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Rhinoplasty or Tip Plasty for Thinner Nose?

I'm considering having a procedure to thin my nose. In the pictures, I always turn to the side because my nose looks nice from a side angle, but you can see in my front view my nose is a bit too wide. The bridge isn't wide though (it's straight, no bumps) and because I like my side profile I'd like to avoid having my nose broken in surgery. Would a tip-plasty help? I would just ask to make the tip thinner and make it a bit more pointed. Could tip-plasty achieve a more pleasing front view or would I need Rhinoplasty?

Doctor Answers 24

Tip rhinoplasty will refine nasal tip but the bony vault will look too wide

A tip rhinoplasty can refine your tip. Be sure to discuss with your surgeon the fact that you will likely need a cartilage graft on the tip to give a refined tip appearance-simply removing and remodelling the tip cartilage you have will be disappointing for you.

It is very important to add a tip graft and strut graft to achieve a refined nasal tip appearance.

The bony portion of your nose will look disproportionally wide after a tip rhinoplasty. You need to have the upper bony part narrowed as well so that the final result looks appropriate.

See before and after photos of rhinoplasty.

Tip-plasty or More?

Based on looking at your photo, I would suggest that tip-plasty alone would probably not do you justice, possibly leaving you dissatisfied with your result.

To achieve an optimal result, your surgeon should consider your goals, concerns and integrate that with expertise in facial and nasal balance and proportion.

The idea of breaking the nasal bones is intimidating to many patients, but don't sell yourself short by placing restrictions on techniques before a proper analysis and recommendations by an expert.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.0 out of 5 stars 17 reviews

Tip-plasty is a Rhinoplasty

A Rhinoplasty is a complex operative procedure with the goal of creating a harmonious beautiful balanced nose. There are multiple components of the nose that create the overall appearance. An experienced rhinoplasty surgeon makes a series of decisions concerning what part of the nose requires modification and how to accomplish this. There are infinite possibilities that come together to produce a beautiful proportional nose.

It is very rare that a nose will appear attractive and harmonious if only the tip is narrowed. There is a complex relationship between the upper boney third of the nose, the middle cartilage portion, and the tip. Most patients require modification of all three parts.

Seek out an experienced cosmetic plastic surgeon, who will evaluate your entire nose and avoid a surgeon who focuses only on the tip.

Good luck and enjoy a beautiful new you.

Richard L. Dolsky, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 4 reviews

Nose Tip region is the most demanding area in performing a cosmetic rhinoplasty.

Many surgeons refer to the rhinoplasty as one of the most difficult procedures in aesthetic plastic surgery. 
I agree.

In particular it is the tip region that has the most complex anatomy, and often the area with the most consideration for the potential patient.  This is the most challenging part of the procedure as well.

I tell all my patients that our goal before surgery is to carefully plan out this procedure in significant detail, consider pictures of likes/dislikes, understand the anatomy, and the importance of the healing period.

Best wishes,

Sergio Pasquale Maggi, MD, FACS
drmaggi.com

Rhinoplasty to create thinner nose

There are many times where tip work alone is indicated.  Based solely on the one photo you provided, it appears that tip work alone would not optimize your results.  The base of the nasal bones appears to be wide and narrowing the tip will likely make this relationship more obvious.  You also have roundness in the supra-tip area that should be addressed.

The thought of osteotomies make some people anxious, but a skilled surgeon will be able to give you better results with minimal added recovery.  I would recommend not making a decision to save a little temporary swelling for a lifetime of results.

You are the one that has to live with your nose though and sitting down with a rhinoplasty specialist will allow you to convey your goals.  Photo simulations can show you what proposed changes will look like.  The process should be a collaboration.

Sirius K. Yoo, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Tip rhinoplasty

Tip rhinoplasty doesn't mean that only the tip would be operated on. A lot of the rest of the nose contributes to the appearance of the tip, including the bridge and nostrils. Therefore it's best to talk to a board certified PS to find out how to best improve your nose.

Love my profile, hate my frontal view

Kristal, 
You pretty much summarized your issue very well. If you are very happy with your profile but you feel that your tip is too wide, then you are an ideal candidate for a tipplasty.  

Philip Miller, MD
New York Facial Plastic Surgeon
4.5 out of 5 stars 58 reviews

Rhinoplasty to Create Balance and Proportion

The results of rhinoplasty surgery are dependent upon correct analysis of nasal aesthetics in the pre-operative period. This analysis is virtually impossible without a physical examination or pictures taken from multiple angles.

                  In addition, aesthetically attractive noses have harmony, balance and proportion. In other words, all the parts fit together to give an attractive appearance.

                  Although you’re primary concern appears to be your nasal tip, your pictures suggest that your nasal bridge may be as wide as well. If this is true, infracture of the nasal bones will be a necessary component of any successful rhinoplasty.

                  Under these circumstances, an isolated tip rhinoplasty might adversely impact facial aesthetics. Refining the tip might actually make the nasal bridge look wider and ultimately create a deformity.

                  For these reasons, consultation with a board certified plastic surgeon with rhinoplasty experience is appropriate. This surgeon should be able to formulate an appropriate treatment plan. 

Tip-plasty vs. Rhinoplasty

Thank you for the question and your photo. First, a tip-plasty is really a kind of rhinoplasty (just without modification of the bridge or nasal bones). In this kind of limited rhinoplasty, the recovery tends to be a bit faster and there is less bruising. Second, the art of rhinoplasty is about balancing form and function, and creating a harmonious three-dimensional structure.  Reducing the size of your nasal tip could be aesthetically pleasing. However, it may disrupt the balance of your nose -- making the bridge look overly wide.  In select cases, it is possible to narrow the bridge without changing its projection (the side view). This type of rhinoplasty is technically challenging but can give you a great result. Best of luck!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 63 reviews

Narrowing the nose

Kristal, thank you for your question and for sharing your photo.  Your concerns are quite common for patients inquiring about rhinoplasty.  Your tip and the refined using some common tip techniques.  I would however probably recommend narrowing your nasal bones to achieve better harmony with the potential changes to the tip.  This can be demonstrated using computer imaging during your consultation.

Edward S. Kwak, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 12 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.