Supratip deformity after rhinoplasty? (photos)

Question

I had rhinoplasty 2 years ago and I have a hump above the tip. I got my nose looked at again and he offered rasping to the bump but from my understanding i thought you couldn’t rasp nose cartilage? Help! Thoughts?

Alan Gonzalez, MD, FACS · Answer

Hello @ipeerlesss, thank you for your question. Rasping is a technique used to sculpt or smooth out bone. While it is generally not recommended to rasp cartilage directly, it may be possible to rasp the bone. A consultation is essential to develop a surgical plan that meets your needs, fulfills your expectations, and takes into account what can actually be achieved. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

Eric M. Joseph, MD · Answer

A polybeak is when the bridge of the nose protrudes from the face further than the nasal tip. Based on your photos, it appears that this protrusion of cartilage on your bridge may have appear worse after surgery due to a bit of tip drooping. Cartilage bumps on the nose may not be rasped. They need to be lowered sharply. Please consider procuring your operative report and consulting with several reputable rhinoplasty specialists who offer computer Imaging so you can see what might be best for you moving forward. Hope this helps! Dr Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.I have evaluated your case regarding the photos and information you provided.I recommend you to get a revision rhinoplasty surgery. You still have a lump on your nose and it looks big. A smaller and shorter nose would fit your face better.

Gurkan Kayabasoglu, MD · Answer

Hello. No worries. This time you should be more careful when choosing a surgeon for your revision rhinoplasty. An experienced and specialised surgeon can easily solve your problem. Please check our Instagram account and RealSelf photos. You can get more detailed information about me, ask all questions about your case and sending your photos to my assistants at the number on my profile. You can also book an online consultation and discuss your problems with me. Best regards.

Steven M. Denenberg, MD · Answer

From my interpretation of these photos, and the ones you submitted with your previous post... You mentioned that you didn't like your profile, but that little leftover bump above the tip isn't the only issue, is it? Although the photos you posted were cropped around the nose, and don't let us see your whole face, it seems to me that your nose might benefit from having the tip elevated a bit, and maybe bringing the tip and entire nose back a little closer to your face.  Could that be part of it as well?

How *much* to elevate the tip, or deproject the nose, or make other changes? We figure that out with morphs, well before surgery. I'd love for you to see some excellent professionally-designed morphs of what could possibly be done with your nose. Morphs could also help you identify better just what's bothering you, and help you set a goal for the rhinoplasty that's accurate for your tastes. Profile and three-quarter views would be particularly important in morphing your nose. (Side note: in my opinion, morphs should really be done by the surgeon, or he should direct an assistant as she makes the morphs. Morphs should be made with a constant eye to what actually *can* be done in surgery, for that particular nose, and the surgeon has that information and judgment best.)

I'd love for you to see some excellent morphs of what could possibly be done with your nose. It might make you feel better about the possibilities and help you plan your ideal goal.

Finally, 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 require advanced techniques, and skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon. And for those who have had previous surgery, it also discusses how to tell whether your first surgeon should be performing your revision. And it also discusses how to take photos that are best for online evaluations.

Zoran Potparic, MD · Answer

It looks that residual hump is result of insufficient reduction of dorsum. Now when your result is mature and stable would be a good time to discuss revision with your surgeon. Hope this helps.

William Portuese, MD · Answer

From the photographs presented, you have what's called a poly beak deformity which is caused by residual cartilage in the lower part of your nasal dorsum. Rasping only works for bone, while the cartilage must be cut with a knife or scissors to give you a better profile.

Supratip deformity after rhinoplasty? (photos)

Answers (7)

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