Possible to Increased Dorsal Height and Reduce Tip Size at the Same Time?

Trauma has left me with inner and outer valve collapse and cartilaginous saddle deformity couple with a deviated septum and fractured tip cartilage, making the tip droop. In other words, my bridge/dorsal area is much too low and the tip is too big and droopy and it looks terrible. It's taken a big toll on both my self-esteem and also the functionality as I have very little breathing ability now. Is it possible to fix this to make my nose look and function the way it used to? Thank you.

Doctor Answers 7

Possible to build up bridge and make tip smaller

What you are describing is a complicated problem that involves both form (appearance) and function (breathing).  This will require grafting to the bridge of your nose to build it up, reconstruction of the inner nose to improve your breathing, and modification of the tip to make it look better.  This is all possible and can be done at the same time.  It may require obtaining cartilage from an ear and possibly fascia tissue from your scalp.  Some surgeons will use rib cartilage to build up the nose.  You should seek out a board certified plastic surgeon in your area for a consultation.  The best news is that something can be done to help you!

Seattle Plastic Surgeon
5.0 out of 5 stars 12 reviews

Dorsal augmentation and tip reduction

Yes, during the rhinoplasty procedure dorsal height can be augmented with septal cartilage taken from the inside of the nose.  The tip cartilages can be reduced through suturing techniques and/or removal of a small amount of bulbous tip cartilage.  Valve collapse is best treated with spreader grafts.  The droopiness of the tip will need to be addressed with either a cartilage strut or suturing techniques to the tip cartilages.  It is also important to improve airflow dynamics through the nose so that it not only looks better but functions properly as well.  

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Rhinoplasty after nasal trauma

Yes, in theory all of these issues can be improved with a Rhinoplasty.  I prefer using a silastic straight dorsal implant along with tip thinning techniques.  Beware of spreader grafts that are sold as something that will correct valve collapse...they increase the size and width of the nasal tip, IMHO and for that reason, I do not use them.

Photos, of your nose, of course would allow a more precise evaluation.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Dorsal height and tip size are directly related

Much of what makes up an attractive nose is proportion--the balance between the height of the bridge and the size of the lower nose.  The higher the bride, the smaller the lower nose looks, and vice versa.  I use this illusion all the time to make noses look smaller--and in fact did so for a woman this morning.

Your airway obstruction is directly related to your bridge height.  When the nose has been badly damaged, the septum will need work but your surgeon may also need rib to get the nicest result--the septum is often too broken or calcified to use easily.

Find a surgeon whom you trust and who does this work often and can show you results that you like.

Mark B. Constantian, MD, FACS
Nashua Plastic Surgeon
4.5 out of 5 stars 25 reviews

Nasal Reconstruction

Yes, it is very possible to address all of the aspects of your nose which you describe.  However, this will require major middle vault and tip reconstruction using cartilagenous grafts.  These grafts are taken from the nasal septum, ear, or harvested from the rib.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Dorsal height and bulbous tip

You pose a very difficult problem. The dosal deformity may well require a rib graft  and a septal procedure. Tip work can be done at the same time. However due to the complexity of your injury, you may need  two procedures to achieve better breathing Send pictures if you can.

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Possible to Increased Dorsal Height and Reduce Tip Size at the Same Time?

Yes, it is possible. It sounds like your nose needs to be built back up. Part of this involves reconstructing the bridge of the nose and adding more projection to the nasal tip. By increasing the inner structure of the nose, this will stretch the overlying soft tissue and skin to make your nose look more defined and refined.

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 19 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.