60 year old - rhinoplasty or tip plasty? (Photo)

Question

I'm 60, 5'5", and in good health. My skin has always been oily, but it's always healed well. Would I need a full rhinoplasty or just a tip plasty? I have a very bulbous tip.

Donald Groves, MD · Answer

Hello and thank you for your question and pictures. Addressing the shape of your nose (especially the tip) is actually one of the most common reasons people seek out and undergo a rhinoplasty. In addition to the bulbous tip, it appears you also have a crooked asymmetric nose. Unfortunately, a minimal procedure or surgery "just to the tip" will not be able to fix your issues- any surgeon that tells you otherwise is either inexperienced or is intentionally doing you a huge disservice. A rhinoplasty can best address your aesthetic concerns and any functional issues with your nose. I would be able to adjust the size, shape, and especially the definition of your nose (particularly the tip), improving your overall facial balance. I'd also be able to open up and solidly reinforce the underlying structural framework of your nose (to prevent distortion and retraction from scarring forces over time)!

Rhinoplasty truly is a surgery of millimeters- and whether you're looking for a minor adjustment or a major transformation, it requires exceptional surgical skill to achieve functional and natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

If you are unhappy with the appearance of your nose, I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Kim Patrick Murray, MD · Answer

I have operated on many patients in their 60s seeking rhinoplasty. Being in good overall health is an excellent starting point. For safety, we do require routine laboratory tests, ekg and a chest X-ray and medical clearance prior to surgery, as you will be under general anesthesia for the procedure.
A full Rhinoplasty is the way to go as without the structural septum work and nose cartridges being supported your nose will look look bigger and more bulbous if not worked on. This is even more important with oily, thicker skin patients.
Therefore for both longevity and the most aesthetically balanced outcome. A full Rhinoplasty approach ensures the nose remains straight and provides proper structural support for the cartilage in the tip. In your case, the tip would benefit from a small, proportionate refinement to harmonize with your facial features, creating a natural and beautiful result.
Operating only on the tip without reinforcing the underlying support often leads to the nose shifting, lacking stability, or appearing uneven over time. This can increase the likelihood of needing a secondary surgery. I always advise patients: if you are going to have nasal surgery, it is best to do it once&mdash;and do it correctly.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. A surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Fascial grafts may also be used to help improve tip refinement. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eyup Bozkurt, MD · Answer

I can see that your nose has a deviation, which originates from the septum &mdash; the central support structure of the nose. The septum should be addressed first. Considering that the septum affects the midline of the nasal pyramid, and noting the overall deviation and a small dorsal hump on your nose, I would recommend a full rhinoplasty to correct all the issues comprehensively.Both procedures would require general anesthesia, and in this context, a rhinoplasty would be more appropriate for you compared to a tip plasty. Being 60 years old is not too advanced for surgery. When you consider increasing life expectancy, the difference between a tip plasty taking about 45 minutes versus a rhinoplasty taking around 1.5 hours is not significant in the long term. In fact, undergoing a full rhinoplasty would be to your advantage.If you had any major health issues or significant anesthesia-related risks, then a tip plasty might be considered as an alternative, but that does not appear to be the case here.

Artur Fahradyan, MD · Answer

All nasal structures are interconnected, and in my opinion, addressing only one part of the nose often leads to unfavorable results. In some cases, a very minor touch-up can be reasonable, but in your situation, I would recommend either doing nothing or, if you truly wish to improve the bulbous tip, proceeding with a formal rhinoplasty to achieve the best outcome.

Eric M. Joseph, MD · Answer

If your bridge is not tall, and over projected on profile, it is conceivable that a tip plastic could be considered for achieving a narrower and more pleasing nasal tip appearance on front view. If your bridge sticks out too far, and makes a bump, bridge lowering with necessitate osteotomies. Thank you so much for your question, and I hope you find this helpful. Sincerely, Dr Joseph

Steve Laverson, MD, FACS · Answer

One never NEEDS aesthetic surgery by definition.

Judging from your expressed sentiment, your single frontal photo, and all all submitted information, if well done by expert plastic surgeon just a tip-plasty with your corner lift would likely offer good return on your investment.

Steven M. Denenberg, MD · Answer

In many noses, the work on the tip is the most complicated and time-consuming. And anytime the purpose of the operation is to change the appearance of the nose, we call it a "rhinoplasty." So really, a tip plasty *is* a rhinoplasty!
The two cartilages that form the tip of your nose are strong and broad, and would be modified in the operation.

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 -- especially the work on the tip -- require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery, so check your surgeon out carefully.

Darryl J. Blinski, MD · Answer

With only one post photo from you no side view very difficult to give a definitive answer. Best of virtual concert with for determination. Most likely a tip rhinoplasty could give a satisfactory result expect feed range from $4000-$6000. A full rhinoplasty expect fee to be 8000 and $12,000. Again, best of virtual consult with.

60 year old - rhinoplasty or tip plasty? (Photo)

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