Which would be the best rhinoplasty option for a bulbous supratip and undefined nose? (Photos)

Question

I have a bulbous tip (more exaggerated on my left side) which gives my nose no definition face on and reflects light in an unpleasant manner leaving me with a shiny round look and throwing off my facial features. Is there any procedures that are not too invasive (not open rhinoplasty for example) where they can just remove excess skin/cartillage in this area to give the nose a refined thinner natural nose? Can anyone recommend a surgeon in the UK/London that has experience with this issue?

Paul A. Wilson, FRCS(Plast) · Answer

Thank you for your question. Your plastic surgeon will obviously guide you through this process. Essentially, you looking at having on open rhinoplasty. Some surgeons prefer the endo-nasal approach however. Your nose looks slightly too long and the tip defining points are wide apart. The bridge of your nose looks okay and is not too wide. Your surgeon will reduce the length of your nose, whilst improving the shape of the tip with some slight rotation. Cartilage grafts will be used to support and define the tip. 
I hope this helps you with your decision to proceed.

Best of luck

Paul Wilson

Philip J. Miller, MD, FACS · Answer

I would recommend starting with a consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery to discuss if rhinoplasty can address your concerns. 
I would recommend writing down the following questions before scheduling your consultation:
1. Are you unhappy with the tip of your nose? 
2. Do you feel that your nose is too wide? 
3. Do you want to make your nostrils smaller in appearance? 
4. Are you looking to decrease the general size of your nose?
I hope some of these questions will help you pinpoint what it is that you don't like about your nose.  Cost will vary due to various factors like anesthesia fees, facilities fees, etc. I wish you the best as you research your options when scheduling a rhinoplasty consultation.
Sincerely,
Philip J. Miller, MD, FACS Double Board Certified Facial Plastic Surgeon

Jonathan Kulbersh, MD · Answer

Your nose could be improved with rhinoplasty, which would give permanent improvements in symmetry and shape while improving the tip. You can bring the pictures that you think would be flattering to your face and these can be discussed.  It takes special interest and study to understand the facial aesthetics to create a nose that is harmonious with your other features. Take the time to find the right facial plastic surgeon and ask them to create digital images of the nose they propose for you and discuss the cost.
Hope this helps.

Deepak Raj Dugar, MD · Answer

Hello!
Thank you for your picture and question!Based on the pictures you have submitted It does appear that you would be a great candidate for a Closed Scarless Rhinoplasty.A closed rhinoplasty procedure is the best option for someone who is looking for a refinement of the nose. Based on your photographs it appears you have a bulbous tip and drooping tip with thick nasal skin.   I recommend going to a Plastic Surgeon that specializes in closed scarless rhinoplasty (preferred by actresses and celebrities) because there is no risk of external scarring and much less healing and recovery time. Closed rhinoplasty enables you to have flash recovery with very minimal bruising if at all. You will only have to wear a cast for 5-7 days, no one will know you had anything done. All the incisions are made from inside the nose. The goal is to finesse and enhance the nose without drastic change. It still looks like it is your nose just more refined without looking fake. Meaningful refinement is the key!  All the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon. 
Best of luck, 
Deepak Dugar MD
Beverly Hills Rhinoplasty Center

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photographs, you have a bulbous tip and drooping tip with thick nasal skin.  You may benefit from a tip refining rhinoplasty, soft tissue debulking of your nasal tip, and, cephalic rotation of your tip to turn
up your tip slightly.  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

Dario Rochira, MD · Answer

Most of the problem is due to the tip cartilage. 
You are a great candidate for a "preservation rhinoplasty" which modifies the bridge very slightly resulting in very natural look and can reduce and support the tip efficiently and safely.

Arshad Muzaffar, MD · Answer

Hello, and thanks for your question.  Tip rhinoplasty is possible using the closed, or endonasal, approach.  If you really want to avoid an open rhinoplasty, you should seek out a surgeon who is very experience with the endonasal approach.  Modification and refinement of the tip cartilages is possible using that method.  Before your consultation, it will be helpful for you to clearly identify exactly what bothers you about your nose, and to list those issues in order of importance to you.  This will help your surgeon best advise you as to how to address your concerns. If your nasal tip plunges when you smile, you may also have a hyperactive depressor septi muscle, which can be addressed at the time of rhinoplasty.  Also, keep in mind that you want to maintain the harmony of your nose with your overall facial appearance. Best of luck.

Basim A. Matti, MBChB FRCS · Answer

Certainly surgery would be the answer, depending on the nature and type of your skin.  The operation can be done through a closed or open approach and that would be to sculpt the cartilage and even suture them - closed approach. A consultation with a reputable certified Plastic Surgeon who has many years of experience in this field.

Which would be the best rhinoplasty option for a bulbous supratip and undefined nose? (Photos)

Answers (8)

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