Will Tip Rhinoplasty Cause Imbalance with Dorsal Hump?

While you could add tip support (to avoid retraction with smiling) with a minimal change to tip aesthetics by using a columellar strut alone, Aesthetic results would be nicer with a subtle change to tip dynamics and dorsal reduction. If you do not want to address the dorsum, a sinmple columellar strut and elevation of the lower lateral cartilages should suit you well. All the best, Rian A. Maercks M.D.

Performing a tip plasty will change the dorsal aesthetic line of the nose. It is a three-dimensional structure, and when changed, it also alters the relationships with the nasal bridge. If there is a hump present, it is probably best to perform a full rhinoplasty rather than just a tip plasty to make sure that the nose is in complete balance with itself and your face.

It appears you have a small dorsal hump. While purists would recommend hump removal, over the years I've had male patients request that the dorsum not be changed. I've done just the tip and achieved a very nice result. The ideal profile for a man is a straight dorsum or a slight convexity. Make your preferences clear at the time of consultation.

Hi, Most noses need a full rhinoplasty. However, your nose, as seen on the photo, does not and will do fine with a tipplasty ( surgery of the tip). You should have your plastic surgeon perform computer digital imaging so that you can get an idea of what your nose will look like after the surgery. Best of Luck, Dr.S.

As a plastic surgeon, we all look to strive for perfection. Although rarely if ever do we achieve it. With this in mind we personally like to fix things based upon our own aesthetic eye. If you are happy with a small dorsal hump, then you certainly do not need to correct it. A tip rhinoplasty is certainly acceptable and can be done without touching the dorsum

I would not necessarily describe your tip as drooping. However, I do agree that it does seem to project excessively. Reducing tip projection will create the illusion of a larger hump and even a "polly or suprtip" deformity. It is my impression that any treatment of the tip will likely require a comparable reduction in the dorsal hump.

Hi Nasal Tip in Conn, I would try to honor your desire to keep your hump with the added stipulation that at the time of surgery after you tip is corrected possibly more may need to done to keep your nose in balance. Best to have in person rhinoplasty consultations with experienced surgeons to get an idea of what would work best for you. Good luck and be well. Dr. P

You have submitted a single picture without lateral view. From the limited views it is hard to give a good recommendation. Your doctor can give you a better answer. The other option is to have an evaluation by a plastic surgeon who offers computer image morphing. This can be very helpful to see how the tip surgery will effect the bridge. I been using imaging for the last 12 years for the rhinoplasty and it been very predictable and helpful.

Tip rhinoplasty alone can be a very satisfying procedure. I do not believe that every patient requires their entire nose to be operated on to achieve a satisfactory result. In fact, looking at your photo if you are happy with the width of your nose and having a small bump doesn't bother you, then you can have a very satisfactory result by just operating on the tip. In fact, most of my patients want a natural result to their nose and only want minor alterations. While it is clear if you have... more

In my experiencein 30 years seeing post op. rhinopolasty patients as a 2nd opinion it often ends in patient dissatisfaction. Even when the bridge is slightly promenent it usually becomes more promenent and dysharmonious after tip plasty Every case has subtle differences and considerations. What can be done digitally cannot always be carried out surgically. It would be best if you were prepaired to have bridge work" if yoursurgeon feels it is necessary during surgery.My patients have... more

You are correct in questioning whether modifying the tip can create changes in how the height of the profile is perceived. There is a relative balance between the different areas of the nose that has to be considered in any corrective procedure. From the limited view you sent, it seems like you have a little extra volume in the tip cartilages, but potentially nice central tip (also called the domal region) contours. Reduction in nasal tip movement when you smile can be accomplished by... more

The tip can be altered alone. In your case the hump is so subtle that just rasping it alone should give the desired change. That means your tip rhinoplasty will not cause any imbalance of the upper 2/3 of the nose. However, it is important for you to realize that sometimes during rhinoplasty as a surgeon you may find that the initial judgement was inaccurate and you have to adjust other areas of the nose to maintain the harmony. You should be prepared for that and discuss it with your... more

Hi, Great question. In all likelihood, any maneuver which elevates or reduces your nasal tip will diminish your nasal length - if the small dorsal hump isn't reduced, it has the very real possibility of looking larger. Although it's absolute size will not have changed, in a shorter nose, it will give the illusion of a larger hump. Hope this helps. Best of luck.