Need Advise on Bluish Nasal Tip After Repeated Rhinoplasties, Options?

The bluish skin discoloration is most likely due to changes in the blood supply to your nasal tip skin from your many prior surgeries. I doubt that the tip graft itself is causing the problem and certainly removing it wouldn't be expected to improve the problem -- only make it worse potentially.

Dear Jessica;

What you have is a skin problem.  Often when the skin has been operated on four times, as in your case, there is a change in the blood supply.  It sounds like you have had Nature deliver somewhat of an excess of veins, and therefore blood is pooling in the tip of your nose.  That would give it the blue color.  I doubt if removing the tip graft is the answer. 

My suggestion is that you see a cosmetic dermatologist.  See if the dermatologist agrees that your major problem is now the nature of your skin and not the underlying structure that has been changed by the rhinoplasty.  Then, if in fact that is the case, you should return to your last rhinoplasty surgeon and discuss with him the recommendations of the dermatologist or, even better, have the dermatologist speak with your surgeon. 

Based on what you tell me, and particularly since “it becomes much worse when I get a cold,” hopefully you now realize that what you have is a consequence of the surgery, which another surgery would have no hope of correcting. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

This may be a sign of poor vascularity which puts you at extremely high risk for skin necrosis with further procedures. Be careful. Don't take going for more surgeries casually.