Will I need a graft to achieve a more refined tip and aesthetically pleasing shape? (photo)

Based on your photo, you appear to have somewhat thick nasal skin and a bulbous tip appearance. He may utilize and extended shield graft in patients with relatively thick skin like yours to achieve maximum tip narrowing and to add structural support. That said, sometimes we put in tip grafts and they don't look good, as seen on the operating room table, and are removed before closure. In that regard, I believe you could achieve tip narrowing without a tip graft, however, sometimes they are very helpful for achieving a desired result. Thank you for this interesting question, and I hope it was helpful! Sincerely, Dr Joseph

Thank you for your photo. Additional photos would be helpful to evaluate your overall nasal tip width, tip projection, dorsal height, and other factors. It would also be helpful to know the thickness of your nasal tip tissues and the strength of your nasal tip cartilages as these are partially responsible for how much definition is achievable in your nasal tip. Judicious trimming of the nasal tip cartilages to remove sections which are too rounded or bulbous as well as nondestructive suturing of the nasal tip cartilages help to improve and refined the nasal tip shape and contour. Cartilage grafts from your septum to help support your nasal tip may be required, depending upon the strength of your nasal cartilages as well as the thickness of your nasal tissues. The best understanding of what would work best in your case and your expected results would be achieved after a face-to-face consultation with a board certified plastic surgeon as well as a detailed examination of your nose. Best wishes.

Unfortunately, you have not provided lateral views or inferior views. However, it looks like you have more than enough cartilage that a graft would not be necessary. I would need additional photographs to give you an accurate answer.

Best Wishes,

Gary Horndeski, M.D.

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. Your own septal cartilage could be used for all structural support grafts. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

The use of grafts will largely depend on the surgeon you choose. Your rhinoplasty could be done with or without grafts. I suspect you would get opinions both ways

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. A large portion of my practice is dedicated to rhinoplasty surgery. In your case, there will most likely be no need for any additional cartilaginous grafts. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Tip refinement in rhinoplasty surgery often focuses on reshaping and repositioning the lower lateral cartilages of the nose. Often, this involves removing a small portion of each cartilage and reshaping them with sutures to give a more defined look. The position of these lower cartilages is also very important in the final appearance of any nose and cartilage grafts are often an important way to ensure that these cartilages are positioned appropriately and are supported for the future.

Hello Amy,As you know the main material we use in rhinoplasty is cartilage but gladly the most of people have enough cartilage in the nose which called septal cartilage.I use septal cartilage except ethnic rhinoplasty and revision rhinoplasty.In you case I will not need any graft cartilage since your septum cartilage will be enough.I wish you the best luck with your surgery processYours, Dr Mustafa Bagli

More information is needed, such as a full set of facial photographs from all angles, since the nose is a three-dimensional structure. Based upon your frontal view only, the bulbous tip is reduced with a conservative cartilage removal and suture techniques applied to the tip cartilage themselves. Adding cartilage grafts will only make your tip bigger, not smaller. Choose your rhinoplasty specialist wisely based on extensive experience producing natural results.

To give you an idea of what an appropriate procedure would be would really require seeing better pictures, especially including a profile picture.
We also need to understand what you’re trying to achieve.
I think could be done removing Cartlidge only without the need for a graft.
I suggest having a few in person consultations with plastic surgeons in your community who have extensive rhinoplasty experience.Profile of views are probably more important than a frontal view for a nasal aesthetic assessment.
Best,
Mats Hagstrom MD