Adivce for a Wide and Bulbous Nose? (photo)

Hello, I am considering having a Rhinoplasty on the tip of my nose as I feel that there is no definition, the shape is very wide and bulbous. I'm not sure whether it is that I have thick skin (making a Rhinoplasty pointless) or an overly sized cartilage? Am I a candidate for Rhinoplasty? If so what would you recommend I do? Because it's dealing with the tip of the nose and the procedure is more complex are the chances high that I would need a revision surgery after a primary surgery? Thankyou

Doctor Answers 13

Wide and Bulbous Nose

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Hi Kyle.  Rhinoplasty (nose reshaping surgery) to address a wide nose is a common request. Most likely, an “open rhinoplasty” (where the soft tissues are gently elevated to allow direct access to the tip cartilages) will be required. These tip cartilages are then sculpted and sutured to refine the nasal tip. Osteotomies are required to reposition a wide nose closer to the midline.

If you like, please follow the link below. The article on Nasal Analysis contains many diagrams that you may find helpful. This may help guide your conversation with your surgeon.

Hope this is helpful. Best wishes.

San Antonio Facial Plastic Surgeon

Advice for wide & bulbous nose

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A bulbous tip is best addressed by cartilage removal and tip cartilage suturing techniques to refine the nasal tip.  Any dorsal hump is also reduced at the same time to decrease the overall projection of the nose and to make sure the bridge is in good alignment with the tip.  This gives more definition to the tip.  Thin or thick skin cannot be made based on a picture, it must be done by palpation at the time of physical exam by your rhinoplasty surgeon.  In very experienced hands the chance of a revision rhinoplasty is approximately 10%.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Adivce for a Wide and Bulbous Nose?

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  From the photos, the nasal skin appears thick with weak, wide and asymmetric tip cartilages.  IMO an open Rhinoplasty or more appropriately an open Tipl-plasty with possible ear conchal cartilage ear graft to the nasal tip for further tip strength and refinement would be suggested.  Be sure the Rhinoplasty Surgeon, you choose, understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally, more attractive nose.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

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Wide tip

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Treatment of a wide or bulbous tip is a common request among rhinoplasty patients.  A number of techniques have been described to manage this problem.  You are correct in recognizing that both skin and cartilage can play a role in the wide nasal tip.  It is important that you see a plastic surgeon experienced in rhinoplasty who will perform a detailed exam and nasal analysis.  Your surgeon will be able to discuss technique and possible results with you.

David Bray, Jr, MD
Los Angeles Plastic Surgeon

Bulbous tip rhinoplasty

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Your photos show a bulbous tip that should be very amenable to improvement with rhinoplasty.  Thickness of skin certainly can effect the outcome, but a skilled surgeon will take this into account when adjusting the underlying cartilagenous support. 

You can expect a great result if you choose the right doctor.  Look for a board certified plastic surgeon with a good portfolio of before and after pictures top show you.

Any rhinoplasty in any patient may require a revision!

Male rhinoplasty

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You certainly are a candidate for rhinoplasty and tip work can help improve the way it appears. A formal exam and an evaluation of your concerns is the first step to take becuase photos can distort things especially as seen in some of the photo views that you took.  Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Male rhinoplasty

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From the pictures and information you have provided, you are likely an excellent candidate for rhinoplasty. I would recommend an open rhinoplasty to decrease the fullness, or bulbosity, in your nasal tip. In addition, your photos suggest that you would benefit from reduction in the area above the tip (the supratip area). Rotating your tip up to a refined but masculine position, and reducing nostril size would also be beneficial. Any surgery has risks; rhinoplasty specifically has a revision rate of about 15% in large series. A thorough consultation with a board certified plastic surgeon who specializes in rhinoplasty would, of course, be needed to determine a specific surgical plan and if this is the right procedure for you. I hope this helps.

Steven Goldman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 168 reviews

You may be a candidate for Rhinoplasty Surgery to refine your wide and bulbous tip.

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I read your concerns and reviewed your photos. Up-close photos, as you posted, are not as good as full-face photos for evaluation.

Your oblique photo demonstrates an acute nasolabial angle, a droopy tip, lack of tip support, and fullness in the supra-tip area. These issues may be improved with well-performed nose job surgery. Hope this is helpful for you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Wide, Bulbous Tip with Thick Skin

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While thick skin will limit the definition that can be achieve, it does not make a rhinoplasty "pointless". Significant improvement is possible without an increased risk of the need for a revision procedure. Although possible, it is unlikely that you have oversized cartilages. In patients like you with thick skin the cartilages are frequently weak, necessitating cartilage grafts in the tip to provide support and narrow the existing tip. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty for the bulbous tip.

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To have a good result from a rhinoplasty for your nose you need to select an experienced rhinoplasty surgeon. You should not need a revision for this normally.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.