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Tip Bulbosity in Aging Nose

asked 1 year ago by Cindarell in Dallas
Latest answer by Rod J. Rohrich, MD
Question viewed 352 times
Tags: aging, bulbous, options, tip

As a result of a aging nose, I'm confronted with tip bulbosity. By resecting some cartilage or dome suturing this can be narrowed. However lower lateral cartilage instability (and apparently lack of support) in the tip will still occur. Which grafts could you use to correct this?

5 answers to Tip Bulbosity in Aging Nose

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Key Elements of Managing the Aging Nose

The 5 key elements of managing an aging nose are the following 1.) Less is more. 2.) Minimal changes for maximum results. 3.) Refinement without tip grafts 4.) Correction of associated drooping nasal tip with the bulbous tip 5.) Making sure that the nasal correction in an aging patient is in harmony with the patient's face. Often I do the correction of an aging nose with a facelift so that this is in harmony with the face and nose.
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Bulbosity of aging nasal tip

The bulbosity of the tip is indeed reduced by removal of tip cartilage and suturing techniques. If the lower lateral cartilages had been stabilized at the time tip suturing techniques were performed, they usually do not need any further cartilage grafts, which could widen the nose if placed.  
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Bulbous nasal tip in aging nose.

Preserving a 5mm or more rim of cartilage in the lateral alar crura will preserve nostril rim support and prevent nostril collapse with inspiration. Weakening (by scoring or dividing the cartilage) and suturing the nasal domes to improve projection, refinement, and reduce tip width actually provide additional tip support also, particularly when the surrounding scar tissue is carefully held in place with tapes and/or splints. Sometimes additional definition is needed, and shield or... more
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Bulbosity of aging nose.

The aging nose can become more bulbous looking due to changes that occur in the attachments of the cartilages . Also skin changes can cause a bulbous look as in the condition known as rhinophyma. What will help your nose appear better cannot be determined without an examination. Possibly some on-line comments could be made if you submitted a series of pictures.
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Rhinoplasty

As long as you leave a 5mm lower rim strip of cartilage left behind that is not true. In the vast majority of patients that 5mm provides enough support to give you structural integrity. For extra safety I test all patients before surgery by closing off a nostril, have them breathe through the other nostril and then test the opposite side. If I detect weaker than normal tip supporting cartilage I will then leave a 7 or 8 mm wide strip. If the patient has had previous surgery with too much... more

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