Is there anything other than a rhinoplasty to fix my nose cartilage? (Photo)

Question

I like my nose shape from the side. And I don’t hate my nose shape from the top. But it’s certain angles that my nose looks like a blob. Is there any minimal invasive procedure that could just quickly shape the tip of my nose? I’m a bit afraid of general anesthesia and would prefer local.

Steven M. Denenberg, MD · Answer

You do indeed have a very nice profile. It very much seems as though the width of the tip is because of the size and shape and position of the two tip cartilages, and that would take a rhinoplasty to correct. There is no injection or quickie operation to modify those cartilages in an attractive fashion.

Finally, remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that most noses need require skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Donald Groves, MD · Answer

Hello and thank you for your question! It sounds like your primary concern is the shape, poor definition, and asymmetry of your nasal tip and nostrils—one of the most common reasons people seek out both primary and revision rhinoplasty. These issues can only be properly addressed through rhinoplasty—fillers will simply add more volume to your tip, worsening the problem.

Many surgeons overlook key techniques that otherwise can soften the appearance of underlying structures in patients with thin skin, significantly improving tip symmetry and refinement. These specialized maneuvers require a high level of expertise and experience, which most surgeons simply do not have. Given your history, an open septorhinoplasty would be the best approach to precisely reshape your nasal tip, improve the definition, refine the bridge, and restore overall balance.

In addition to reshaping your nose aesthetically, your septal cartilage (or an alternative graft material) would be used to create structural grafts, reinforcing key areas like the columella (the strip of tissue between your nostrils). This is crucial to maintaining long-term symmetry and preventing future distortions.

Rhinoplasty is one of the most technically demanding procedures in all of plastic surgery—millimeters make all the difference. If a surgeon is only performing one or two rhinoplasties per month, they simply do not have the level of experience necessary to achieve the best possible result. Your nose defines your entire face—this is NOT a surgery to leave in the hands of just anyone.

I have had extensive training in complex rhinoplasty, working under one of the highest-volume rhinoplasty surgeons in the world (who performs 1,000+ nose surgeries per year). If you’re serious about getting the best possible result, I’d be happy to see you for a consultation (Virtual or In-Person) where we can discuss your goals, perform a detailed examination, and create a customized plan for your ideal nose.

I look forward to helping you achieve the refined, balanced nose you deserve!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your concerns and providing your photos. It's understandable that you would prefer a less invasive option to address the specific aspects of your nose that you are unhappy with.

Non-Surgical Options:

Dermal Fillers: Hyaluronic acid fillers can be used to make minor adjustments and enhance the shape of your nose. This procedure is often referred to as a "liquid rhinoplasty." It can help improve the contour and appearance of the nasal tip and other areas without surgery.
Benefits: Minimal downtime, immediate results, and the procedure can be done under local anesthesia.
Limitations: Results are temporary, typically lasting 6-12 months, and may not address more significant structural issues.
Minimally Invasive Surgical Options:

Tip Plasty: This is a surgical procedure focused solely on reshaping the tip of the nose. It can be done under local anesthesia with sedation, minimizing the need for general anesthesia.
Benefits: More permanent results compared to fillers and can provide precise alterations to the nasal tip.
Considerations: While more invasive than fillers, it is less extensive than a full rhinoplasty.
Consultation with a Specialist:

Personalized Assessment: I recommend consulting with a board-certified plastic surgeon or facial plastic surgeon who specializes in nasal procedures. They can evaluate your specific concerns and discuss the best options based on your anatomy and aesthetic goals.
Safety and Comfort: Ensure you discuss your concerns about anesthesia with your surgeon. They can explain the options for local anesthesia and sedation to ensure your comfort during the procedure.
It’s essential to have realistic expectations and to choose a treatment plan that aligns with your comfort level and desired outcomes.

Best wishes for achieving the look you desire!

Best regards,

Eric M. Joseph, MD · Answer

Sometimes an injectable gel filler may be helpful for achieving tip definition, however, sometimes filler can lead to an unnecessarily wide nasal tip appearance. In general, when somebody is looking to reduce the size of a bulbous nasal tip appearance, we tend to recommend rhinoplasty surgery. I hope this helps. Sincerely, Dr. Joseph

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