I don’t have enough cartilage in my nose. It’s flimsy at the tip. Can I still get rhinoplasty?

Thank you for your question. Ultrasonic Rhinoplasty device Piezo®:

In traditional Rhinoplasty, surgical instruments known as rasps and osteotomies (hammer and chisel) are used to reshape the nasal bones by removing the hump and/or narrowing the nasal bone width. These tools are relatively imprecise and their use can lead to contour irregularities, etc. if not used in the proper manner. Recently, a technology that uses sound waves has been developed to contour nasal bones in a precise and far less traumatic way when compared to traditional techniques. Ultrasonic, or Piezo, Rhinoplasty is now the most advanced technology available for minimally traumatic nasal bone reshaping and hump removal during Rhinoplasty. There will be hardly any bruising and swelling which will make the recovery period a lot easier for the patient.

Rhinoplasty requires exceptional skill on behalf of the surgeon and great communication with the patient about realistic goals and expectations. Common cosmetic concerns include a dorsal hump, wide nose, sunken nose, irregularities, and asymmetries. Functional concerns include difficulty breathing through the nose, which can and should be addressed at the same time as your rhinoplasty.

In your situation, recommendations are very limitted withour photos but it does seem like you would be a candidate foor a revision rhinoplasty.
Find someone you connect with, who will listen to your concerns and provide you with a framework for what is possible.

Gary Linkov, MD
Rhinoplasty Specialist
Manhattan

Thank you for your questions.

I am sure that you appreciate that it is difficult to provide you with advice without the benefit of examining your nose or at very least review your photographs. Yes, rhinoplasty can improve upon your concerns. Of course you must appreciate that there are some limitations based on the individual's intricate nasal anatomy and nasal skin quality. For example, a thick nasal skin is great in covering up minor irregularities but since it does not shrink well after surgery, it will not show fine underlying refinements.

I would suggest that you consult with another expert rhinoplasty surgeon and discuss what you do and do not like about your nose.

You should expect a full detailed examination of your nose is required to assess your nasal skin, cartilage, bony structures, and your nasal airway/ breathing. This will allow the surgeon to evaluate your nasal appearance and its relation to your facial features.

The use of manipulated (morphed) digital clinical photography provides a platform for discussion as to your desires and expectations. Such images are not a guarantee of exact results, but a great tool to ensure that you and your surgeon are on the same wavelength.

It is paramount that you have a realistic expectation before proceeding with this surgery.

Best wishes,

is maintaining or restoring adequate support .... this is especially true of the over-projected nose that needs 'de-projecting'.... maintaining adequate support in the form of spreader flaps, septal extension grafting, etc. is key in preventing collapse and over-rotation

good luck...