I am highly considering a rhinooplasty. I know that until a PS checks me, it is hard to know for sure, but I wanted opinions before I go in on whether a tip plasty would work for what I wanted. The bottom half of my nose has A LOT of cartilage and my bone seems to be straight. All I would want is for my tip to be less bulbous/more refined, esp. when I smile as it seems to droop and widen. I know that I have read that once something is done on the bottom though, it can mess up higher areas
Would a Tip Plasty Work for Me?
Doctor Answers (9)
It is a very limited number of patients who require only a tip plasty. Typically, the remainder of the nose is already in balance and only the nasal tip is bulbous and out of proportion. The tip can be refined by removal of cartilage and tip suturing techniques, which narrow, feminize, and refine the nasal tip. To prevent nasal tip drooping upon smiling, the depressor septi muscle is released and the tip will stay straight upon animation. This can all be done through closed rhinoplasty techniques.
Tip Plasty for Bulbous Tip
Rhinoplasty surgery should be individualized to meet the needs of each patient. In over 30 years I've never done 2 noses exacty the same. An experienced surgeon will tell you if a tip plasty is all that is necessary to achieve a natural, proportional result.
Wouls a tip plasty work for me?
Yes, but a profile view would be helpful in the evaluation of your nasal tip as it would show the angle of tip rotation. The tip is slightly asymmetric with thicker, flared nsotrils. The tip cartilage can be thinned and shaped but there's limited reasonable things to change the thick nostrils as they leave unsightly external scars. Bottom line, improvement is possible with a Tip Plasty.
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Refinement of nasal tip
Good question. One must consider entire nasal dimensions when considering surgical improvement of one area in order for the entire nose to be 'in balance' and aesthetically pleasing. So, if you are desiring nasal tip refinement, you most likely will need narrowing of the nasal base to 'match' the tip. Drooping of the nasal tip while smiling is an easy fix. Best wishes, Dr. H
Questions about a tip plasty
Providing any sort of helpful advice is impossible particularly with limited views of your nose including absence of a side view. You can receive a more helpful answer by consulting with one or more plastic surgeons who can examine you closely, determine your goals and then make suggestions.
Is tip refinement possible?
Subtle refinement to the tip can be performed with rhinoplasty surgery, though one must be careful about narrowing the tip too much as this may lead to chronic nasal congestion.
Meet with a few surgeons who are board certified in facial plastic surgery or plastic surgery and who perform quite a bit of nose surgery. Discuss your goals and see if they feel they are reasonable to attain whil maintaining normal nasal function.
Tip Plasty vs Rhinoplasty
What you can do with your fingers may not be what one can accomplish with a full rhinoplasty. If you notice that when you compress your nose, you also cause the nostrils to "notch" or crease which will lead to a clover-like effect on the nose. Also, narrowing your tip cartilage can make the base of the nose seem disproportionately wide. An attractive nose needs to be in balance with itself and the rest of your face.
See an experienced, board certified plastic surgeon in your area who performs a good deal of rhinoplasties.
Best of luck
Vincent Marin, MD
San Diego Plastic Surgeon
Rhinoplasty for the bulbous tip.
Tipplasty for tip refinement rhinoplasty
A tip plasty would address your areas of concerns. There is a muscle that pulls the tip down when smiling and that can be released so it does not pull on the tip when you smile. Working exclusively on the lower third of the nose will not mess up the higher areas, but the surgeon performing the rhinoplasty has to make changes to your tip so that it blends in and remains harmonious with the upper two thirds. Though I mentioned the effect of the tip drop when smiling, I did not discuss the wideness when you smile. That can also be addressed but much less so than the tip droop. If your nose is narrowed when you smile, it will be too narrow when you are not smiling! Best, Dr. Phil