I will be having a septorhinoplasty in 2weeks and I dont know to what my tip could change into! Besides my deviated septum I want to improve my bulbous droopy tip, mainly cuz when I smile I look very bad as my nose drops more and looks more wider! So I would like to narrow my bulbous tip and lift the tip higher so my nose can look more straighter and of course when I smile it wont drop and keep its firmness! Just to mention I wont do anything to my hump or nasal bone only tip!
What Kind of Tip Would Likely Suit Me Best Without Touching my Hump or the Nasal Bone? (photo)
Doctor Answers (3)
Septo-rhinoplasty for bulbous and drooping tip
The bulbous, drooping tip is best addressed with a combination of suturing techniques of the lower lateral cartilages, occasional cartilage removal of the cephalic portion of the lower lateral cartilages and possible cartilage strut to hold the tip up. Releasing of the depressor septi ligament will prevent the tip from drooping upon animation. Straightening of the nose is accomplished with a combination of osteotomies and a spreader graft placed on the concave side. For examples of noses similar to your own please see our rhinoplasty photo gallery link below
Tip refinement without changing the nasal bones (bump)
Thank you for the question and the photos. I get asked this type of thing a lot in rhinoplasty consults with men. Generally, this means that the patient wants to make sure that the nose doesn't come out looking scooped or overly narrow (i.e., feminine). For your tip, refinement of the cartilage would be very helpful, though the exact degree to which this is possible will depend on the thickness of your skin. In addition, elevation of the tip (so that it doesn't droop, particularly when you smile) would be recommended. Finally, small adjustments to the alignment or projection of the nasal bones can be made without dramatically changing your profile. This can help maintain symmetry with the new nasal tip. Best of luck moving forward!
Tip refinement and elevation would be helpful
Based on the photos, your tip looks broad and low. If I were your surgeon, I would recommend that the tip be elevated and narrowed into a more triangular (less rounded) shape. I use structural cartilage grafting to create changes to the framework of the tip cartilages so the results will be durable and predictable. I think reduction of the width of the nasal bones and eliminating the hump would also help you. But if you are sure you want to leave those areas alone, I would recommend that the tip narrowing be done conservatively. This is because any narrowing of the tip will make the upper bridge look even wider by virtue of their proximity. Below is a video link to a lecture I present about tip refinement.
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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.