Asian Rhinoplasty: Q&A
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Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping? (photo)
I am ok with my small hump, width of nose bridge from frontal view, nostirls & alar base.I want to change my droopy tip. It points downwards, nearly touching my upper lip when I smile.I will stay with my hump cause a rasping plus an osteotomy will cause me too much down time, cost is fine.Will a tip rotation disguise a dorsal hump to be lower? Can suture technique alone elevate my tip without cutting of cartilage and implant? What do you suggest for me? My surgeon will rasp hump & suture my tip.
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13 Doctor Answers |
Asked by
Shanghai Baby
in Shanghai
+1
Lifting nasal tip to disguise dorsal hump
The tip cannot be raised high enough to make the hump go away. The hump will need to be surgically removed. A small hump can be simply rasped but a large hump will require osteotomies. In addition, the depressor septi ligament of the tip will need to be softened to prevent the tip from drooping upon smiling. To raise the tip, suturing techniques of the nasal tip cartilages will need to be performed.
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Lifting Nasal Tip
I agree that raising the nasal tip would be a good way to improve your profile. This can be done without cutting any cartilage out. However, the small nasal hump you have will still be present. If you like it, you can avoid rasping it down, but to have a straight profile, it will need to be very slightly rasped. I don't like using silicone in Asian Rhinoplasty surgery
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No shortcuts for your rhinoplasty, please.
Hi Shanghai;
I understand your thought process, and it is a good one. Your photographs are also very helpful. I am sure that when you raise the tip of your nose, the migration upward makes the bump look like it is going to be gone.
In the operating room, that will not happen. You need to have the bump removed. When the tip is rotated up, you will certainly have a better profile. I do appreciate the fact that when you smile, the tip plunges, which...
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Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping?
Aesthetically speaking, yes that might be a possibility. From the photo, the nasal tip is below 90 degrees, lower when smiling, which is under-rotated for an aesthetically ideal tip at 105 to 115 degrees. In this case, it appears that the dorsal hump may be from cartilage, at least in part and not all bone. This would not require rasping of bone but would be removed using a scalpel blade to simply trim some cartilage off the top.
Your observations, however...
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Can Nose Tip be raised without lowering the Hump?
You can have the nose you want as long as you and your surgeon agree to it. In my opinion, your drooping nasal tip can and should raised, creating the supratip break, the clear border between the dorsum of the nose and the tip. But doing so will not make the hump go away. Although it could be masked nicely with a filler for a time ("Nonsurgical Nose job"), as long as you are improving your nose why not address all its deformities? Again, it's up to you.
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Options in rhinoplasty
From your photos, your tip will require some sort of support and/or projection, whether it be a tip graft to augment the tip and/or a columellar strut to support the tip. Your hump will not be "disguised" by these manuevers and may still requires some reduction.
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Increasing tip projection can help profile
In my opinion, you do need something to stabilize the tip. This usually is done with a columellar strut, but can be accomplished with other techniques as well (ie the septal tongue-in-groove maneuver). You are right that by first projecting your tip, the amount of reduction of your bridge will be less. You have basically a "pseudohump" caused by a low radix (the starting point of the nose) and an underprojected tip. The key to having a long-lasting and...
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Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping?
From your photos I would recommend you consider a type of rhinoplasty. Minor attention to the hump is needed.
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Tip work t hide a dorsal hump
I think doing some work on your tip will still leave the supratip area, the area right above the tip lower than the dorsal hump and the hump will still be visible. You could have a filler placed into that area though to hide the hump
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Wait until you have time for rhinoplasty
Your tip is underprojecting and will benefit from a tip graft, though the nose may lack balance if the hump is not reduced slightly. You could work this out on computer to 'see' the cause and effect. We feel you will look better with the full rhinoplasty so a wait until you have time to recover is worth the effort.
Best of luck, peterejohnsonmd.com
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