I'm self-conscious about the thickness and roundness of my nose tip. Is it possible to change the tip and add a little more height to the bridge and have it look natural and not change it too drastically? Also, I've read about "Diced Cartilage" Wrapped in Fascia and it sounds less risky than implants. Would that be a good option for the bridge? Does it add more recovery time since it's harvested from other parts of my body?
What Can Be Done for a Thick and Round Nose Tip? (photo)
Doctor Answers (7)
What Can Be Done for a Thick and Round Nose Tip?
Yes, a straight silastic dorsal implant can add height to the nasal bridge and the nasal tip can be thinned using a retrograde tip-plasty. The proper aesthetics of facial (and nasal beauty) dictate that your nasal tip should be rotated downward slightly from the current 120 degree position. This is best accomplished using a Columellar tuck procedure as well as avoiding and open Rhinoplasty technique that will cause the tip to rotate upward an additional 5 degrees.
Rhinoplasty for the bulbous tip and low bridge.
Rhinoplasty for the bulbous tip and low bridge is better done without implants. There are 2 ways I use to raise the bridge depending on the thickness of the skin. One is to use cartilage shaped like and implant , but this is your own tissue. The other is to use diced cartilage in fascia which is better for thin skinned noses. Make sure you see an experienced rhinoplasty surgeon for the best result.
Think and Round Nasal Tip Refinement
Evening, refining your nasal tip is very practical but there's always a limit. Your nasal work can be done endonasally with no external incision. A physical exam is always needed to give you the most detailed information but here's general info about what your nose would benefit from:
1. For the tip you can make it more refined or narrow with what's call "cephalic trim" of your lower lateral cartilages. This allows the tip to narrow without it looking too pinched.
2. The bridge, or dorsum, can be made more defined with better height with an implant, rib cartilage, or ear cartilage. I don't use the crushed cartilage in fascia that often. I feel a solid piece of cartilage is more robust and maintains it's volume. Cartilage from the ear does well if you have enough to give and you'd be surprised how much you have to offer. Rib would work well in you but might be overkill. Implants for the dorsum alone do well also when sized properly. Risk of infection's a bit higher but still minimal. A fourth, and to some less attractive option, is irradiated donor cartilage. This also works well but it's ability to maintain it's volume is a tad unpredictable.
In any case, particuarly with your tip, be patient post op. It will take a good 3 to 4 weeks for the swelling to go down to the point that you'll look more defined. Your down time is only about 7 days.
Hope that helps.
Chase Lay, MD
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Thick nasal tips are very difficult to refine. I do not like to thin the skin because I fear that it will leave dents and may devascualarize the tissue. A dorsal augmentation can be performed with rib cartilage as a graft or diced and wrapped in fascia.
Fixing a bulbous, thick, poorly defined nasal tip
Hi and thanks for your question. There are many ways to address a thick, poorly defined nasal tip. I use techniques to reduce the cartilages of the tip and to sew the cartilage domes that make up the tip together as close as possible. I also use cartilage grafts to increase tip definition and to build up the nasal bridge. I prefer to use cartilage grafts for nasal augmentation as opposed to implants. I would never use an artificial implant for nasal tip augmentation.
Building up the bridge and refining the tip and nostrils are the most common changes that are made for patients of Asian background.
Tip refinement is performed with a combination of suture contouring (to shape the tip and make it slightly more narrow) and cartilage grafts (to add shape to the structure of the tip).
Diced cartilage wrapped in fascia can often produce a nice, soft, natural appearance and I have used it in many patient with great success. Other options include using some rib cartilage to augment the bridge.
I do believe it's best to use your own natural cartilage rather than implanted sources.
Dr. Jamil Asaria
FACE Cosmetic Surgery, Toronto, Ontario, Canada
Asian Rhinoplasty - Diced Cartilage in Fascia
Most Asian and ethnic patients are concerned about building up the nasal bridge, defining the nasal tip, and narrowing the nostrils as they tend to flare with smiling. I prefer to use diced cartilage wrapped in cartilage to avoid the complications I have seen in patients who have had synthetic materials placed in the nose. It does not add more recovery time but takes longer to perform in the operating room. Please make sure you see a board certified specialist to discuss the best option for you.