Can Excessive Cartilage Be Removed Without Breaking the Nose?

The only part of my nose I do not like is how big the tip is and how much larger it appears when I smile. I have wanted to have it fixed for 25 years, but I fear having my nose broken. I am trying to find the best plastic surgeon in Virginia----please recommend.

Doctor Answers 19

Tip rhinoplasty without osteotomies

Although it is possible to do what you are asking it may not always be the right thing to do.  Osteotomies are certainly not the hardest part of rhinoplasty and narrowing the bony part of the nose can help keep the structures balanced.

Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews


Rhinoplasty involves reshaping the cartilage and possibly breaking the nasal bones. However, not every rhinoplasty requires breaking of the bones. It really depends on your anatomy and what the goal of the surgery is. To give you better advice, it would be best if you post some pictures. Good luck with your surgery.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Rhinoplasty Doesn't Always Require Breaking the Nose

There are situations where tip rhinoplasty would not require breaking nasal bones or cartilage. However, it is impossible to say without photos or an in-person consultation if this would apply to your case. You can use this site to find board-certified facial plastic surgeons in or around your area. Research their before-and-after photos and their testimonials. Make appointments to talk to a few in person. It may be that your tip can be fixed without addressing the rest of the nose, but it may be that you will need to reshape the entire nose to get the most aesthetically pleasing result. Consulting face-to-face with a facial plastic surgeon will answer your questions and allay your fears. I hope this helps.

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Rhinoplasty without osteotomies

I find it difficult to answer a question like this without really seeing the photographs.  Anything is possible in rhinoplasty surgery in terms of what combinations of techniques spell success in surgery.  However, I find it troubling when patients say - I want a rhinoplasty, but please do not break my bones.   Well, what if that limits the result?  Would you really sign up for surgery and then limit your own result?  Probably not.  Its like saying, "I want you to build me a house, but please do it without using cement."  

In general, rhinoplasty is a combination of techniques that add up to pleasing results.  These are ideas that you must discuss with your surgeon in detail and do not be disappointed if you cannot get what you want the way you want it.

Jay Calvert, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 51 reviews

Removing Excessive Cartilage

If you have a large tip with prominent cartilages and if the bones of your nose in the region of the bridge are narrow and not high,  it is possible to contour and refine the tip of your nose without doing any bony work ("breaking" the bones).  On the other hand, if you have a nasal hump or bump and, or, your nasal bones are wide, then it is necessary to perform "osteotomies" in order to reduce the bump and appropriately re-contour the nasa bones. 

Following a rhinoplasty, the ultimate architectural configuration of the nose should be in balance.  If the structure is not in balance, the results are not good and are often not readily accepted by the patient.  Basically, you should trust the judgement of a good, competent, aesthetically oriented rhinoplasty surgeon who understands your desires but who also appreciates your needs in the goal of producing an aesthetically pleasing nose. 

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Tip plasty to remove excess cartilage


Excess cartilage can be removed from the tip of the nose and a tiplasty can be performed to reshape the nasal tip.  The nose bones do not necessarily have to be broken, however, the tip must balance with the remainder of the nose.  If the nasal bones are too wide and the tip appears pinched, then the nasal bones will have to be narrowed or broken to make the bridge now fit with the new narrower tip.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Cartilage Removal Without Nasal Fractures

Tip reduction or contouring is possible without nasal fractures depending on your goals. Rather than worrying about the surgery, consult an experienced surgeon so you can make an informed decision.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Rhinoplasty without "breaking" the bones

I don't actually like the term "breaking."  The medical term for "breaking" the bones is "osteotomy" and I prefer to describe it as a controlled and delicate cut.  To answer the question, yes of course, the tip can be improved without changing the nasal bones. 

Your doctor can discuss with you if correcting the nasal bones is a necessary change for you.  Often for the tip to set up properly, other small changes must be made to the other parts of the nose.  This is evaluated on an individual basis.  Osteotomies don't add additional pain to the procedure, and they sound worse then they actually are.  Good luck!

Jennifer Levine, MD
New York Facial Plastic Surgeon
4.4 out of 5 stars 25 reviews

Rhinoplasty without "breaking" nose

It is possible to have cartilage removed without having to break your nose. Only the first 1/3 of your nose is your nasal bones and the other 2/3 is cartilage, so many times it is not necessary to break the nose. However, it depends on the anatomy of your nose and what look you want to achieve.

Should it come down to having to break the nasal bone in order to achieve the look you want, discuss all concerns with your plastic surgeon. He/she should be able to minimize your fear with their expertise and advice.

Best regards,

Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 1 review

Tip rhinoplasty

A tip rhinoplsaty is commonly done just to correct problems with the tip. Quite often I will do this procedure without doing any other work on the nose .

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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.