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Second Opinion for a Bulbous Tip? (photo)

asked 5 months ago by Perth-ness in Lidcombe, 02
Latest answer by William Portuese, MD
Question viewed 307 times
Tags: nose tip, bulbous, recommendation, second opinion

I have gone to a consultation for rhinoplasty on my nose.. My main problems are that I have a large tip and flared nostrils.. My side profile is straight so that doesnt concern me However the surgeon suggested that he will just reduce the tip and not worry about the nostrils as it will create a "pinched" look.. But I think I might need the nostril base narrows as my narrows are quite big Do you have any suggestions?

17 answers to Second Opinion for a Bulbous Tip? (photo)

Rhinoplasty for the bulbous tip.

Rhinoplasty to refine the tip can be done however, you should choose wisely since you will need alar cartilage grafts to prevent pinching of the tip. You may need alar base wedges removed as well. See a very experienced rhinoplasty surgeon to get the best result.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Recommendation for bulbous tip

A bulbous tip can certainly be reduced by tip suturing techniques as well as cartilage removal with a combination of cartilage removal in the nasal tip. This will feminize and refine the nasal tip to be more in balance with the bridge. Alarplasty excisions of excess skin at the base of the nostrils can be performed if the nostrils are too wide.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Treatment of Bulbous Nasal Tip

The tip can be reduced and definition improved. With the single picture you sent, it is difficult to determine if the base of your nose should also be narrowed. This can be achieved without pinching the tip or causing nostril retraction when done by an experienced surgeon. A more complete set of nasal pictures would help us be more specific in our recommendations. Go to my website for instructions on the submission of photographs.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Second Opinion for a Bulbous Tip? (photo)

Based ONLY upon the posted photo I recommend seeing rhinoplasty PS in person for a full examination. My guess is a tip rhinoplasty with wedge excisions.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Rhinoplasty can correct a bulbous tip.

Rhinoplasty can correct a bulbous tip and I think that you are an adequate candidate and should expect a very reasonable improvement. Unfortunately with the block over your eyes I cannot comment on whether your nostrils need to be narrowed because the landmark most surgeons use to determine this is the width between your eyes.

Richard H. Fryer, MD
Salt Lake City Plastic Surgeon

Bulbous nose tip and flared nostrils

From what I can see in the single photo, you are absolutely correct. Your nostrils (alar base) are wide relative to your mouth and rest of the nose. They would be in better balance when made less wide. If only the bulbousness of of the tip is addressed, then the more refined tip will make the nostrils appear even more flared. They both need to be addressed at the same time for a good outcome.

Ramin Behmand, MD
Walnut Creek Plastic Surgeon

Tip rhinoplasty surgery

From the picture, there seems to be some bulbosity which needs to be addressed. I think a conservative refinement would yield the best result. I would not overdo it. Because we can see your face only partially on this photo it is difficult to assess your nose in the context of your entire face. Therefore, I would tend to approach the nostrils in a conservative way. I would leave them for now and reassess after a few months following tip refinement. Good Luck.

Mark Samaha, MD
Montreal Facial Plastic Surgeon

Alar reduction or not?

Hi there I think your tip is the main problem, and whether you have an alar base resection very much a secondary problem in terms of the aesthetic outcome. By that I mean that you could not achieve an excellent result without remodeling your tip. And in terms of a possible pinched look, that would be due to overresection of the tip not the base. So a careful, aesthetic and functional tip remodeling is the key to a nice result for you. Whether the alar base is resected to reduce nasal base... more

Howard Webster, MBBS, MBA
Melbourne Plastic Surgeon

Second opinion for tip

It's hard to offer advice without seeing your entire face. Many aesthetic "norms' would say that if your nostrils are within your intercanthal distance (lie between the inner corners of your eyes) then they do not need to narrowed. This however needs to be interpreted in context or nostril sill width, flare and your own goals. I would recommend you have some computer imaging to see how it would look either way. When I feel strongly about not doing it I will advise the patient to... more

Michael L. Schwartz, MD
West Palm Beach Plastic Surgeon

www.palmbeachface.com

Rhinoplasty surgery

I would make sure that you are going to a good board certified surgeon who has a lot of expertise in rhinoplasty surgery. I would suggest looking through the surgeons before and after photographs and reviewing those in particular that are similar to your nose. Ask the surgeon to show you multiple photographs of post surgical patients who have undergone reduction of the nostrils. You may want to get several opinions and see what the consensus is regarding your proposed surgery. It is hard to... more

Michael Elam, MD
Orange County Facial Plastic Surgeon

Rhinoplasty

It is difficult to say exactly what you will need without an in-office exam. However, narrowing your alar base with internal incisions might be helpful. Make sure you surgeon is boarded in Facial Plastic surgery. Good luck!

David Alessi, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty

Hi, I think you need a full work for the tip to speak more on the rest of your nose actually we need more pictures: profile and inferior views to tell you more. Howevere, i think you need and nostril width reduction.Good luck

Fatema S. Alsubhi, MD, SSC-plast
UAE Plastic Surgeon

Nasal base reduction and a pinched look

I partially agree with your surgeon who stated the nostrils could be left alone. However, you could reduce the flair very very conservatively by using an approach on the inside of the nose with almost no outside incisions. We're talking about less than 2 or so mm of tissue removed on both sides. Very small but noticeable to you. Your surgeon is illegitimately concerned about scarring and an unnatural look to your nostrils.... more

Chase Lay, MD
Bay Area Facial Plastic Surgeon

Second Opinion for a Bulbous Tip?

The nasal tip could be thinned but you'd have to include a base view (looking up the nostrils) for the evaluation of that area to be performed. Be certain that your Rhinoplasty Surgeon understands and follows the proper aesdthetics of facial (and nasal) beauty.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Refining a Bulbous Nose Tip

In the interest of an accurate opinion either a face to face examination or barring that review of MULTIPLE views of the nose are required. It would be presumptous to comment and recommend the exact surgery for your tip based on a single frontal view. Your nasal tip can be vastly refined by surgically narrowing the Lower Lateral cartilages of the tip and using suturing techniques to further bring them together. The decision on correcting nasal flaring needs to be based on a view from... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Bulbous tip and flared nostrils

It's hard to assess your tip width without seeing your eyes, but an alar base reduction is a possibility if you find your nostrils too wide. There are also rhinoplasty techniques available to improve the roundness of your tip itself. I favor techniques that reorient the convex nasal tip cartilages in the area. This maintains a natural appearance that shouldn't appear pinched.

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Bulbous tip rhinoplasty

I agree with you that a tip platy would work for you. However, it is hard to judge the flare of your nostrils because the standard for nostril base width is that the nose should fall within the distance of the medial most portion of the eye. Since your eyes are covered it is hard to make this judgement. Based on what I can see and the fact that you have a narrow face, I would agree with a bit of nostril management...