How do you reduce a bulbous nasal tip?

Sutures are almost always used to refine a bulbous nasal tip. In most cases, these are temporary sutures such as PDS that will be reabsorbed within 6-9 months following surgery. The cartilage is often shaped and excess bulk is removed. Sutures are then used to shape and narrow the remaining cartilage. Without suture it is near impossible to create shape and size changes in a predictable fashion. I would be interested to know the nature of your concerns about suture. The sutures used in rhinoplasty rarely, if ever, create problems following surgery.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Hello mickeyrourke. There are several methods to reduce a bulbous nasal tip. These methods vary depending on the other features of your nose and other cosmetic goals (for instance if the goal is to decrease or increase projection or change rotation of the nose). The methods also vary by surgeon. I favor surgical techniques which reshape cartilage as opposed to resecting large amounts of cartilage to narrow the nose. Resecting large amounts of cartilage from the tip of the nose may lead to long term instability and weakening of the nose. I would recommend an in office consultation with a rhinoplasty expert. Good luck. Best, Dr H 

I agree with my colleagues, removing some of the upper portion of the lower cartilage and then suturing the domes of the cartilages together at the tip usually do the job very nicely. Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

  The Bulbous tip is reduced by application of  dissolvable  stitches to the  lower lateral cartilages of the nasal tip. In our practice, we do not use permanent sutures to the nasal tip cartilages. When the cartilages are excessively wide, a  Conservative cephalic trim is also performed.

The most effective way to reduce tip volume is by removing some of the cartilage in the tip. This is usually done along with suture techniques that narrow the tip of the nose. Sutures used can be of the type that absorb, so you are not left with a permanent foriegn body in your nose.

Dear  Mickeyrourk,the internal stitching is not needed if your bulbous tip is already well projected but caused mainly by fat, soft tissue, thick skin and non- separated tip cartilages. However absorbable sutures will not leave any foreign bodies at long term.