Rhinoplasty Bulbous Tip? (photo)

Hello, I am getting Rhinoplasty soon and I wanted to ask something. First off I am getting a number of things corrected ( you will see in the photo) but I need help explain a certain part to my surgeon. I just can't figure out how to describe that I want the " bottom " part of the tip (no the columella) to be smoothed out if im going to smooth out the "top" of my tip or else its going to look silly. Thanks

Doctor Answers 5

Rhinoplasty bulbous tip

A bulbous tip is corrected with suture techniques to narrow and refine the entire lower lateral cartilage of the tip located at the actual dome projection points.  This narrows the upper and the lower portion of the cartilaginous portion of the tip.  In addition cartilage is removed from the sidewall of the tip to give more refinement in that area as well.  It is also important to address the columella to make sure it is not hanging and is balanced with the remainder of the nose.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty questions

I definitely see what you mean about having your nose narrowed and correcting the bulbous tip. Your explanation of what you want with the tip is pretty vague. Younshould be more specific with your surgeon about finding what can and cannot be accomplished in your particular case. Your surgeon will know what can be reasonably accomplished. The most important thing is to go to an experienced surgeon in whom you have confidence to,make the right corrections in your situation.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Imaging with a Rhinoplasty

The most important thing in a rhinoplasty is that you are able to communicate well to the surgeon what you want done to your nose.  In turn, he should be able to tell you what is and is not possible.  Photo imaging is a vital part of this communication.  In my office, we use Vectra 3D imaging to aid in this communication.  Does he use some form of photoimaging?  If not and you don't feel like you are talking the same language, maybe you need to think about a second opinion.

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 87 reviews

Rhinoplasty Bulbous Tip?

 It seems to me that you should describe what you want done to your nose, during the Rhinoplasty, just as you have here.  Take your computer or e-mail the Rhinoplasty Surgeon a photo with the proposed changes and instructions.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Proposed changes during rhinoplasty

Your question is why I use computer imaging to discuss proposed changes with patients.  As you can see, it is very difficult to describe exactly what you would like to accomplish with rhinoplasty since the nose is a very complex structure.  I will say that at some point, you have to turn over your trust to the surgeon's aesthetic judgement.  I think most rhinoplasty surgeons want the nose to look good overall and so would not leave an area that looks "silly" on the table.   You have a bit of a "hanging infratip lobule", noted by your black lines.  A good surgeon will take all these areas into consideration when re-shaping your cartilage.  Make sure you are on the same page with your surgeon before the surgery, however.  Good luck. 

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 24 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.