What is the current most effective approach to tip refinement and supratip break with least potential setbacks?

My biggest fear is that everything will be narrowed and then my tip will be buluous still. he said the tip will improve to a certain exctent. i DO NOT want to be told to wait 6 months for the "swelling" to go down and that if it doesnt take shape they will reduce my nose tip im a year. it isnt going to magically sit that way afterwards all defined without it.i had more questions that i forgot to ask in the initial consult. can my bone be narrowed just by osteotomies. is my nose overprojected?

Doctor Answers 6

Good questions


Your questions are great ones, though without a photograph or two it's hard to give a specific answer.  The key is that rhinoplasty surgery requires an expert experienced surgeon.  I'd suggest finding a facial plastic surgeon doing well over 75 rhinoplasty procedures a year for the best results and advice.

Boston Facial Plastic Surgeon
4.6 out of 5 stars 62 reviews

Closed scarless rhinoplasty as 100% of surgical practice


You should seek counsel from a board certified closed rhinoplasty surgeon who performs closed scarless rhinoplasty as 100% of his surgical practice.  All incisions are made inside the nostrils with no external cuts or scars. You could subtly enhance and refine the nose with this technique without drastic change. Meaningful refinement is the key.  All the best!

Deepak Raj Dugar, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 14 reviews


These types of questions need to be addressed in person so that your nose can be evaluated properly.  I will warn you that most swelling will take a year or more to settle completely.

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

Approach to the tip

There is no new addition to the approach for fixing or refining a nasal tip. The most important thing is the surgeon's technique and luck. Luck because the healing process of the nose cannot be controlled and the scar tissue during healing can lead to deformities even in the best of hands. So, please go in knowing the risk factors and prepared. 


Dr. J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 107 reviews


Hello and thank you for your question. There are many ways to accomplish what you describe.  Unfortunately, I cannot see your pictures.  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 126 reviews

Don't have surgery unless you are completely satisfied with your consultation and your doctor's skill

If your surgeon cannot show you before and after photos of noses like yours, where you think the results are just what you want, then he probably cannot accomplish your goals with surgery. And if you don't define with him exactly and precisely what to do, and if he doesn't prove to you that he understands completely, well, what do you think will happen after surgery?!

Computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. When you see his goals, you'll know whether he has an eye for a beautiful nose, and whether he shares your opinion of what constitutes a beautiful nose. You'll also know whether the changes he proposes are enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. But remember, you're not hiring him for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.

I can't know whether your nose is overprojected, or if you're a good candidate for rhinoplasty, because I didn't see any photos. I usually make a morph when I'm answering questions like this, to show the changes that are possible for your nose with a rhinoplasty. See the "Web reference" link, just below my post. At the *very* bottom of that page is a link to instructions on taking photos that are most useful for online consultations like this.

Steven M. Denenberg, MD
Omaha Facial Plastic Surgeon
4.8 out of 5 stars 41 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.