Tip pasty or full rhinoplasty?

My bridge is thick but my bulbous tip is what drives me crazy, also, could the nostril skin be "pulled" in more? Would this require open rhinoplasty?

Doctor Answers 10


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Dear griffinlautner, You will require a full rhinoplasty if you just address the tip alone then the bridge will appear wider. Seek consultation with some experts in the field of rhinoplasty surgery and have imaging performed to show you the possible changes rhinoplasty will provide for you taking into consideration your nasal anatomy and skin thickness. You should excellent results in the hands of an expert surgeon that will nicely balance your facial aesthetics. Best regards, Michael V. Elam, M.D.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews


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your photo doesn't give enough information, however, it looks like just narrowing the tips lone will not be sufficient to get a nice overall result.  I think your bridge needs to be narrowed as well.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Rhinoplasty for the male nose with wide tip and bridge.

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A rhinoplasty is needed since if just the tip is narrowed the remaining bridge will appear very wide and not balanced. See a very experienced rhinoplasty surgeon for the best results with full discussion of your goals and what can be achieved. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Ethnic rhinoplasty - Tip pasty or full rhinoplasty?

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Hello GriffinLautner - Thanks for your question. You certainly can have a tip rhinoplasty and narrow the nostril base without touching the bridge if you wish. Just understand that this will leave your bridge wide. In your case, I don't think that is a problem. If you have bridge surgery as well, it will be harder to create harmony with your thick, wide nasal tip, even if the tip is reduced and the nostrils are narrowed. In my opinion, open rhinoplasty is the best option to work with your type of skin. Unlike most rhinoplasty practices, my practice is 70% made up of ethnic rhinoplasty cases. I have a lot of experience with patients of many different nationalities. I would recommend that you consult with an ethnic rhinoplasty expert to be evaluated in person and have rhinoplasty simulations performed to better understand your goals and the different options. 

Good luck, 

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Rhinoplasty and the nasal tip

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A tip rhinoplasty will narrow the tip and nostrils.  Whether or not an open rhinoplasty depends on your in-office exam.  Also, side pictures are needed to see if anything should be done to the bridge.  From the front, it looks like only a tip-plasty is needed.  Best wishes. 

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Tip Plasty or Full Rhinoplasty

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Based on this one picture your tip can be narrowed and refined but with your thick skin you must consult with an experienced rhinoplasty surgeon so you can establish realistic goals. Profile views are necessary to determine if anything else would be recommended.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews


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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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

full rhinoplasty to narrow the nose

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A full rhinoplasty is required to narrow the nose. Thick skin specially in the nose will be a significant  impediment to seeing refinement in that area. It is very important to have realistic expectations on what can be accomplished with the rhinoplasty procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Tip pasty or full rhinoplasty?

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Improving the nostril width and refining the tip are frequent requests of patients wanting nasal refinement. It is possible to improve the cosmetic appearance of the tip alone without altering the rest of the nose in some patients. Whether the optimal option in your particular situation would be a tip rhinoplasty alone or an artistically performed natural appearing full rhinoplasty would best be determined at a consultation. Either procedure can be performed with a closed or open approach.

Following 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 (ENT) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla,California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Thick skin will limit

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thanks for your question . If you want some tip refinement only then only a small amount of refinement can be achieved due to your thick nasal skin and you should make sure your exceptions are set realistically -bringing the nostrils in too much will pinch them and affect your breathing

This can be done open or closed depending whether your surgeon is an open or closed rhino surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.