Need Advise on Bluish Nasal Tip After Repeated Rhinoplasties, Options?

Question

The tip of my nose often has a bluish color to it, and this becomes much worse when I get cold. Presently there is a graft in my tip. I have also already had four rhinoplasties. Is there anything I can do to remedy this problem? I want to get my tip graft removed (I never agreed to a tip graft). Would another surgery to remove the tip graft potentially make my tip even more blue in color? Would you advise to get the tip graft removed, or do you think another surgery could make my problem worse?

Thomas A. Lamperti, MD · Answer

The bluish skin discoloration is most likely due to changes in the blood supply to your nasal tip skin from your many prior surgeries. I doubt that the tip graft itself is causing the problem and certainly removing it wouldn't be expected to improve the problem -- only make it worse potentially.

Robert Kotler, MD, FACS · Answer

Dear Jessica;

	What you have is a skin problem.  Often when the skin has been operated on four times, as in your case, there is a change in the blood supply.  It sounds like you have had Nature deliver somewhat of an excess of veins, and therefore blood is pooling in the tip of your nose.  That would give it the blue color.  I doubt if removing the tip graft is the answer. 

	My suggestion is that you see a cosmetic dermatologist.  See if the dermatologist agrees that your major problem is now the nature of your skin and not the underlying structure that has been changed by the rhinoplasty.  Then, if in fact that is the case, you should return to your last rhinoplasty surgeon and discuss with him the recommendations of the dermatologist or, even better, have the dermatologist speak with your surgeon. 

	Based on what you tell me, and particularly since &ldquo;it becomes much worse when I get a cold,&rdquo; hopefully you now realize that what you have is a consequence of the surgery, which another surgery would have no hope of correcting. 

	Robert Kotler, MD, FACS
	Facial Plastic Surgeon
	Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
	Author, THE ESSENTIAL COSMETIC SURGERY COMPANION

Michael L. Schwartz, MD · Answer

This may be a sign of poor vascularity which puts you at extremely high risk for skin necrosis with further procedures. Be careful. Don't take going for more surgeries casually.

Francis R. Palmer, III, MD (retired) · Answer

The bluish discoloration, of the nasal tip skin, is an indication of decreased (compromised) blood supply to that tissue.  This occurs from Rhinoplasty, more with Open Rhinoplasty than Closed IMO and is an absolute contraindication for any further nasal surgery IMHO.  You will need to proceed with extreme caution with any further nasl manipulation, including removal of the tip graft should that become necessary.  The risk is a complete loss of the nasal skin, over the nasal tip, which is a disfiguring event.

Richard W. Fleming, MD (retired) · Answer

After multiple rhinoplasties, the bluish color to your nasal tip may indicate compromised circulation. If this is the problem skin loss could occur, with or without another procedure. Remember the rumors about Michael Jackson's nose. Be careful if your considering the removal of a tip graft.

Need Advise on Bluish Nasal Tip After Repeated Rhinoplasties, Options?

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Need Advise on Bluish Nasal Tip After Repeated Rhinoplasties, Options?

Answers (5)

Answer: Need Advise on Bluish Nasal Tip After Repeated Rhinoplasties, Options?

Answer: Need Advise on Bluish Nasal Tip After Repeated Rhinoplasties, Options?

Answer: Bluish Nasal Tip

Answer: Bluish Nasal Tip

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.