Tip Rhinoplasty: What Is It?
Doctor Answers (101)
Rhinoplasty is one of the most complicated and intricate operations. The most difficult aspect of rhinoplasty is the the tip of the nose.
The tip of the nose is the most variable aspects of the nose. Cartilages that makes up the tip varies in each patient in regards to the length, strength and shape, different curvatures, unique asymmetries, and so forth. The nasal bones of each patient may be of different lengths and thickness, and of different orientation. The skin thickness also differs significantly between patients. All these variables have to be paid attention to if one wants to get a natural perfect nose.
Changing one aspect of the nasal anatomy can have a complex and cascading effect on other aspects of the nose. Rhinoplasty surgery is not only the science but also an art. Like a solving a puzzle understanding the complex interactions of the pieces, the surgeon must be able to understand the complex interactions of each patient's nasal anatomy. Therefore, knowledge, experience and technical ability are as important traits for a rhinoplasty surgeon as his artistic ability.
Tip Rhinoplasty: The Nose Knows
Rhinoplasty is surgery to change the shape of the nose. The nose has many subunits, one of which is the nasal tip. This area is a critical part of the nose and gives it much character. Reasons to perform a "tip rhinoplasty" are to change the shape of the nasal tip. Common complaints are to change a nasal tip that is wide, boxy, bulbous, or narrow.
Other procedures may be performed at the time a nasal tip is addressed during rhinoplasty. Such procedures include addressing the width, height, and length of the nose. Procedures can also be performed to improve breathing (e.g., septoplasty, turbinate reduction, spreader grafts).
It is important to select a surgeon who is properly licensed, trained, and experienced in performing this type of procedure. Clearly communicate your goals to your surgeon so he/she can meet and hopefully exceed your expectations.
A tip rhinoplasty is a nose job, no matter how you cut it.
Generally, a rhinoplasty operation may address several distinct anatomic parts of the nose, including the tip, the bridge, the radix (starting point of the bridge at the top of the bridge), and so on...
Tip rhinoplasty refers to a cosmetic nose operation that focuses on alteration of the tip of the nose. The tip of the nose is comprised of skin, subcutaneous tissues, and the paired lower lateral cartilages resembling an arched "M".
The tip of the nose has several aesthetic characteristics that may be altered in a rhinoplasty surgery.
Manipulation of the arched lower lateral cartilages allows your surgeon to increase or decrease the projection of the tip (the distance the tip of the nose projects from the face), the rotation of the tip, the angle between the tip of the nose and the upper lip, the width of the tip, the vertical height of the widest portion of the tip, among other more detailed considerations.
These aspects of the tip may be altered surgically using many different approaches. The external or "open" approach involves an incision on the skin of the collumella (skin between the nostrils)and a few hidden incisions inside of the nostrils, while the internal approach involves only hidden incisions inside of the nostrils.
There is no one way that is better. The best method is the one which your surgeon feels will allow him/her to peform all of the necessary steps for the desired result.
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What is a tip rhinoplasty?
A tip rhinoplasty involves changing the relationship of the lower lateral (alar cartilages) with the upper lateral cartilages and the caudal septum to refine the tip of the nose. It can be as simple as a "cephalic trim" or trim of the upper part of the bulbous tip cartilage, or more involved with adjustment of the septum at its base and grafts placed between the nasal ala to enhance and rotate the tip.
Best bet is to consult with either a board certified plastic surgeon or otolaryngologist who does a large volume of rhinoplasties (or "nose jobs") so that you have adequate information before entering into surgery.
Be careful, as changing one aspect of the nose (i.e. the tip) can change the whole balance of the nose (i.e. the bridge or dorsum, etc), so you never want to go with someone who is offering you the shortcut or easy way to do a rhinoplasty, as it is inherently a complicated procedure that varies from individual to individual depending upon their nasal anatomy.
What is a tip rhinoplasty
The nose is made up both bone and cartilage. The top third of the nose is bone , and the lower two thirds of the nose is comprised of cartilage. The very tip of the nose consists of two paired cartilages that resemble rams horns. Those are the cartilage is responsible for the contour, shape, projection and rotation of the nasal tip. A tip plasti rhinoplasty, limits the surgical attention to just the lower third of the nose, that is the tip.
Tip Rhinoplasty is One of the Most Challenging Aspects of Rhinoplasty
Tip Rhinoplasty refers to shaping of the nasal tip. This can be done closed or open. Most tip sculpting procedures , in my opinion, are best done through an open approach where your surgeon can three dimensionally see the cartilage frame right before his eyes without having to pull and yank it around through small nostril incisions. Many of the tip revision rhinoplasties I do are on noses that have been operated on through a closed approach. While closed rhiinoplasty can give you good results. Often times, the tip cartilages need much much more finesse and attention to detail so that the nose does not warp and look weird over time. Structural grafts and tip suturing techniques can be used together to effectively and elegantly shape the nasal tip.
It is rare to only need a tip rhinoplasty. Many times, it is best to harmoniously balance all aspects of the nose and reshape the bridge and other related or adjacent areas on the nose.
Good luck. The article in the link below is advanced but does show the importance of taking baby steps and using an algorithmic approach to nasal tip shaping so that the tip can be strong and aesthetically balanced with the rest of the nose and face. You can also download the PDF version and read it.
Shaping the nasal tip in rhinoplasty
A "tip rhinoplasty" refers to surgery to reshape the lower third (tip) of the nose, for patients who do not have any issues involving the bridge. Most commonly this surgery is for individuals who have a bulbous tip, but other problems can also be addressed. These can include asymmetry of the tip, droopy tip, hanging columella, and over or under-projection, meaning that the tip sticks out too far (or not far enough) from the face.
The surgery involves reshaping the lower lateral cartilages and, in some cases, the lower portion of the septum as well. This reshaping process can be done through an open or closed (endonasal) technique. My own personal preference is to use the open technique when there is extensive tip work to be done, as I am able to directly visualize the cartilages while reshaping them, but there are certainly many patients for whom I would used the closed technique as well.
In a true tip rhinoplasty, changes are made only to the tip cartilages of your nose. It is less surgery than a full rhinoplasty.
But your nose should be evaluated before deciding all you need is your tip done. The key is to keep the entire nose looking like it fits together. Digital imaging at the consultation may help you visualize this. The link below shows someone who wanted just a narrower tip.
Tip rhinoplasty is different because it only focuses on the aesthetic enhancement of the tip of the nose.
What is a tip rhinoplasty?
Rhinplasty involves two distinct parts one of them and probably the most challenging one is the reshaping of the tip called, tip rhinoplasty. Therefore it is not a different rhinoplasty, but it’s part of the procedure. There are patients who do not require ant change in their tip shape. In those patients a tip rhinoplasty is not necessary. These patients will have the best and the most natural results in the long run.
Today a tip rhinoplasty is normally done with an open approach which requires an incision across the columella, the part between the nostrils. The skin is lifted to show the cartilages and they are reshaped by sutures, resection and grafts.