Revision Rhinoplasty Q&A
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Tip is Still Bulbous After Revision Rhinoplasty - Can I Do Anything Else?
asked 2 years ago by 3377Kat in Dallas
Latest answer by Sam Naficy, MD
Question viewed 431 times
Tags: bulbous, tip
I did extensive research before deciding on a revision PS 4 yrs ago. I interviewed/looked at pics of 8 or 9 PSs. It took me a year & flights across the country to decide. I thought I really did my homework. My nose is bulbous with thick and oily skin. Right after my surgery with graft, the tip looked good. Then the tip pretty much went back to its wide self. I waited for the swelling to go down & 4 yrs later my tip is still wide. My PS advised against any more surgery due to scar tissue. Can it be fixed?
8 answers to Tip is Still Bulbous After Revision Rhinoplasty - Can I Do Anything Else?
+2
More surgery may not be helpful.
A bulbous tip in a patient with "thick and oily skin" is often impossible to make as small or defined as some patients would like. It's simply a limitation of our technology and techniques with rhinoplasty.
If your surgeon(s) are recommending against further revision surgery, it's usually best to leave it alone rather than making it worse.
All the best,
--DCP
David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
Jacksonville Facial Plastic Surgeon
+1
Thick oily skin
With thick and oily skin you need strong structure under the skin and may have to be willing to have a larger nose on profile to get the narrower shape on the front view
+1
Bulbous Tip after Revision
Thick oily skin can frustrate both patient and surgeon. Without seeing pictures or examining you, it is impossible to answer your question. I know you did this 4 years ago, but I suggest getting another opinion, perhaps from a surgeon you did like when doing your previous research. Have your last operative report during additional consultaions.
+1
Revision rhinoplasty with thick skin
Thick oily skin will certainly limit the refinement of the nasal tip. In your case, since it initially looked good, your graft may have been absorbed, A review of your previous operations by an experienced surgeon should tell you whether additional surgery will be helpful.
Randy J. Buckspan, MD
Austin Plastic Surgeon
Austin Plastic Surgeon
+1
Extreme approach to a thick bulbous nose
From what you describe and without supporting photos, I would think that further conventional surgery will not get what you want. In extreme cases , I have actually cut out the thick skin of the nose in order to create a smaller nose. This creates a vivble scar which usually has to be dermabraded at a later date to minimize it. I have only done something like this 4 times in over 3o years , but the results were very gratifying.
Sheldon S. Kabaker, MD
Oakland Facial Plastic Surgeon
Oakland Facial Plastic Surgeon
+1
Looking for the perfect nose.
Pursuing revisions afer revision in the attempt to get a better result may eventually produce a nose that is excessively thin or complicated not unlike the consequences of Michael Jackson's pursuit of a better nose.
Otto Joseph Placik, MD
Chicago Plastic Surgeon
Chicago Plastic Surgeon
+1
Thick tip
A thick tip that is oily and bulbous can be very difficult to make more refined. It may not get better with revision but it is difficult to say without seeing you in person.
+1
Bulbous Tips
Hi,
Thick oily bulbous tips are very difficult to make smaller. These tips require defatting and extensive cartilage grafting. The only way to determine if your tip can be make smaller is to actually see and examine your tip.
Best,
Dr.S.
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