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Correcting Nose to Lip Angle and Bulbous Tip

asked 2 years ago by neyhaa in india
Latest answer by Rian Maercks, MD
Question viewed 1,663 times
Tags: lips, nose, bulbous, septum, skin, tip

How to correct acute nose to lip angle and bulbous tip at same time? My nose and lip angle is approximately 70 degrees and I have a bulbous tip with a large base. I am an Indian so I have thick skin, I guess.

What would be the best possible way of correcting all the 3 faults together, while keeping in mind the skin thickness? Can nose to lip angle change only by trimming the septum or is there any other way to do so?

15 answers to Correcting Nose to Lip Angle and Bulbous Tip

Correcting Nasolabial Angle and Bulbous Tip

Rather than self-diagnosis, and then studying all the various techniques and combinations of techniques, see a rhinoplasty surgeon who will examine your nose and make suggestions based on his/her experience. After the evaluation ask that physician about alternatives, with the advantages and disadvantages of each. You may want to get more than one consultation. Then you can make an educated decision.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Ways to correct nose to lip angle and bulbous tip

The bulbous tip can be addressed through a full delivery technique. Suturing of the dome to the lower lateral cartilages can be performed with the possible addition of a cartilaginous strut graft if needed for support. Any large, wide nostrils can be address through Weir alar-based excisions if needed. Thick, olive, oily skin will need Kenalog shots in the supratip area starting at the time of surgery and during the first, second, and third month following surgery. Any type of acute... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Correcting an ethnic or Indian nose

The nose issue that you are describing is very common in Indian noses. Specificially, thick skin with a large bulbous tip with a wide base and a ptotic tip with a poor columellar labial angle. The ideal columellar labial angle for a female is about 105 to 115 degrees and about 95 degrees for a male. Ways to correct that include taking down some anterior septal angle to allow upward tip rotation as well as techniques that alter the tip itself or tripod of the nose and lengthen the medial... more

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon

Correcting nasolabial angle and bulbous tip

It is difficult to say without pictures, but with my experience in ethnic noses with thick skin a different approach is indicated. The bulbous tip is corrected by performing a cephalic trim of your lower lateral cartilage and suture techniques, but a satisfactory result in an ethnic nose also usually requires a hearty columellar strut to support the tip, change the nasolabial angle and provide appropriate columellar show. I hope this helps! All the... more

Rian Maercks, MD
Miami Plastic Surgeon

Rhinoplasty

The nose and lip angle can be addressed in several ways. One as you said is by working with the septum. You may also benefit from a columella strut and tip sutures alone or to the septum to raise the tip.

Steven Wallach, MD
Manhattan Plastic Surgeon

Correcting nose to lip angle and bulbous tip

Shortening the caudal end of the septum and rotating the nasal tip will increase the nose to lip angle. Subcutaneous fillers (I prefer septal or ear cartilage) will create a fuller, less acute angle. A bulbous nasal tip requires definition. Careful judicious sculpting of the tip (lower lateral) cartilages perhaps with a modification of a Goldman type tip (vertical dome division) procedure and possibly with a supporting columella strut and/or batten grafts have been helpful in my experience.... more

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Improving the nose-lip angle with rhinoplasty.

Many options exist for addressing the angle between the lip and the columella of the nose. Caudal extension grafts designed to project the nasolabial angle can work well as can plumping grafts. Creating proper tip rotation is a typical aspect of rhinoplasty and is often combined with creating better tip definition. The definition, however, is limited, as you suggested, by thicker skin. Trimming the septum at the anterior angle *may* also be employed, but a specific recommendation on that... more

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

Nasal Tipplasty

Hi Neyhaa, Bulbous tip, acute columella (nose) lip angle and wide nares can all be corrected by doing a tipplasty, assuming tat the rest of the nose is satisfactory. Sculpting the tip by cartilage removal, repositioning and permanent sutures as well as placement of columella cartilage grafts can alter and improve the ange and shape of the tip. Thick skin creates its own challanges but can be compensated for in the experienced hands. External incisions would be needed at the base of the... more

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

facedr.com

Combination of nasal grafts and increase of nasolabial angle would likely help

You have provided a very nice summary of the issues that you have with your nose. There are many ways to address the issues you currently have. Most surgeons would be very cautious in consideration of shortening the septal cartilage. Given the description of your nose, you would likely benefit from a combination of cartilagenous grafts to add tip support and definition, as well as increasing the nasolabial angle. An experienced rhinoplasty surgeon should be able to give you a good idea... more

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon

Fixing a bulbous nasal tip

Hi Neyhaa - A rhinoplasty can address the issues that you brought up of a bulbous nasal tip and acute nasal tip angle. The cartilages of the nose are trimmed to decrease the bulbous look to your tip and they can then be tailored to bring up the tip and increase the angle. The entire procedure is can be done as an outpatient with minimal post-operative discomfort. Good luck!

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

See a rhinoplasty specialist

There are many ways to correct these problems, but each depends on the various factors involved in rhinoplasty. You should forget about trying to figure out which way to go from surgeons who have not examined your nose. See an experienced rhinoplasty surgeon and let him guide you as to what would look good on YOUR face.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Many ways to correct a nose with a large plunging tip

For patients with thick skin and heavy noses, the tip often droops. There are a number of ways to elevate the tip of your nose. The septum can be shortened, but most heavy noses require more support for the tip. This is provided by using grafts of cartilage to strengthen and push the tip upward. In a nose that hasn't had surgery before, the best source for this graft material is the nasal septum. The tip cartilages can be narrowed as well. For very thick skin and extra strength, a graft... more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

You can increase the nose-lip angle, and correct a bulbous tip with Rhinoplasty Surgery.

A droopy, bulbous tip is one of the most common conditions treated with Rhinoplasty Surgery. Septal shortening may be necessary, but you'll likely require reconstruction of your tip-cartilage, and possible cartilage-grafting to achieve a desired result. You should consult qualified, experienced Rhinoplasty Surgeons with many photos of noses like yours before proceeding with surgery. I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Rhinoplasty to Correct Bulbous Tip and Nasolabial Angle

Hi Neyhaa, There are various methods to accomplish lifting your nasal tip and decreasing the bulbosity of your tip. Trimming your caudal septum will not change it enough, though may be part of the procedure. The tripod of your lower nasal cartilages needs to be altered to rotate your tip upwards, again your rhinoplasty surgeon should be able to share will you the various techniques that can be used to accomplish the task. Good luck and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Options for changing columella-lip angle, drooping, or plunging nasal tip in rhinoplasty (nose job)

Resecting the septim is one method of changing the angle of the columella to lip. However, it does not address the lower lateral cartilages which if not rotated superiorly can contributing to a pluching tip. Clearly these will need to be treated in order to manage your bulbous tip. In order to maintain them in a rotated position several maneuvers are used by different surgeons which include : suture suspension, tongue-in-groove imbrication, cartilage strut or batton, lateral crural wedge... more