How risky is rhinoplasty for a bifid tip?

The bifid nasal tip can present its challenges depending on the severity of it.. many surgeons would use a piece of cartilage to camouflage it. Although I do many rhinoplasties I have not corrected a bifid tip and would refer you to someone with ample experience in treating it.

The treatment of a bifid nose in the tip of the nose can be addressed several ways, with or without cartilage or the use or not use of permanent sutures.  I would ask your rhinoplasty surgeon about their technique and experience and postoperative course... however it is treatable.. 

Is your bifid nose like the nose in the short video that I posted with this answer?First, a couple thoughts about your listed concerns. Correcting a bifid tip does not necessarily result in a droopy tip. In fact, usually, the techniques used to correct a bifid tip tend to elevate the tip at the same time.Cartilage trimming does not prompt the body to continue resorbing additional cartilage.Permanent sutures do not predispose to infection.So here is the real caveat: 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 a bifid 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 it also discusses how to take photos that are best for online evaluations.
A bifid nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?

I think it is generally safe to have a rhinoplasty for your condition.  It depends on how bifid it is.  Check out the photos I have of a mild to moderate bifid tip correction.  All the items you listed are certainly risks associated with a rhinoplasty - but they are relatively uncommon.  

You must have been reading something that was 30 years old, where closed rhinoplasty and only reductive techniques may not have been able to properly or reliably fix it. Open structural rhinoplasty with strongly affixed cartilage grafts can fix this issue soundly.

Hello and thank you for your question.  A patient with a bifid nasal tip can definitely benefit from a tip rhinoplasty.  I saw a patient with pronounced bifid nasal tip just yesterday, as a matter of fact.  She not only had a vertical groove between her lower lateral cartilages, but they were also retracted cephalad (towards the top) and a horizontal groove was also visible underneath her bifid lower lateral cartilages.  Treatment of a bifid nasal tip, just like with other tip rhinoplasties, is done by modifying the nasal tip cartilage with trimming, stitching or grafting.  If your septum is deviated and you have breathing difficulty, a septoplasty may benefit you as well.  The next step for you is to find the right aesthetic plastic surgeon.  In your rhinoplasty consultation, be sure your surgeon addresses all your aesthetic goals and concerns specifically, and discusses the surgery details including the position and size of the incisions used (with actual photographs and not just digital animations), the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar nose appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome.

After seeking out a board-certified plastic surgeon who specializes in aesthetic plastic surgery, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired nose outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.

For more information on rhinoplasty, please refer to my link below.

Good luck.

Mark K Markarian, MD, MSPH, FACS

Harvard-trained Board Certified Aesthetic Plastic Surgeon

Your bindi tip can be treated with excellent natural results IF you see a very experienced  rhinoplasty surgeon who does natural noses!

Tip rhinoplasty for bifidity is straightforward and low risk for the experienced rhinoplasty surgeon.If you prefer surgery over filler to solve the problem, you may add additional desired changes:  smaller more angular tip, change(s) in tip projection, columellar and/or nostril changes, etc.Procedure risk is significantly mitigated in expert hands.  Choose your surgeon wisely and you'll be fine.

Hi cdmkellie,Thank you for your inquiry from beautiful Laguna Beach, CA.  The most important aspect of any aesthetic procedure is to make sure that you choose your treating physician most carefully based on their skill, training, knowledge, experience, and their natural artistic vision.  Once you choose a great rhinoplasty surgeon, you need not be overly worried about the concerns that you have listed above.  Please contact our office for a complimentary consultation with my very talented rhinoplasty specialist Ari Hyman, MD.  After performing rhinoplasty for the past 35 years and observing many rhinoplasty surgeons, I have been amazed at the beautifully natural results that Dr. Hyman is able to create, even on the most difficult of noses.  You may rest assured that if you choose Dr. Hyman to perform your rhinoplasty that you will be recieving the best possible nose surgery results.  Happy and Healthy New Year!!!Michael A. Persky, MDEncino, CA 

Hello and thank you for your question. It would be helpful to view pictures of your nose in order to determine the best advice regarding your bifid nasal tip.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon