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I Had Open Rhinoplasty 8 Months Ago. Am I Developing a Polly Beak Deformity? (photos)

I Had Open Rhinoplasty 8 Months Ago,I Used To Have A Big Deviated Concave Nose So I Had The Surgery..I Had The Cast Off 1 Month Post The surgery ,The Shape Was Great! The Time Passed By, Its Been 9 Months , My Nose Changed Shape , It Gone Worse , My Bridge Is Great , But I Have Problems When It Comes To The Nose Tip ,its frustrating! am i developping a polly beak deformity? or is it just swelling? shud i consider revision? my surgeon is against steroids injection,wat shud i do? thanks in advance

Doctor Answers 12

Suprtatip fullness after rhinoplasty

Thank you for your question!

It is understandable that you are concerned especially at 8 months after your surgery. Changes after rhinoplasties vary with every patient and what you are experiencing is not uncommon. Swelling takes time to subside as it masks the results of your surgery but you are at 8 month post-op and the amount of swelling should be minimal.

Without a physical exam, it is not possible to provide you with a definitive answer. Usually, a year is required before formulating how your nose will be, but longer with a thick skin. Even then, your nose will keep shaping itself to complement your face for better results in the years to come.

My best recommendation at the moment is to be patient, and allow nature to take its course. There is no doubt that once the swelling resolves, more definition and shape will be achieved and you should be happier with the results.

Also, it is important that you keep communicating with your surgeon and work as a team together to achieve the best results possible.

Should you be unsatisfied with the end results, revision rhinoplasty is easily discussed with a surgeon of solid experiences and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.


Congratulations on your surgery and please remain positive!

Ali Sajjadian, MD FACS


Orange County Plastic Surgeon
5.0 out of 5 stars 172 reviews

Polly Beak Deformity

In my opinion you do have a pollybeak deformity, which is best described as fullness above the nasal tip.  It also appears as if the nasal dorsum was taken down a little low.  I would recommend a steroid injection into the area of the pollybeak and a little more time before making a final impression.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 53 reviews

Pollybeak

It looks more like you have an over treated bridge rather thana true pollybeak deformity.  This can be treated by a dorsal onlay to raise your dorsum a bit.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

Polybeak after rhinoplasty.

Yes, you have a polybeak and a bridge that is too low. This can be corrected with septal or ear cartilage grafts. Make sure you see a very experienced revision rhinoplasty surgeon to do this!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

What's the treatment for Polly Beak deformity after rhinoplasty

Polly Beak Deformity is fullness immediately above the nasal tip, which can occur after rhinoplasty. There are two broad causes for this deformity. The first common cause is under excision of the dorsum of the nose immediately above the nasal tip. The second cause is poor nasal tip projection, which gives the appearance that the nasal dorsum is too high. 

In looking at your pictures, it appears that your nasal tip is not projected far enough, which is causing a polly beak. I notice an additional problem of over resection of the upper part of the nasal dorsum. I find the over reduction of the upper dorsum to be more of an aesthetic problem than the poorly projected nasal tip.

Your choices are to have the dorsum augmented with a filler such as Restylane or Radiesse, or having a revision surgery to increase the nasal tip projection and augment the upper dorsum. Obviously, the revision surgery will be more involved in terms of risk, recovery, and cost. However, a revision surgery is the only wayto address your concerns in a permanent way.

Maurice M. Khosh, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

A polly beak after rhinoplasty?

The term polly beak is a very old term used perhaps 25 years ago to describe a full area on the bridge just above the tip of the nose. The image is of a parrot beak with a downward curve toward the tip, also called a ram's tip. Now we tend to keep animals out of the discussion and refer to 'supra-tip' fullness. The cause can vary, under projection of the tip, under reduction of the cartilage of the lower bridge, or over reduction of the upper or bony bridge which I think may be what is troubling you. Revision with a graft over the bridge may improve your result.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 35 reviews

Polly Beak deformity

You do have polly beak deformity and the reason your nasal dorsum looks good one month post op. is due to swelling. Once the swelling has gone down, the polly beak deformity shows itself. I recommend you have steroid injection and if you didn't see improvement, then may consider filler injection on the upper part of the  dorsum or alternatively revision rhinoplasty with an experienced surgeon.

Mohsen Tavoussi, MD, DO
Newport Beach Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

Is this a Polly Beak Deformity

Yes, you do have a polly beak deformity. After careful examination, a good revision rhinoplasty surgeon will explain the treatment alternatives. Wait another 3-4 months for surgery, but you can start to investigate your options.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Polly Beak Deformity After Rhinoplasty Can Develop Months After Surgery

The simple answer to your question is yes, you do have a polly beak deformity after your rhinoplasty. With such a large hump removal, and now collapse of the middle vault, there is now apparent fullness in the supratip area. While steriod injections can still be done at 9 months after surgery, they would have had a better chance to be effective if done much earlier. It is now time to wait another 3 months to get to the year anniversary of your surgery. At that point, you can discuss revisional rhinoplasty which he/she may be more amenable to do.

Best Treatment for Pollybeak Deformity After Rhinoplasty

Hi Alex,

It appears that you have had quite a bit of your nasal dorsum removed at the time of your rhinoplasty.  It also appears that  you are developing a polly beak deformity of your lower dorsum.  At about 12 months post rhinoplasty you may consider revision rhinoplasty.  An alternative is to have filler injections to build up the deficiency in your dorsum.  You should discuss your concerns and these matters with your rhinoplasty surgeon.  Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 28 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.