The cartilage at the end of my nose sticks out under the skin, what can I do to remove this? (photos)

Question

The cartridge at the end of my nose sticks out under the skin, what can I do to remove this. Do I need surgery or will filler resolve this?

Lucian Ion, FRCS · Answer

Hello and thank you for your question.
The support cartilages of the nasal tip can be reshaped, reduced or both depending on the characteristics of the cartilages and your target shape. 
In general, it is primarily a matter of what you want to achieve as final shape rather than what you want to get rid of.  This is about ensuring harmony with the rest of the nose and the face. 
In consultation it is possible to evaluate your goals using computer simulations as well as determine feasibility.

Hagen Schumacher, PhD, FRCS(Plast), FEBOPRAS · Answer

Hello,
These are called the tip-defining points and represent the domes of the underlying cartilages. In the right position, they are considered to be an attractive  feature. They can be repositioned with a tip rhinoplasty. Fillers can hide them by increasing the surrounding volume but that doesn't solve the essential problem.

Gurkan Kayabasoglu, MD · Answer

Hello,Your photos show that you have prominent domes of your lower lateral cartilages, it can be refined with a tipplasty. You can benefit from only tipplasty, If you do not have any issue other than that.Nonsurgical treatment, filler can help to improve that area, with adding volume for a temporary time period. Surgical option is permanent. You can have detailed in-person examination and discuss with your surgeon for your customised treatment plan.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. 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

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Pejman Aflaki, MD · Answer

Hello and thank you for the question and sharing your photos. You do have a boxy nasal tip from prominent alar cartilages. I believe you are a great candidate for rhinoplasty, focusing on nasal tip refinement. There are a variety of techniques that can be utilized, including trimming the nasal tip cartilage, suturing techniques, cartilage grafting or combination of those. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Michael Dobryansky, MD, FACS · Answer

The lower lateral cartilage forma the tip defining points. Yours are nice and crisp, no nothing needs to be done about them. If you want them to be less prominent, some filler will do the job very nicely.

Joshua A. Halpern, MD, PA · Answer

those bulges are secondary to your lower lateral cartridges. They represent the curves of these cartlidges. One can modify these areas utilizing suturing techniques, altering the size and shape of the cartlidges. Before choosing a technique one would like to also find out what else you don't like about your nose and what your goals are. During a consultation i like to then examine the patient and write up a detailed operative plan which i then review with the patient. I incorporate the finesse technique which i developed. I typically do not pack the nose. Bruising, pain and recovery are minimal versus traditional techniques. ( please see the nose patient ten days out video on our page). I hope you find this information useful. Please see inclosed video.

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your question. A subtle tip plasty can address your concern by enhancing and modifying tip defining point on your nose . I suggest that you take advantage of a free first consultation and visit rhinoplasty expert surgeons. The most important step is to chose an experienced surgeon that you feel most comfortable with and can provide you with before and after photos of their patients.
Best Wishes

Barry M. Weintraub, MD, FACS · Answer

Based on the provided images, I believe a subtle and conservative tip refinement would be beneficial to you and help you meet your aesthetic goals. The lower-lateral cartilages can be trimmed to correct the protrusion, or “knuckling.” Keep in mind the importance of an in-person consultation with a board-certified plastic surgeon with a wealth of experience in rhinoplasty. Be sure to review his or her before-and-after images when making your final selection to find someone whose aesthetic is reflective of yours.

Bulent Cigsar, MD · Answer

Hello and thanks for the question. Sometimes, following a nose surgery, the grafted or reshaped cartilages may be visible under the skin. Especially if the skin is thin, this may be a problem.  A second porcedure may be needed to carve these visible cartialges, which I believe won't be hard.

The cartilage at the end of my nose sticks out under the skin, what can I do to remove this? (photos)

Answers (12)

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