Can I get tipplasty only to address the overprojection of my nose?

Question

My nose looks too big/long for my face, especially from the side profile. I don't want to pursue an extensively invasive procedure and was wondering if it is possible to deproject/reduce the tip only without adjusting the bridge ? I have a small hump in the bridge but this doesn't bother me too much.

Jonathan Kulbersh, MD · Answer

Thank you for your question and for providing photos. While a tip rhinoplasty can address the size and shape of the nasal tip alone, determining what type of procedure you may benefit from most would require a thorough physical examination. It is possible that other portions of your nasal structure would need to be addressed in order to achieve your desired result.  
Both tip and traditional rhinoplasty are the most complex of all plastic surgery procedures, requiring experience, skill, and even artistry to achieve an optimal outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon with expertise in rhinoplasty techniques. They will be able to conduct a physical exam, assess your aesthetic goals, and suggest the best course of action.

Oakley Smith, MD, FRCSC · Answer

Hello,
The best option is to have a full rhinoplasty procedure to de-project the whole nose. De-projecting the tip alone might make your nose looks disproportionate. It is better to consult a facial plastic surgeon who can examine you and discuss how your nose could looks like after the surgery.

Lucian Ion, FRCS · Answer

Thank you for your question and photographs.

Isolated reduction in projection of the nasal tip will create a disproportion with the bridge.

The only solution to have an isolated reduction in the tip projection without the impression that he has generated a convex bridge or a bump on the bridge would be to combine reduction in projection with shortening of the nose. This is effectively following the line of the profile take the tip up which would correspond to a reduction in projection.

The more likely solution for you would be to reduce both the tip and the bridge projection if you wish to achieve a reduction in the tip projection.

Steven M. Denenberg, MD · Answer

Your nose has strong "projection," which means it comes out forward away from your face strongly. The bridge comes down to match the tip of your nose. If the tip is moved back closer to your face, and the bridge is left where it is, well, it just wouldn't look like a nose, with the bridge sticking out well beyond the tip.
There is another consideration, too, though: when a nose is brought back closer to the face, it makes the nose *look* longer, as if the tip had drooped down. So, even though you're not complaining of a droopy-tip nose, it's crucial that the surgeon recognize this effect, so you don't wonder why your nose looks so long after surgery.
The woman in the links with my response had a projecting nose brought back closer to her face.
Then also, really, from the surgeon's standpoint, reducing the projection of the tip, all by itself, is a complicated task, and making the rest of the nose fit the newly-deprojected tip is not an additional huge undertaking.
How *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

I'd love for you to see some excellent morphs of what could possibly be done with your nose. It might make you feel better about the possibilities. Morphs help you plan your ideal goal, and help the surgeon understand what you need in order to be happy, and correlate that with what he thinks is possible in his hands.
Remember that rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And it also discusses how to take photos that are best for online evaluations.

Eric M. Joseph, MD · Answer

I don't think so. Based on your photos, both your bridge and nasal tip appear overprojected on profile. In order to achieve a more pleasing nasal profile appearance, I suspect your bridge would need to be lowered as well, and that might necessitate osteotomies, or bony bridge work. Hope this helps. Dr Joseph

Ronald J. Edelson, MD · Answer

Doing the tip only won’t reduce the projection. The bridge is contributing more to the projection than you think and needs to be lowered as well.

Robert Ciardullo, MD · Answer

Can you have a tip plasty only? it is theoretically possible to do a tip plasty without addressing the dorsum and other aspects of the profile. However if you deproject the tip without deprojecting the area above it called the supratip and the small hump above that, you will make the dorsal hump look larger and the whole side profile will be convex in shape. The tip should be the most projecting part of the nose so reduction of the tip projection without reducing the remainder of the profile would probably not give the most aesthetically pleasing end result. A closed rhinoplasty is rather minimally invasive if that is your concern.

Joseph Shvidler, MD · Answer

Unfortunately the bridge and tip are interrelated and under-projecting the tip alone would make the bridge look out of balance. In addition you should strongly consider a chin implant as a small chin makes the nose stand out more. I think you can get a really nice result by gradually lower the bridge, deproject the tip and a chin implant.

Victor Manuel Agudelo, MD · Answer

Hello.  Having just a tip plasty may be an option, but it will not give adequate nasal proportions. Tip and bridge must be balanced, so results will be much better if both are reduced.
Ask your doctor for computer surgical simulations, so you can have an idea of your outcome and make a right decision.

Thomas Spalla, MD · Answer

Overall, I think you've given yourself a fairly good assessment. The overall shape of your nose is quite nice. I do think that you are a little over-projected, as noted from the lateral view. A tip-plasty can set the tip back but your overall dorsal height being lowered along with osteotomies (cuts in the bone) would give you the best chance for fulfilling the goal of more "aesthetic" nasal proportions. Doing this would also address the small dorsal hump that you notes doesn't bother you "too" much. I strongly feel that if the tip alone is addressed, the appearance of the dorsal hump and dorsal projection would become more noticeable and a distraction to you.
You look great and I think you should take the time to assess whether surgery is the right step for you. As long as you're breathing well through your nose, you don't NEED nasal surgery, so only undertake this when 100% ready. 
Best of luck in your journey,
Thomas C. Spalla, MD

Can I get tipplasty only to address the overprojection of my nose?

Answers (11)

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