How Do You Fix a Nose with a Bulbous Tip?
- Asked by Eva S in Seattle, WA
- 4 years ago
How exactly is excess tissue removed from the tip of the nose?
Nasal bulbous tip
The most precise way to correct a bulbous nasal tip is to perform an open rhinoplasty. The tip can be bulbous for several reasons. Some of these include, thick soft tissues, wide nasal cartilages, and flat tip to name a few. A careful physical exam will provide the answers and then a surgical plan can be created.
There are actually several types of bulbous tips. The is a cartilagenous bulbous tip which typically occurs in caucasion patients. This requires resculpting or reshaping the tip cartilages to a more aquiline or structured look. The second kind of bulbous tip is a fatty bulbous tip which is typically seen in ethnic patients ( African Americans, Hispanics and Asian). These noses require not only cartilage grafting to the tip but also defatting of the tip thereby thinning the subcutaneous skin. The third type of bulbous tip is a result of scar tissue build up from a previous rhinoplasty which requires removal of the scar tissue and possible cartilage grafts. See link for more explanation.
Web reference: http://www.africanamericanrhinoplasty.com
The Primary Problem With A Bulbous Tip Is Excess Cartilage With A Suboptimal Shape.
The primary cause of a bulbous tip is excess cartilage that creates a sub-optimal shape. The procedure involves careful cartilage removal and reshaping. It is important to leave a strong framework in order to prevent collapse. Some patients also have excess fatty tissue, which can be thinned out. However, overly aggressive soft-tissue thinning can impair blood supply, which can lead to severe complications.
Recent Rhinoplasty Reviews
Closed rhinoplasty and refining a bulbous tip
I have a different take then others that have posted. I see very few indications to ever performing an 'open rhinoplasty.' While the difference between an open rhinoplasty and closed rhinoplasty is only a few millimeters of tissue that is preserved or cut, it is very important tissue. Inside the columella there are important arteries and veins and preservation of these vessels makes maneuvers like debulking the tip much safer and sppeds healing recovery and resolution of swelling. Perhaps more important are the aesthetic ramifications. When dealing with a bulbous tip usually a combination of maneuvers is indicated. One must debulk the soft tissue, trim the lower lateral cartilage, remove interalar tissue, suture the lower lateral cartilages together to refine and define the tip +/- a complex arangement of cartilage grafts to restore aesthetic dimensions. To get a true idea of the result that a surgeons maneuvers are having, the columella and its natural tensions must be present. This is near impossible to do with a divided columella in open rhinoplasty so it is much harder to judge the result of the underlying structure. I recommend finding a surgeon comfortable operating in a closed technique.
All the best,
Rian A. Maercks M.D.
Web reference: http://www.RianMaercksMD.com
How is a bulbous nasal tip fixed during Rhinoplasty?
I have performed Rhinoplasty for over 20 years and what's required to thin a wide (bulbous tip) depends on several factors including the angle of tip rotation, if the tip cartilage is asymmetric or weak and whether the skin is thin or thick. Taking all of these factors into account along with the proper nasal aesthetics (differ for men and women) an individualised plan for the Rhinoplasty can be formed. The tip cartilages will be typically trimmed and possibly sewn together. A cartilage graft can be added if additional tip support is required or the skin is very thick.
Rhinoplasty for Bublous Tip
Absolutely, a good rhinoplasty by an experienced rhinoplasty surgeon can refine a bulbous tip nicely. The limiting factor is skin thickness, the thicker the skin the harder it is to gets definition.
Web reference: http://www.aventuraplasticsurgery.com
How Do You Fix a Nose with a Bulbous Tip?
Thick skin and large cartilages are the reason for bulbous tip. The cartilages are reduced and sutured to refine the structure but most importantly the skin needs to be aggressively thinned to achieve adequate drapping over the refined cartilagenous structure.
Web reference: http://www.cosmeticsurgery4you.com
Usually a combination of things is done
A bulbous tip which is caused by enlarged cartilage is best improved by a combination of removing some cartilage and using suture techniques to create a better shape. Sometimes a nasal tip looks wide because it lacks projection and placing a cartilage graft can both improve the projection and create a tip that looks more narrow. Sometimes the tip skin is thick, and this can be carefully thinned down to help the overall shape.
The bottom line is that many things can be done to improve the nasal tip, but it varies from nose to nose. The important thing is that you select a surgeon skilled in rhinoplasty to properly evaluate your nose and tell you what can be done. Good luck.
Correcting a Bulbous Tip
The appearance of a "bulbous tip" most commonly arises from the shape of the underlying cartilages. If this is the case, the lower lateral cartilages (tip cartilages) can be trimmed and reshaped either with sutures or with grafts to relieve the excess curvature. Sometimes, increasing the amount of tip projection makes the nostril sidewalls straighter and can help alleviate bulbousness
Thick skin is an additional factor that can contribute to a bulbous tip. Thinning the undersurface of the skin is dangerous maneuver and can damage the blood supply.
Usually, nose tissue is not removed but reshaped
Removing tissue from the tip of the nose for a bulbous tip is actually a risky maneuver. This can devascularize the tip and lead to skin death at the tip of the nose. Most of the time, cartilage reshaping can do wonders to narrow the tip even in the Asian nose.
Many believe in the surgical community, that the nasal tip of the ethnic nose is mostly fat and thick skin. This is true to an extent but with proper shaping of the cartilage siginificant changes can be made to the tip and the bulbous tip especially. The only way to know if to have us look at it closely and examined. Open techniques are also a more accurate way to shape the nose.
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.