your surgeon, photo simulation can be very helpful, and if it is possible to alter just the tip all the better, though complications do not increase if full rhinoplasty is necessary. The complications of rhinoplasty are few, and often the greatest 'complication' is an unsatisfied patient. As surgeons, it is important to know what our patients expect, and know through experience that the changes represent a realistic outcome.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 29 reviews

Tip plasty versus full rhinoplasty

+1

The effect of cutting the depressor nasi septi muscle can be simulated with injection of Botox. You may want to try this as it is the easiest way to "check it out". If you like the result, you could consider surgical options for a longer lasting result.

Yes a tip graft would be easier but it is does not guarantee that the graft will not rotate, warp, extrude, encapsulate, become infected or resorb. No surgery is without risk. However, it is a less invasive operation when compared to a full open rhinoplasty.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.