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

Question

I got a rhinoplasty over two years ago and pretty soon after noticed the left side of my nose had pointy cartilage on one side of the nasal tip while the other side was rounded and soft. My doctor told me to push on it and it should resolve over time but it never has. What could have happened here? Did a cartilage graft slip or was one side of my nose just not done like the other? Is a revision rhinoplasty risky? I would not want a collapse.

Andrew Miller, MD · Answer

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.

Gianfranco Frojo, MD · Answer

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.

Eric M. Joseph, MD · Answer

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

Richard G. Reish, MD, FACS · Answer

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

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

Answers (4)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

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Everything you need to know about Revision Rhinoplasty

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

Answers (4)

Answer: Revision rhinoplasty

Answer: Revision rhinoplasty

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.