I Had Open Rhinoplasty 8 Months Ago. Am I Developing a Polly Beak Deformity? (photos)

Hello,
In my experience, the usual cause for pollybeak deformity is under correction of the dorsum of the nose in the area above the tip.  The other less common cause is post surgical scarring.  If the first postoperative photo showed no pollybeak and then it appeared several months later, the cause is most likely scarring.  This can be improved with either Kenalog (steroid) injections or with surgery.  I recommend consulting with your surgeon and giving him the opportunity to either reassure you or resolve this problem.
Best of Luck,

Thank you for your question!It is understandable that you are concerned especially at 8 months after your surgery. Changes after rhinoplasties vary with every patient and what you are experiencing is not uncommon. Swelling takes time to subside as it masks the results of your surgery but you are at 8 month post-op and the amount of swelling should be minimal.Without a physical exam, it is not possible to provide you with a definitive answer. Usually, a year is required before formulating how your nose will be, but longer with a thick skin. Even then, your nose will keep shaping itself to complement your face for better results in the years to come.My best recommendation at the moment is to be patient, and allow nature to take its course. There is no doubt that once the swelling resolves, more definition and shape will be achieved and you should be happier with the results.Also, it is important that you keep communicating with your surgeon and work as a team together to achieve the best results possible.Should you be unsatisfied with the end results, revision rhinoplasty is easily discussed with a surgeon of solid experiences and certified by the American Board of Plastic Surgery who is
ideally a member of the American Society of Plastic Surgeons that you will
trust and be comfortable with. You should discuss your concerns with that
surgeon in person.Congratulations on your surgery and please remain positive!Ali Sajjadian, MD FACS

In my opinion you do have a pollybeak deformity, which is best described as fullness above the nasal tip.  It also appears as if the nasal dorsum was taken down a little low.  I would recommend a steroid injection into the area of the pollybeak and a little more time before making a final impression.

Yes, you have a polybeak and a bridge that is too low. This can be corrected with septal or ear cartilage grafts. Make sure you see a very experienced revision rhinoplasty surgeon to do this!

Hi Alex,

It appears that you have had quite a bit of your nasal dorsum removed at the time of your rhinoplasty.  It also appears that  you are developing a polly beak deformity of your lower dorsum.  At about 12 months post rhinoplasty you may consider revision rhinoplasty.  An alternative is to have filler injections to build up the deficiency in your dorsum.  You should discuss your concerns and these matters with your rhinoplasty surgeon.  Good luck and be well.

Dr. P

Your 1-month post-op photograph shows a good result, but now your nose appears to have a collapse of the upper lateral cartilages in combination with a slight supratip fullness (subcutaneous scar tissue causing a "polly-beak" deformity) that actually looks worse because of the middle-third collapse.

Steroid injection can help reduce the supratip scar tissue, but correction of the mid-nose collapse may require more surgery. Consult with your surgeon about your options, and rely on his examination, expertise, and previous experience with your tissues more than our impressions here, which are meant only to be guidelines! Good luck!

It looks more like you have an over treated bridge rather thana true pollybeak deformity.  This can be treated by a dorsal onlay to raise your dorsum a bit.

Polly Beak Deformity is fullness immediately above the nasal tip, which can occur after rhinoplasty. There are two broad causes for this deformity. The first common cause is under excision of the dorsum of the nose immediately above the nasal tip. The second cause is poor nasal tip projection, which gives the appearance that the nasal dorsum is too high. 

In looking at your pictures, it appears that your nasal tip is not projected far enough, which is causing a polly beak. I notice an additional problem of over resection of the upper part of the nasal dorsum. I find the over reduction of the upper dorsum to be more of an aesthetic problem than the poorly projected nasal tip.

Your choices are to have the dorsum augmented with a filler such as Restylane or Radiesse, or having a revision surgery to increase the nasal tip projection and augment the upper dorsum. Obviously, the revision surgery will be more involved in terms of risk, recovery, and cost. However, a revision surgery is the only wayto address your concerns in a permanent way.

The term polly beak is a very old term used perhaps 25 years ago to describe a full area on the bridge just above the tip of the nose. The image is of a parrot beak with a downward curve toward the tip, also called a ram's tip. Now we tend to keep animals out of the discussion and refer to 'supra-tip' fullness. The cause can vary, under projection of the tip, under reduction of the cartilage of the lower bridge, or over reduction of the upper or bony bridge which I think may be what is troubling you. Revision with a graft over the bridge may improve your result.
Best of luck,
peterejohnsonmd

You do have polly beak deformity and the reason your nasal dorsum looks good one month post op. is due to swelling. Once the swelling has gone down, the polly beak deformity shows itself. I recommend you have steroid injection and if you didn't see improvement, then may consider filler injection on the upper part of the  dorsum or alternatively revision rhinoplasty with an experienced surgeon.