Bulbous Tip And Deprojection Of Tip? How Much Can Be Done?

Realistically how much can be done with the tip when it comes to deprojection and slimming the bulbous tip? From what I understand deprojecting the tip makes the nose wider? What can be done to satisfy both of these issues? Does a nasal hump effect the outcome? I've heard some doctors say that with an open nose job they are able to shape the nasal tip better rather than with a closed technique. What is your opinion on that? You can check my photos by checking my last question I submitted.

Doctor Answers 9

Refining and deprojecting nasal tip

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The same results can be obtained through either closed or open rhinoplasty techniques.  The only difference is an incision across the columella with an open technique.  All other techniques on the nasal tip cartilages, grafting, hump removal, osteotomies, and any cartilage grafting can be done through either closed or open technique.  It is a surgeon and patient preference as to whether closed or open technique is done.  The tip can be narrowed and refined 30-40%.  The hump can be removed, tip deprojected and slightly rotated, along with releasing the depressor septi ligament.  This can all be done through closed rhinoplasty techniques.  The surgical approach for a wide bulbous tip is to narrow the tip cartilages by suturing the lower lateral cartilages together with a conservative removal of the scalloped portion of the lower lateral cartilages.  There will be a slight tip projection but this would probably not be enough to flare the nostrils significantly.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Rhinoplasty With Multifaceted Approach

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Based on the photos, you are a good candidate for a multifaceted rhinoplasty.

Open or closed procedure should not be a concern to you as far as the results are commendable.

Choosing the type of the surgical procedure (open vs closed) to achieve your desired goals will be based on the physical examination you will have with the surgeon of your choice during the consultation.

To deal with the bump of your nasal dorsum, your overprojected tip and the possibly remaining areas of interest not shown in the photos, you will have to consult with a board certified surgeon of extensive experience in rhinoplasties who will guide you to make a well informed decision.


Thank you for your inquiry and the best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews


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 Rhinoplasty are often classified in difficulty from 1 to 3 with 3 being the most difficult. Based upon your pictures and without an examination your are probably a 2. Yes, there are issues of a dorsal hump, bulbous tip, and under rotated or hanging tip. But, there are also other issues that should be addressed such as a projecting nose, prominent caudal septum, etc. May I suggest you write down the 3 things you really hate about your nose and take them to a surgical consultation. Make sure to tell your practitioner if you have difficulty breathing or suffer from sleep apnea. Express your concerns to your Rhinoplasty surgeon and ask how each issue will be addressed. Typically experienced rhinoplasty surgeons will have an Action Plan for their procedures and be able to show you photographs of similar patients who have a condition like yours. Best,

Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon

Bulbous Tip And Deprojection Of Tip? How Much Can Be Done?

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 Aesthetically speaking the nose has a dorsal hump, is wide at the mid nasal segment as well as the nasal tip that is over-projected and under rotated.  An Open Rhinoplasty would be able to address all of these issues and create a naturally, more attractive nose IMHO.  Hope this helps.

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

How much can be done

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I get a sense from your questions that you are "over thinking it". It reminds me of the common disclaimer "professionals at work, do not try at home". There is a tremendous amount that can be done to deproject, shape and balance your nose. These steps are all interrelated and take years for surgeons to easily visualize them. I suggest that you focus more on the outcome you are looking for and let your surgeon worry about the steps you need to get there.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Tip rhinoplasty for a bulbous and droopy tip

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Tip rhinoplasty can address tip bulbosity and droopiness.  However, you must realize that rhinoplasty is a complex procedure. Changing one part will affect the overall shape of a nose relative to other parts. I would recommend an open rhinoplasty to reduce your overall nasal size which includes nasal tip, dorsal hump and projection. You need to have a consultation with an experienced rhinoplasty surgeon to evaluate your nose as a whole. Good luck. Dr. Kevin Sadati.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 222 reviews


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While I prefer to perform the majority of my rhinoplasties open, there are those that can achieve nice results closed.  Either way is OK in ther right hands.

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


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Nice structural support and thin skin allows us to make significant changes to your nose.  The tip, dorsum and mid-nose should all be addressed.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Decreasing Nasal Tip Projection and Bulbous Shape

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Refining your bulbous tip will help the problem with over projection. It would be easier to answer your question after an examination of your nose. The hump should be reduced so a straight profile can be achieved. That combined with narrowing the nasal pyramid will give you a natural result that is proportional to your facial features.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 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.