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

Question

I am considering a rhinoplasty to refine the tip of my nose and achieve a more aesthetically pleasing shape. Based on my goals, would grafting be necessary to achieve the desired results? I’m specifically interested in understanding whether grafting would help with structural support and overall refinement of the tip, or if there are techniques that could achieve this without the need for grafts. Thank you!

Eric M. Joseph, MD · Answer

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

Jeffrey M. Darrow, MD · Answer

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.

Gary M. Horndeski, MD · Answer

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.

Richard G. Reish, MD, FACS · Answer

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

Ronald J. Edelson, MD · Answer

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

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

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

Answers (10)

Answer: Rhinoplasty

Answer: Rhinoplasty

Answer: Rhinoplasty

Answer: Rhinoplasty

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Everything you need to know about Rhinoplasty

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