Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. Cartilage grafts may also be used to help improve tip refinement. Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. The most important
aspect is to find a surgeon you are comfortable with. I recommend that you seek
consultation with a qualified board-certified plastic surgeon who can evaluate
you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Closed Rhinoplasty all the way!
This is an ideal nose for scarless closed rhinoplasty! Depending on your needs your surgeon would perform delivery of the cartilages (no external cuts used), cephalic trim of the cartilages (to refine the cartilages) and transdomal suturing of the cartilages (to bring the tip to the midline in a more refine position).
No need for the longer healing time, scar tissue, excess swelling, and permanent external scar with open rhinoplasty.
Consult with a surgeon whose 100% surgical practice is closed rhinoplasty.
All the best!
Closed rhinoplasty for bulbous tip reduction
A closed rhinoplasty approach can accomplish narrowing the bulbous nasal tip. This involves suture techniques and a conservative cartilage removal applied to the lower lateral cartilages of the nasal tip. This accomplishes narrowing and refining the wide and boxy square tip that is present. Once the tip has been refined, the rest of the nose need to be adjusted accordingly along the bridge line and nasal bones. For more information and many before-and-after results, please see the video and the link below
You look like an excellent candidate for at least a tip rhinoplasty. The technique, open versus closed, depends on what your surgeon is most comfortable with. In my opinion, tip changes are most predictable with open approaches and also helps preserve nasal function. Also, it looks like you have some asymmetry to the nasal tip, which would be easier to visualize and correct in an open procedure.
Correcting Bulbous Tip with Closed Rhinoplasty
Of coarse any rhinoplasty procedure can be done using the closed technique where all incisions are made inside the nose. Having said that, select the surgeon not the technique. Most people who achieve the ideal result by a rhinoplasty specialist using modern techniques don't really care how it was done.
In truth there are standard poses for rhinoplasty that help us see the nose as a whole. The photos that you supplied are not useful for determining a surgical plan. It does show a close up of a nasal tip that appears wide, but only general statements can be given. Closeups are useless.
I prefer to perform an open rhinoplasty to visualize the nose structures directly. In your case it looks like the tip needs to be refined.
Yes, the nose tip can be narrowed through a closed or open technique. In genera, the open technique is more precise. However, you need to know that the dynamics of each nose alteration is very complicated and you need to consult a board certified plastic surgeon who understands those and can explain to you what the consequences of the limited surgery would be.
Is there any way for my bulbous tip to be rectified with closed rhinoplasty?
Excellent natural appearing
cosmetic results can be achieved with both closed and open techniques. There is not a best way
to perform the procedure. Individual surgeons have their own preferences of how
to produce the best results in their hands. What is more important than whether
a closed or open approach is utilized is the experience and artistry of the
plastic surgeon and your comfort level and confidence in that individual.
the advice from a surgeon on this or any other website who proposes to tell you
exactly what to do based on limited 2 dimensional 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 that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.
Singer, MD FACS
La Jolla, California
Thank you for your question and photographs.
I would recommend scheduling a consultation with a board certified plastic surgeon who specializes in rhinoplasty, that way they can perform a physical examination of your nose and give you the most accurate suggestions. Based on your photographs, it appears that your tip is bulbous. You would benefit from a tip rhinoplasty which includes trimming the lower lateral cartilages and placing precision sutures to refine the tip and make it look more pleasing. These incisions can be made discretely on the inside of the nose if an open rhinoplasty is out of the question for you.
Best of luck in your endeavors!
James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science