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Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping? (photo)

asked 3 months ago by Shanghai Baby in Shanghai
Latest answer by William Portuese, MD
Question viewed 274 times
Tags: drooping tip, hump, recommendation, technique

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.

13 answers to Can I Elevate my Tip to Disguise my Hump Without Dorsal Rasping? (photo)

+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.
William Portuese, MD

Seattle Facial Plastic Surgeon
+1

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
Kimberly Lee, MD

Beverly Hills Facial Plastic Surgeon
+1

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... more
Robert Kotler, MD

Beverly Hills Facial Plastic Surgeon
+1

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... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

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.
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

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.
Ricardo Izquierdo, MD

Chicago Plastic Surgeon
+1

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... more
Matthew Bridges, MD

Richmond Facial Plastic Surgeon
+1

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.
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

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
Julio Garcia, MD

Las Vegas Plastic Surgeon
+1

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
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Can I elevate the tip of my nose (photo)?

The approach to rhinoplasty is very individualized. In general, I agree with Dr. Lee that your tip should be augmented with cartilage tip graft in addition to slight elevation of the tip. Upward tip rotation, in my hands, is predictably accomplished by trimming lower lateral cartilages, caudal septum, tip graft, and potentially, suturing to septum. Lowering the dorsum and/or augmenting the radix (top of the nose) won't really add much down time, although it may add some... more
Steve Laverson, MD

San Diego Plastic Surgeon
+1

Rhinoplasty for Tip LIfting

You can acheve your desired nasal change by upward tip rotation. But it wil not be as 'simple' as just a few sutures to achieve it. It will require tip support (columellar strut) and suture plication/modification of the lower alar cartilages done through an open rhinoplasty to create a significant tip movement that is stable. An open tip rhinoplasty will be less recovery than a more complete one but there will be tip swelling for some time after surgery.
Barry L. Eppley, MD, DMD

Indianapolis Plastic Surgeon
+1

Tip augmentation can improve your profile

The nose can be improved by giving more tip projection. However, you'll need more than suturing in order to accomplish this. The cartilages at the tip are very soft and will need reinforcement with additional cartilage in order to get the tip projection and strength you need. Also, you can place a graft, usually temporalis fascia, in the area between your eyes (radix) in order to make the bridge more straight without rasping the hump.
Charles S. Lee, MD

Los Angeles Plastic Surgeon

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