Is it a simple procedure to shave down cartilage nose tip graft that is showing through skin? Is it an in-office procedure? (Pho

Hi behien. Revision rhinoplasty can either be simple or complicated. It depends what we find when we open up the nose. Sometimes it the edge of a cartilage graft, other times its the edge of a pinchy lower lateral cartilage (which is the cartilage which makes up the tip). The goal is to make the nose look as good as possible. If it the edge of the cartilage graft, then it can be shaved down, which is relatively simple. It is the edge of the lower lateral cartilage (tip cartilage) reconstruction is a little more involved. We do all surgeries in my office under sedation. Meaning, that you are asleep but not general anesthesia. This is so that you are as comfortable as possible. The cost depends on the extent needed. You really need an in person exam to evaluate. Good luck. Best, Dr H 

Hello Behien116,There is a lot that goes into a revision rhinoplasty  Your photo does show the cartilage at the tip that is creating a point.  As far as what needs to be done it will likely be more in depth than you would otherwise think.  The reason is that there is scar tissue present.  The graft is also creating fullness to that area and when the point is removed it may make the surrounding area look different or indented.  The best way to determine what needs to be done is with an in person evaluation and a series of standardized photos.  I'd recommend you consult with a facial plastic surgeon to learn what can be done.I hope this helps and good luck. 

A revision rhinoplasty is much more difficult than a primary rhinoplasty due to the previous alterations of the anatomy, and scar tissue.  A thorough  examination of the internal and external portion of the nose is required to make a determination about what is causing the issue, and then come up with a customized treatment plan to address this issue.  Trying to perform nasal surgery under local anesthesia can be very painful due to the fact there are lots of nerve endings the tip of the nose.  It is possible to perform this maneuver under local anesthesia however it still needs to be performed outpatient surgery Center for patient's safety.  For more information, our current price list and many before and after examples of revision rhinoplasty, please see the link and the video below