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Does Tip Refinement Result in a Tip Becoming More Elevated?

asked 8 months ago by Nosee in Los Angeles, CA
Latest answer by William Portuese, MD
Question viewed 455 times
Tags: nose tip, bulbous, Middle Eastern, upturned

Hi, I have a boxy, bulbous tip that I would like refined to a more slim almond-shape. I currently like the elevation of my tip, and I'm satisfied with the amount of nostril show I have from the front view, but I'm wondering if tip refinement will result in my tip being pulled up more..which is something I don't want. For what it's worth, I am of Middle Eastern descent and have thick skin. Thank you!

16 answers to Does Tip Refinement Result in a Tip Becoming More Elevated?

Tip Refinement in Middle Eastern Nose Does NOT Need to Elevate Tip

You ask a very important question. It is critical especially in Middle Eastern patients to not over-rotate the tip while refining it. I have written on this topic in numerous textbook chapters and articles on Middle Eastern Rhinoplasty because it is so important to not erase ones ethnicity. Producing too much tip rotation is a problem I see a lot in noses that I have to revise. The tip can be shaped and refined without tip rotation however, you should discuss thoroughly with your... more

Ashkan Ghavami, MD
Beverly Hills Plastic Surgeon

www.Ghavamiplasticsurgery.com

Nose tip refinement

Upper tip rotation usually does not occur at the time of primary rhinoplasty when narrowing the nasal tip. In a few select patients there can be a very slight (1-2 mm) elevation that is very miniscule. Refinement of the tip has to be performed by either removal of tip cartilage, sewing the tip cartilages together, or a combination of both. The thick skin can be an ongoing postoperative issue which most likely will necessitate several cortisone shots in the postoperative... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Does Tip Refinement Result in a Tip Becoming More Elevated?

Thank you for your question. Tip refinement is a general term. Per your preferences, rhinoplasty can improve tip shape without necessarily elevating the tip. Communicate your preferences clearly to your surgeon. Your skin thickness, ethnicity, and desire to preserve certain nasal characteristics can and should be factored in when your surgeon develops a surgical plan. Good luck.

James M. Pearson, MD
Los Angeles Facial Plastic Surgeon

Tip refinement in the Middle Eastern nose

It is possible to refine the tip without causing greater upward rotation (or "pulling up") of the tip. Tip refinement is a term that can include many different techniques. Commonly performed steps to address a boxy tip include cephalic trim of the lower lateral cartilages, and various suture techniques to alter the shape of the tip. Tip rotation, tip projection, the relationship of the tip to the dorsum, and nasolabial angle are also important factors in what makes a nose... more

Anita Patel, MD
Beverly Hills Plastic Surgeon

Nasal tip refinement and tip position

Nasal tip size, shape, and position tend to be related variables, but also may be independently controlled during rhinoplasty. Be sure your surgeon understands your desired result, and agrees that he or she expects to accomplish at least a close approximation.

Steve Laverson, MD
San Diego Plastic Surgeon

feelbeautiful.com

Tip refinement without tip elevation

Your question raises two important issues. The first issue is whether you can modify a boxy tip without upwardly rotating the tip. Many of the steps uses in tip refinement during rhinoplasty often times can lead to slight to significant upward rotation of the nasal tip. Awareness of the fact that you like the current position of your tip will enable your surgeon to perform tip refinement without tip elevation. The second point that you bring up is that you have... more

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon

Tip refinement in rhinoplasty

Tip refinement in rhinoplasty can certainly be performed without elevating the tip. I would be careful when choosing a surgeon who is an expert in rhinoplastic surgery. Computerized video imaging will also help with the pre-op consultation to make sure you are both on the same page. Ask to see photos of patients your doctor has done in the past . Thicker skin can be a problem in sculpting tips , however, a skilled surgeon knows how to optimize the results.

Robert M. Jensen, MD
Medford Plastic Surgeon

Tip Refinement Surgery

A tip refinement procedure does not necessarily have to change the tip rotation at all. It is a procedure often best designed to reshape a bulbous tip to a more refined shape. If done properly, this is something I can maintain your ethnic features while also reshaping your nose to a more attractive look. Ensure that you see an experienced rhinoplasty surgeon to get the best results. Best of luck. Vincent Marin, MD San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon

Rotation with Tip Refinement

Rhinoplasty surgery should always be individualized to meet the needs and desires of the patient and surgeon. I''ve never done two noses exacly the same. A bulbous tip with thick skin can be refined without increasing rotation if that is the desired result.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Refining tip without changing tip elevation

An experienced surgeon can perform rhinoplasty is such a way that the tip can be refined witout changing your nostril show or tip rotation. Not everyone does it in this way, however, so you need to be clear about your wishes. Look at before and after photographs of similar patients to make sure you like the results.

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Rhinoplasty Tip Refinement

Hi Nosee (I like your name)! The most effective and accurate way to treat the boxy/bulbous tip is through non-destructive suture technique which is almost always performed through an open rhinoplasty incision. Tip position is completely controlled by cartilage graft reinforcement to allow for tip elevation (rotation), tip de-rotation, or neutral position. Your thick skin may have a negative effect on tip refinement in general. A detailed in-person examination by... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

Nasal Tip Refinement and Elevation

Nosee in Los Angeles, CA The relationship bewtween refinement, support and elevation of the nasal tip are intertwined. Often a bubous, thick skinned nasal tip lacks support and rotation. Every nose is different and requires a pesonalized apporaoch. I would recommend a consultation and computer imaging so you can visualize the possible changes to your profile and communicate your desires with your surgeon. Good luck! Tom Kaniff

Thomas E. Kaniff, MD
Sacramento Facial Plastic Surgeon

www.facialcosmeticsurg.com

Nasal Tip Refinement Without Rotation

The answer is yes, you can improve tip definition without rotation. This may be best done through and endonasal approach. That means there's no external scar/incision and the cartilages are viewed, trimmed, and sutured by the surgeon with less tissue dissection. When you have more dissection or and open rhinoplasty you can have some rotation early that will settle, so just be aware. Regarding you skin thickness. If the goal is a more defined tip the changes... more

Chase Lay, MD
Bay Area Facial Plastic Surgeon

Tip Work

Tip refinement is a bit of a "generic" term- It is possible to alter the tip surgically, and rotate the tip significantly-or on a limited basis. Your overlying skin also has a significant contribution to your result. This is a great question, and you should ask your surgeon the same

William Loutfy, MD
Albuquerque Plastic Surgeon

Does Tip Refinement Result in a Tip Becoming More Elevated?

I have performed Rhinoplasty for over 20 years and refinment of the tip does not have to cause tip rotation (elevation). An Open Rhinoplasty, IMHO, does cause the nasal tip to rotate upward between 5-7 degrees and I factor that into who is and is not a candidate for an Open Rhinoplasty. If the nasal tip is at the desired position a closed Rhinoplasty with a retrograde tip plasty is the procedure of choice to thin the tip without causing an change in tip rotation. more

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty

Tip refinement is a common request for patients considering rhinoplasty surgery. The nasal tip can be refined without changing the amount of tip rotation (or the amount of nostril showing). However, it depends on your underlying anatomy and what, if any, previous work has been done on your nose.