Help with bifid nasal tip. What could be expected of the actual procedure? (Photo)

Question

What type of surgery would be best for my nose? Also, with so many plastic surgeons, I need to know how to go about selecting one who could "repair" a complex bifid tip. Any suggestions/recommendations for a surgeon in the Southeast are most appreciated.

Jonathan Kulbersh, MD · Answer

It is not uncommon for patients seeking to improve a bifid tip during a rhinoplasty.  The bifid tip is a result of:1)  Wide nasal cartilages2)  Thin nasal skinThe wide nasal cartilages can be narrowed and reshaped with tip suturing technique. This takes multiple tip sutures.  After reshaping the tip, the skin is slightly thickened by the addition of temporalis fascia to the region.Temporalis fascia is tissue that is harvested from underneath the hairline.  It is placed underneath the skin and on top the cartilage at the end of surgery.  It will slightly thicken the skin and is an important step in the procedure.I hope this helps.

Eric M. Joseph, MD · Answer

Digital photos are not a substitute for an examination, but the correction of your asymmetrical bifid tip will require expertise from your surgeon. The thickness of your skin will not change after rhinoplasty and you may be more prone than most to see post-rhinoplasty irregularities because of your thin skin.May I suggest consulting several rhinoplasty specialists so you could see what may be best for you.Wishing you well. Thank you.Dr Joseph

John Michael Thomassen, MD · Answer

The procedure would involve excising and suturing nasal tip cartilage.  You have very thin nasal tip skin so the complexity lies in reconstructing the cartilage tip in a very symmetrical fashion.  Meet with several surgeons and review their pre and post photos to find someone you are comfortable with.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for the question.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, After having analyzed all the info. and photos provided to us, i recommend you perform an Open Full Rhinoplasty, includding narrowing of the nasal base and nostrils, with nasal bones treatment (controled fracture) and alar + triangular nasal cartilages re-shaping.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Barry L. Eppley, MD, DMD · Answer

A bifid nasal tip is a very straightforward rhinoplasty operation to perform. By thinning the tip cartilages and closing the gap between them, the nasal tip will have a unified and non-bifid appearance. There may also be a need for some small amount of tip shortening as well.

J. Charles Finn, MD · Answer

An accurate assessment would, of course, require an in-person evaluation. It appears the problem is both thin skin and very strong lower lateral cartilages. This is a common problem and is fairly straightforward to address with an open rhinoplasty. Surgery would entail softening and shaping the cartilages and sometimes grafting with fascia to thicken the skin. Find a surgeon with a specialty in rhinoplasty for the best results, and look at that surgeon's photographic results with similar patients. Good luck!

Steven Wallach, MD · Answer

A bifid tip can be treated by a tip rhinoplasty.  I prefer to do these open to get a precise view of the cartilage so that I can adjust them under direct vision.

Darryl J. Blinski, MD · Answer

Usually an open rhinoplasty option with closure and only graft to area is needed. Sometime adding a HA filler to avoid any surgery might help. But I would prefer to totally improve the tip by surgical intervention.

Jeffrey Zwiren, MD · Answer

You have an enlargement and asymmetry of the domes of your nose with thin overlying skin.  This allows you to see the nasal cartilage anatomy directly through the skin.  This can be corrected with a rhinoplasty where the cartilage of the nasal tip is reduced and the separation of the cartilage is suture repaired.

Jeffrey Marvel, MD · Answer

your case would require transdomal sutures (suturing the two bifid tips), as well as limited trimming of the cartilages since I feel the tip is also too bulbous in appearance.   It would be performed through a small incision placed in the columella ( bridge of tissue between the nostrils).  Recovery and time off work is about 3 days.  No sports for 2 weeks.  Costs should average about $5000 all inclusive.  I would choose a Facial Plastic Surgery with an extensive repertoire of cases and proven results in performing rhinoplasty.  Pay particular attention to the Before & After Gallery.  A good surgeon should have lots of examples of their work to show.  Good luck.

Help with bifid nasal tip. What could be expected of the actual procedure? (Photo)

Answers (11)

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