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How Are Bulbous Tip and Upturned Nose Corrected?

asked 2 years ago by ashley123
Latest answer by Michael R. Macdonald, MD
Question viewed 5,018 times
Tags: nose, bulbous, tip, upturned

I am wanting to have a Rhinoplasty to reduce my bulbous tip and to de-rotate my naturally upturned nose. How exactly does the surgeon fix my nose?

15 answers to How Are Bulbous Tip and Upturned Nose Corrected?

Lengthening the Nose

Stacey: I will play devil's advocate and question if your nose is really too short (over-rotated). The columella (the strip between your nostrils) appears to be hanging, which could give the illusion of too much rotation. However, if de-rotation is necessary, it is best done by someone with experience because this is one of the more difficult maneuvers in rhinoplasty surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Procedures for bulbous and upturned nose

The bulbosity of the nasal tip can be refined through dome suturing techniques whereby each lower lateral cartilages are sutured together with a dissolvable stitch that takes approximately four to six months to dissolve. The procedure, when done as an endonasal approach, will automatically decrease the upturned nose and will drop the tip as well as de-project the nose. A small supra-tip cartilage graft can also be placed to push the tip down.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

De-rotation of your nose may not be easily obtained with Rhinoplasty surgery.

Most of the Rhinoplasty tip-modification techniques will lead to further rotation of your nose, or no rotation at all. You have an attractive appearance, and your nose-lip angle is appropriate. Your nose does not appear too upturned on the profile photo provided. It's not impossible to derotate a tip, but in my hands, it's difficult, and unpredictable. I'd like to try to talk you out of rhinoplasty, but I don't want to dismiss the whole idea without seeing your front view. Feel free to post... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

A nose bulbous tip is corrected by removing some cartilage and either suturing together or weakening the remaining cartilage

Because these two problems are quite distinct, I will try to answer them for you separately. Although I am often happy to perform rhinoplasty surgery through a “closed” or endonasal technique, the two problems that you are concerned about generally are easier to address using an “opened” technique so that the cartilage can be directly and clearly visualized. A bulbous tip is the more easily corrected of the two problems. This is done by removing some... more

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon

www.drmmacdonald.com

Repostioning tip cartilages "lower" can work

Hi Stacey: Taking care of a bulbous tip is easier than relocation the nasal tip lower. As rhinoplasty specialists we all have lots of experience in scultping the tip but lowering the tip remains a challenge. One technique I have used is to release all the attachments of the tip cartilages and bring the tip lower. This can usually accomplish a slight lowering of the slightly elevated nasal labial angle you have.

Richard Gentile, MD
Cleveland Facial Plastic Surgeon

www.facialplastics.org

Bulbous tip and upturned nose correction

Modern rhinoplasty is customized to each nose with a specific repertoire of surgical techniques. To refine a nasal tip and then reposition it in a less prominent position the following surgical sequence is usually done. First the nasal tip is refined by thinning the widths of the lower lateral cartilages. Then, these cartilages are united and shaped with several stitches until a small, more defined tip is created. When the nasal tip has been created, IF there is no further work to be done... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Rhinoplasty and upturned nose

As a general rule a bulbous tip can usually be treated by performing tip surgery to refine the lower lateral cartilages. This can be done with some excision of the cartilages and tip sutures. If the bulbous component is due to the thick skin, then it is very difficult to improve it. If the tip is "too upturned," then sometimes grafts can be placed internally to de-rotate the tip a bit.

Steven Wallach, MD
Manhattan Plastic Surgeon

Rhinoplasty

Hi. On the one view that you posted, your nose looks great, and I recommend leaving it strictly alone. It is easy to make a nose such as yours worse with surgery. If your tip really is bulbous (in front view), then that can be reliably corrected.

George J. Beraka, MD
Manhattan Plastic Surgeon

How are bulbous tip and upturned nose corrected?

hello Thanks for including your picture. Usually, the cartilage at the tip of your nose is re-shaped to the desired width and location. I prefer to do this through an incision at the columella that extends into the nose. In rare cases, if the person had previous nasal procedures, implants may be required to obtain the desired shape. Computer modified pictures of your current nose can help with the communication process between you and your doctor.

Michael Kulick, MD
San Francisco Plastic Surgeon

Rhinoplasty surgery to correct a bulbous tip

My first impression in looking at the photo you posted, is that you have an attractive nose already. There may be a strong argument for leaving it alone. However, if after examining you it appears to indeed be "bulbous" as you described, the tip can be remodeled and rotated down as you wish.

Darrick E. Antell, MD
Manhattan Plastic Surgeon

Correcting a Buulbous Tip & Upturned Nose

Rhinoplasty can effectively correct problems such as a bulbous tip and a nose that is upturned -- these can be a complex combination of problems that a surgeon who specializes in rhinoplasty should address. 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. An upturned... more

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon

www.rhinoplasty-usa.com

This can be discussed with plastic surgeon

The ideal thing would be to get a consultation with plastic surgeon and use imaging soft wear to plan for surgery. front view also need to to show the tip width. Please do your homework and get more than one consultation.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

See a rhinoplasty specialist.

Derotation of the upturned nose requires a great deal of rhinoplasty experience. After more than 30 years of rhinoplasty, I still see many overdone noses, as well as primaries, that have this problem. You should see several experienced rhinoplasty surgeons that can show you how they corrected these problems.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

This could be a complex but rewarding experience

Both the things you request can be accomplished. However, they are considered more complicated than basic reduction rhinoplasty. The tip of a nose is typically narrowed by removing some cartilage and sculpting with sutures. Noses can be lengthened by using grafts of your own cartilage. Please seek out a qualfied rhinolasty specialist who has a lot of experience in this procedure.