I like my nose shape but I have to much cartridge on the tip of my nose, I would like to remove it. Options? (photo)

Improving the nasal tip to achieve an improved natural appearing cosmetic result is a frequent request of patients wanting nasal refinement. It is possible to improve the cosmetic appearance of the tip alone without altering the rest of the nose in some patients. Whether the optimal option in your particular situation would be a tip rhinoplasty alone or a full rhinoplasty would best be determined at a consultation. Either procedure can be performed with a closed or open approach.

Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of the operative procedure would not be in your best interest. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (otolaryngologist) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California

The bulbous nasal tip can be reduced with a combination of cartilage removal and suture techniques when there is wide cartilage is present. Thick skin in the tip of the nose prevents refinement in that area, so is important to have realistic expectations.