Pointy cartilage - What is going on with my nasal tip? (photo)

Based on your photos, your correction should not be too difficult. In experienced hands, a revision procedure is not risky and can nicely smooth out the point you see. As healing occurs, scar forces can pull cartilage into a position that it was not at when the procedure was completed. So the revision should give you a nice result.

In thin skinned patients, it is not uncommon to see cartilage irregularities that can sometimes be seen as "white pointy" areas on the nasal skin. Usually this is either a cartilage graft or the native cartilage that has been strangely positioned/tensioned/oriented. Sometimes it can be the native lower lateral secured over a very prominent graft (septal extension graft or columellar strut). The solution is to perform a revision with mastoid fascia or some other type of soft tissue interface to provide more soft tissue coverage.

Based on your photos, you appear to have very thin nasal skin. When all swelling resolves after rhinoplasty surgery, sometimes those people within nasal tip skin may see visible nasal tip irregularities. In our experience, microdroplet Silikon-1000 nasal injections may be considered for camouflaging this, without additional surgery. I hope this helps! Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photographs, you are a good candidate for a revision rhinoplasty. Maneuvers for your surgery would include nasal tip deprojection and placement of a mastoid fascia tip graft to provide a smoother tip contour. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon