What is Easier to Fix in Rhinoplasty, A Wide Bridge or a Bulbous Tip?

Question

A wide bridge or a bulbous tip? I understand both can be done, but I am wondering which is easier to improve upon. Thank you so much!

Thomas A. Lamperti, MD · Answer

Both a wide bridge and bulbous tip can be treated using modern rhinoplasty techniques. Tip work is generally more complex than narrowing a wide bridge. Tip bulbosity can be caused by several factors including cartilage size and orientation and skin thickness. Many methods are available to address the cartilage aspect. Skin thickness is harder to address, though in some people the skin can be thinned somewhat to help with improving the appearance.

	A wide bridge can be improved by performing controlled bone fractures to narrow the nasal bones. Of course, you can certainly treat both a wide bridge and bulbous tip at the same time during rhinoplasty.

John Bitner, MD · Answer

Both of these concerns are commonly and frequently addressed during a rhinoplasty.  Maybe another way of asking your question is to say, what are possible complications in each of these areas after surgery.

	Wide Bridge

	
		inverted V deformity from high lateral osteotomy
	
		lumps and irregularity on the bridge
	
		removing too much or too little of the bridge


	Bulbous Tip

	
		Pinched appearance
	
		Bossae formation (migration of the tip cartilages to the side)
	
		twisting of the tip cartilages


	Rhinoplasty is a very difficult surgery.  However, in the right hands, complication rates are rare and you can get very nice results that would correct the problems you report.

John M. Hilinski, MD · Answer

My opinion is that correcting a wide bridge is generally easier than reshaping a bulbous nasal tip. The former involves a more predictable surgical technique in a good majority of cases. There are certainly going to be exceptions to every rule, but in general narrowing a wide bridge is more readily done than defining a bulbous nasal tip.

Houtan Chaboki, MD · Answer

Hi legallyblonde502,

	Easy may be a relative term for plastic surgery. Rhinoplasty generally is a difficult operation due to many factors, including some unpredictably in the healing period after surgery. Both bridge and tip surgery may be easier than another when comparing the two different areas, but nothing is necessarily easy in rhinoplasty. After a comprehensive evaluation by a rhinoplasty surgeon can he/she help determine the degree of difficulty for your potential surgery. Best of luck.

	Dr. Chaboki

Toby Mayer, MD · Answer

Wide bridge or tip rhinoplasty are both easy to perform if the surgeon knows how to do this. Find an experienced rhinoplasty surgeon and go over these things with him.

Sam Naficy, MD, FACS · Answer

The correct answer is that it depends. Certain types of bulbous tip are harder to fix that others and certain types of wide bridges are harder to fix that others. There is little that is ever 'easy' in rhinoplasty and more commonly things that appear easy are much more complex to execute correctly.

William Portuese, MD · Answer

Technically a wide bridge is easier to narrow than the bulbous tip.  Narrowing a wide bridge or a bulbous tip are both routine procedures to perform during the rhinoplasty procedure.

Aaron Stone, MD · Answer

The margin of error in tip rhinoplasty is a millimeter or 2 while for the bridge being a millimeter off does not show so much. Also thick nasal skin can decrease the visibility of tip surgery more than bridge surgery. Therefore tip surgery is more difficult than bridge surgery although both require sufficient surgical skill.
	
	My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Peter E. Johnson, MD · Answer

Given our understanding of rhinoplasty today, the wide bridge and bulbous tip are both correctable with ease, if your surgeon has the experience. Of course, there are limitations as to what your tissue will do and a careful consultation can help you sort out the proper plan.
	Best of luck, peterejohnsonmd.com

Steven Wallach, MD · Answer

Both a wide bridge and a bulbous tip can be repaired but if the skin is very thick it may be difficult to narrow the tip enough to your satisfaction.

What is Easier to Fix in Rhinoplasty, A Wide Bridge or a Bulbous Tip?

Answers (14)

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