Tip work.

I have a dorsal hump I want to rasp down, but I do not want tip work. I'm Armenian,&want to keep parts on my ethnic nose. I love my columella/doublebreak & would be so heartbroken if it was lifted/tucked. I've seen so many scary stories here on realself with very distraught girls coming out with an over shortened nose, retracted columella or too much of a lifted tip.The space between the nose,& lip becomes too big giving a masculine appearance. How can I make sure this doesn't happen to me?

Doctor Answers 7

Dorsal hump reduction without tip contouring

While your request is certainly possible it may not be recommended depending on nasal anatomy, the extent of dorsal reduction desired and the related need for osteotomies to prevent an open roof deformity.  Changing one part of the nose can result in a relative disproportion with another part of the nose so, for example, narrowing the middle third of the nose causing the nasal tip to seem too wide.  PRE-operative 3D computer imaging of the nose with the Canfield VectraM3 system is a very helpful tool that can help patient and doctor align surgery goals and realistic outcomes.

Sarasota Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Limited rhinoplasty procedures

It is very possible to leave the nasal tip unit alone and just address the dorsum of your nose without affecting the nasal tip. It is very common in many of my female patients to just address the bridge of the nose without operating on the tip of your nose. In fact, if you leave the tip alone it should not change in shape or its position. The most important thing is to make sure you are clear with your surgeon regarding your concerns so that he/she does not make any additional alterations in your appearance. Good luck in your area.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Communication communication communication!

Thank you for your question, and this is something that you will hear me say over and over again.  You should never do any surgery if you are not 100% in tune with what your surgeon intends to do.  Both of you should be on the same page.  During consultation, this should be stressed and that is the time where both of you have a "meeting of the minds" so to speak, where upon a plan is laid out.  In my office, you never go from "consult to the OR" - particularly with noses.  It is of utmost importance, particularly in ethnic rhinoplasty, to improve, not change, the overall appearance.  Take as much time as possible during your consultation and discuss what you would like and would not like to happen - even bring examples if possible.  If someone does not want to take the time to listen...then it probably is not the right place.  Best of luck.  I hope some of this helps.

Miguel Mascaro, MD
Delray Beach Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Tip Work is Optional

I think patients should be the ones to decide on what features they like and dislike, obviously changing only the ones they want to improve upon. In fact, taking down the bump only would make the surgery somewhat more predictable, as I feel the more things needing to be changed, the bigger the risk that everything doesn't fall exactly into place with good harmony. I let patients tell me what they want, although I do show them the different options as well as give my opinion with computer imaging. I think seeing the change on your own face in this way is very helpful. Depends on the face, but I too like a little columellar show usually and definitely avoid an overly rotated nose. This is somewhat subjective however as some patients prefer more rotation that others. For me, the final call is up to the patient and I do everything to get as close to the agreed upon simulation as possible. This type of communication is key to a successful outcome and a happy patient.

Rhinoplasty candidate for dorsal hump removal

As long as the nasal tip cartilages are appropriately  shaped, they can be left alone and only the dorsal hump can be removed.  When removing a dorsal hump, osteotomies are required the placed in the nasal bones to narrow them and closed the open roof.   Digital computer imaging would be helpful to understand what can and cannot be accomplished with the rhinoplasty procedure.  Communication with your surgeon is of the utmost importance to understand what your desires are in combination with what can be accomplished with the procedure.  For more information  and many examples, please see the video and the link below 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Ethnic Rhinoplasty

I suggest you find a surgeon in your area that specializes in rhinoplasty surgery, with expertise in ethnic rhinoplasty.  During you consultation, you will be able to discuss with your surgeon the specific areas of your nose that you want improved, while also discussing maintaining certain features in order to maintain your ethnicity and natural look.  This is the key to ethnic rhinoplasty surgery.  Good Luck!

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon
4.9 out of 5 stars 31 reviews


Hello and thank you for your question. Nasal tip refinement can be done well using the right techniques.  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 67 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.