Rhinoplasty and tip shaping
You're exactly right...the tip of the nose can be made smaller and more pointy with suture. Cartilage does not have to be removed to accomplish this, but the amount of shaping is limited with sutures alone. When cartilage is removed, enough cartilage is left to maintain support for the tip. So, when you're reviewing your procedure with your surgeon, ask if cartilage removal is necessary to accomplish your goals. Good luck!
Nasal tip refinement in an ethnic nose
There are a number of techniques used to create more tip definition in an ethnic nose. The procedure that is best for you really is dependent on a personal examination. A rhinoplasty specialist will not only look at your nose, but touching and feeling the strength of your tip cartilage as well as the skin thickness will help determine the best procedure for you.
The most common procedures used to create tip definition are sutures as well as one or two different grafts. These are called struts and grafts. These grafts are taken from your own cartilage, usually the nasal septum. Therefore they are natural.
Suture techniques are a great way to make your nasal tip more refined and pointy
And they are potentially reversible. Different techniques can make your nose look different and better in many ways. One thing that you have to consider in ethnic rhinoplasty is the thickness of the skin envelope over the tip. If your nasal tip is thick it is harder to make it more refined. Thinning the skin is an option but that risks the survival of the skin to some degree. Often times grafting in the nasal tip and creating more structure is what is needed. Your side profile can be maintained while still making the front more refined.
It appears that you are looking to define your tip without necessarily changing the tip position. This can typically be done in cases like yours with preservation of the underlying cartilage. Although many surgeons prefer to remove cartilage in order to define the tip, such technique can result in unpredictable changes in tip position and shape post-operatively. Experienced rhinoplasty surgeons can use one of many other techniques to achieve this goal without cutting cartilage out. One option is to use permanent sutures (stitches) to narrow the cartilage contour thus creating more tip definition. Another commonly used technique involves taking stiff cartilage from inside the nose (from the septum) and using it to permanently splint the sides of the tip. The splinting graft (referred to as a lateral crural underlay graft) is sutured to the undersurface of the bulbous segment of cartilage thus making the tip less rounded. Choice of technique depends on how your tip cartilage is actually structured and what works best in your surgeon's hands.
Redefining Bulbous Tip on Ethnic Nose
A bulbous tip can be restructured to look sharper and to add more definition to your nose. Typically, this involves sutures and grafting techniques that your surgeon can customize in accordance with your specific interests. If you are looking to modify and reshape a bulbous tip on an ethnic nose, you want your surgeon to create your a nose that looks most in line with your background and that best suits your face. Ethnic rhinoplasties are different than a traditional, Caucasian nose job. In the case of a bulbous tip, patients often seek my help to make their nose look more pointy, as you mentioned. Ethnic rhinoplasties can sometimes be tricky to perform, so it is important to keep in mind that you want a surgeon that has experience and can provide you with before-and-after photos of his/her patients.
Bulbous nasal tip on ethnic nose is a common problem. Usually this is the case for several reasons such as weak lower lateral cartilages (tip cartilages), thick skin, wide intercartilage distance, and weak tip support. Depending on your condition several techniques can be used. Suture technique can be used but if you have thick skin and weak cartilage, it may not be enough to make a difference. Sometimes, conservative defatting of the tip skin can help in addition to adding a stronger cartilage tip graft. If it is due to weak cartilages, augmentation using a stiffer cartilage in the area will also help.
There are several types of bulbous tips. Ethnic, cartilaginous and bulbous tips caused by scar tissue from previous rhinoplasty. From looking at your pics, it looks like you have a cartilaginous bulbous tip. This can be corrected to a certain degree using a suture technique without removing cartilage. However, a small cephalic strip may be necessary.
See video link below for further information.
Tip Rhinoplasty Can Correct Bulbous Tip for Ethnic Patients
Tip rhinoplasty is a very effective means of reducing the roundness or bulbousness of a tip - particularly in ethnic patients.
The techniques used will depend on the patient's specific nasal structure and characteristics. The lower lateral cartilages (tip cartilages) can be trimmed and reshaped either with sutures or with grafts to relieve the excess curvature. Regardless of the technique, it is possible to correct the tip without changing the profile.
To get a better understanding of what your nose would look like after surgery, your prospective rhinoplasty surgeon should be able to show you before and after computer simulations. Many rhinoplasty surgeons use computer imaging, and recently 3D rhinoplasty imaging has become available (http://youtube.com/?v=m0-NPaSp9no). This allows patients to preview how their nose might look after surgery from any angle.
See a rhinoplasty specialist.
It is necessary for the surgeon to examine your nose to decide which of many techniques is the best for your particular nose. See an experienced rhinoplasty expert who does a large number of ethnic noses.