Do I have polly beak deformity? Would revision help much? (Photo)

Question

I had a rhinoplasty 1.5 years ago. I’m not entirely happy with result- I had hoped it would improve with time but it looks the same. The nose does look better than it did though and I don’t think I dislike it enough to have surgery again (I will likely get some filler to refine the tip). I was just wondering if I had Pollybeak deformity? Would revision help much?

Randal Haworth, MD, FACS · Answer

Polly beak deformity is a complication that may occur after rhinoplasty, which is characterized by a dorsal convexity on the nose that resembles the shape of a parrot's beak. Based on the picture you provided, it looks like you have it. A revision rhinoplasty can, in my experience, resolve that issue with great results.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photo it looks like you have very upturned nose. If you can provide photos with better lighting, from the side of your face and 1 meter away I would be able to make a proper evaluation. Anyway, filler and the other non-invasive ways would not be help you because it is a functional deformity as a result of rhinoplasty surgery. You may need revision rhinoplasty for get rid of this very upturned look. It would be more convenient to decide with face-to-face consultation. Best Regards!

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photograph.

The problem that you are concerned about could be related to cartilage but the general appearance suggests more likely soft tissue origin.

It would be important to a consultation in person for an assessment which will guide you about the treatment options. If the area of fullness above the tip is entirely soft, sometimes a course of isotretinoin can help to reduce the soft tissue thickness and change the shape around the tip and supratip. It is more challenging treatment and requires a dermatologist to assess and supervise the treatment.

It is also possible to reduce the soft tissue thickness surgically that it will be associated with a additional scar tissue buildup may require strong support for the nasal tip to sustain changes.

Eric M. Joseph, MD · Answer

Depending upon your examination, injectable fillers may be considered for adding volume to your nasal bridge above your tip. This might result in a more pleasing profile nasal appearance. And this may also be welcome alternative to revision nasal surgery. Hope this helps. Doctor Joseph

Ryan Rebowe, MD · Answer

As the picture you submitted is not entirely from the side profile, it is difficult to tell about the deformity you describe. You possibly have a small effect of this supratip fullness, but would need more standard pictures and likely an in person exam to really tell. In terms of whether or not a revision would help, any surgeon would likely need your before and after pictures as well as the operative note from the original surgeon. Rhinoplasty is an extremely delicate surgery and what is possible with revision surgery often depends on the original surgical maneuvers and how much cartilage support is left in the nose. I would make sure you are pursuing surgery with a board certified plastic surgeon or facial plastic surgeon to ensure that you completely understand all of your options.

Robert Ciardullo, MD · Answer

Do you have a poly beak?Based on the photo you show, it does appear to be a “Polly beak“. In some cases this is due to protrusion of the dorsal portion of the caudal septum, and could only be treated with surgical refining of that area. In some cases the “Polly beak“ appearance is due to a buildup of scar issue under the skin and/ or thick skin which has not yet fully redraped. In the latter two instances some surgeons inject steroid to reduce scar tissue and help shrink thick pre-existing supra tip skin. You should speak to you a surgeon and ask whether it is Cartilage or scar tissue or thick skin causing the defect and whether steroid injection would help.