Hey, I would like to know how to communicate this to my surgeon on my last meeting before my surgery. I drew pictures to explain. I want to say " I want the bottom part of the tip smooth" but i am not sure how to word it. Or if their is a specific name for it. The first one is what I have The second one is what I want This is a profile view I am getting the bulbous tip done and I want the bottom to be smoothed out too and not bulbous. Thanks to anyone who answers. It's much appreciated.
Doctor Answers (10)
Nasal cartilage irregularity
A bump in the portion of the nose that you have indicated is usually due to an irregularity of the lower lateral cartilage. There are many ways to smooth this out surgically including suture techniques and cartilage grafting. Just point out your concern to your surgeon so that it can be addressed at the time of your operation.
- You are referring to the infratip lobule (the curve underneath the tip), and the columella (the bridge of skin between the 2 nostrils)
- That should help you talk to your surgeon about what you want
The anatomical component in the drawing is considered a columella. The columella can be made more smooth by trimming back a portion of the membranous and cartilaginous columella, which can all be done from the inside of the nose. This is also known as a columella-plasty. Trimming the columella will not make the tip look any more bulbous.
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this is the infratip lobule. You can point this out to your surgeon and discuss your goals for its appearance on lateral view with him/her.
You are pointing to the infratip lobule area. There are many special maneuvers we perform to obtain results for patients. You need to make sure you voice your concerns and even point them out before your surgery because this is the most important step in order to obtain the result you are looking for. Clear communication is key!!!
It seems that you are referring to the infratip area/columella. The best way to explain it to your surgeon though is to point out the area as you are being examined.
The best way to describe what you are bothered by is to show yoru doctor in person. It sounds like you are bothered by something with regards to the tip columella region.
Columella changes with Rhinoplasty
The columella is typically addressed in rhinoplasty surgery especially when the columella is "hanging". Discuss this with your surgeon. If your surgeon uses digital imaging he/she should be able to show you the proposed surgical result so that you may discuss this during your final preoperative appointment. Best regards, Michael V. Elam, M.D.
Web reference: http://www.michaelelammd.com
Your picture shows a drooping tip where the infratip lobule is below the columella. This is not a bottom bulbous tip. This is due to lack of support for the cartilages that make up the tip, so gravity pulls them and the soft tissue down. A bulbous tip is due to the size of cartilages of the tip and to a lesser extent the thickness of the soft tissue. Correcting a bulbous tip will not affect a drooping tip and vice versa. Like a big hump, bulbous tip, or twisted dorsum, correction of a drooping tip is one of those things that a basic rhinoplasty should address unless the patient specifically wants to retain them. I actually have a list of these things that I have my patients fill out if they want to preserve any of them. Just let your surgeon know you do not want a drooping tip and he/she will know what you mean.
Drooping Tip or Hanging Columella
If have a drooping tip or hanging columella, the surgeon should be able to address either of those during rhinoplasty.
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.
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