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Why Do I Have Bulbous Tip So Long After Rhinoplasty?

Why would my tip become bulbous so long after the Rhinoplasty surgery? My pre-op tip was fine and my post-op tip was fine for the first year or so. Could this be attributed to the normal aging process (I am age 30)? Could it have something to do with the fact that I gained about 10 pounds in the last 2 years? Could steroid injections help, or is it too late? Thank you.

Doctor Answers (9)

Bulbous tip

+2

The bulbous tip you are describing may be related to scar tissue development. Bulbous tips can be due to several things: 1) the overlying thick skin envelope, and 2) the way the tip cartilages are shaped, and 3) scar tissue from previous surgery. Usually #2 is easy to correct. Thick tissues are very difficult to thin without leaving unwanted depressions. Sometimes the scar tissue can be removed as well, but it may be difficult.


Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Bulbous Tip After Rhinoplasty

+2

Following rhinoplasty, the body heals by laying down scar tissue. As scar tissue matures (over the first 12 months) it contracts. This contracture of scar tissue can distort both the skin the nasal framework.

When scar tissue contracts and pulls the nostril sidewalls inward (even very slightly as in your case) it can give the nose a bulbous appearance -- some patients describe this as having a "ball-like" tip. This can be corrected by supporting the nostril walls and/or nostril rims with cartilage grafts.

Speak to your surgeon or a rhinoplasty surgeon that specializes in revision rhinoplasty about your concerns.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 91 reviews

Bulbous tip after rhinoplasty

+2

Hi,

If your tip was initially good after surgery, it's likely that your body has put down some scar tissue which is making it look fuller. A steroid injection probably won't make a significant difference at this time, as this works best when the scar tissue is actually in the process of forming (that is, within the first year after surgery). I would recommend returning to your initial surgeon for an evaluation, bearing in mind that additional surgery may be advised. Good luck.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

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Rhinoplasty Bulbous Tip Over One Year Following Surgery

+2

Hi Sue,

If your tip was initially fine, and has become bulbous a year after your rhinoplasty then it is due to scar tissue formation. The best time for steroid injections is before scar tissue forms or in the early stages. The other possibility is an inclusion cyst which is very rare.

The changes in your tip are not due to weight gain or aging, or most of us would have bulbous tips.

You should consult with your rhinoplasty surgeon or with another surgeon expert in revision rhinoplasty if your tip concerns you.

Be well.

Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Hard to say, but

+2

There are several possibilities. I didn't catch how long after surgery you are, but it seems like a significant time. You may be experiencing scar tissue, or even the resolution of swelling from other areas around the tip making the tip more prominent. I do not think aging or weight gain should have a significant impact on this area.

I think a visit to your ps would be in order. A steroid injection may help, or may not help.

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 46 reviews

Steroid injections won't help your bulbous tip over a year after rhinoplasty.

+2

I see your concern. Is it possible that your tip looks bulbous because there are indentations on each side of the tip?

If this is the case, you could consider Non-Surgical Rhinoplasty, or a surgical revision rhinoplasty. I've attached a link to my Non-Surgical Rhinoplasty page for your perusal.

Whichever you decide, make sure your doctor is certified and experienced with photos demonstrating favorable results.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 276 reviews

Bulbous tip

+2

It's simply too hard to answer these questions online. Rhinoplasty is a complicated procedure and both pre and postop pictures are necessary along with a complete examination and review of the operative report. I suggest you see your original surgeon about your concerns. If you are not satisfied with what he/she tells you then get a second opinion from another board-certified plastic surgeon who specializes in rhinoplasty. Good luck!

Elan B. Singer, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 11 reviews

Bulbous Tip

+1

Hi Sue,

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. In your case, you may have accumulated scar tissue from the previous rhinoplasty. Kenelog may or may not help but its worth a try.See link for more explanation.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 211 reviews

Thickness after Rhinoplasty

+1

Patients can have an over zealous healing  curve and develop thick scar.  This can be injected with a small amout of steroid and get a positive response.  It is better to put a small amount perhaps twice, than too much and get an indentation.

Rodger Wade Pielet, MD (in memoriam)
Chicago Plastic Surgeon
5.0 out of 5 stars 2 reviews

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.