Can bulbous tip refinement be reversed? (Photo)

Question

The surgeon used sutures- can these be cut so I can have my old tip back? Or does cartilage have to be added? It has been 6 months and my tip still feels sort of hard. The tip looked like this before (in photo) and now it blends into my nasal bridge and looks a bit pointier. Without the bulbous part it looks like I have no tip to my nose anymore.

Jules Walters, MD · Answer

I would wait until your tip softens before deciding to have revision. What needs to be done decides on what was actually done in your operation.  Cartilage is added quite frequently to correct this issue.  Best wishes.

Kimberly Lee, MD · Answer

Changes can be made to the tip but the firmness you describe can be a sign of residual swelling.  The best recommendation is to have an in person consultation with a board certified specialist who can evaluate you and assist you with achieving the goals you seek. 3-dimensional computer imaging can help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon.

Richard Mark Winters, MD · Answer

each time a rhinoplasty or revision is performed irreversible changes in the coverage, supporting structures and lining occur....even when subtle, these phenomena affect the appearance of the nosethat said, many of the changes made in rhinoplasty can be changed dramatically to change the appearance and function of the nose what what it is or what it's been made to be.... these maneuvers depend on type and degree of the abnormalities they are meant to address... suturing techniques, cartilage grafting and other methods can be utilized with precision to yield desired resultsyou need a thorough evaluation and a well thought out plan....you will need to gain the confidence that your surgeon has the skills and aesthetic judgment to fix your problem....do your homework and be sure that your revision rhinoplasty surgeon has:1. many years of rhinoplasty practice experience2. judgment and techniques that have evolved over time3. a practice focused on rhinoplasty 4. a willingness to do difficult, secondary and reconstructive cases5. an interest in teaching others how to evaluate and do rhinoplasty properly6. a willingness to share rhinoplasty resume, photos and patient experiences with prospective patientsgood luck...

William Portuese, MD · Answer

It is important to wait at least one year before undergoing revision nasal tip surgery, so the healing process has fully subsided before another operation.

Tom D. Wang, MD, FACS · Answer

Hi CarsonC, while it may be possible to reverse the tip refinement, it does depend on what was done to narrow the tip in the first place.  If only sutures were used, it may be possible to release the sutures and have the cartilage return to their previous position.  However, surgeons will often do additional maneuvers such as scoring or trimming cartilage in addition to suture refinement.  In that case, simply releasing the sutures will not give you back the previous shape, you will likely need additional cartilage or grafting to get more fullness.  If you haven't already, you may wish to check with your previous surgeon on this question.  Hope this helps!

Michael Elam, MD (retired) · Answer

Dear CarsonC, Since the nose is a three dimensional aspect that you are working with it is important to know all of the surgical techniques used that lead you to this point of concern. Refining the tip can be done with multiple techniques. With that said, a current post operative photograph is needed to see your concerns and help diagnose the problem. If you feel you are at the point where a secondary opinion is needed then I suggest requesting your operative report as well as your preoperative photographs that were taken in the surgeons office. These two items will be very beneficial in giving you any further advice. Best regards, Michael V. Elam, M.D.

Richard W. Fleming, MD (retired) · Answer

You can make changes to your tip but firmness indicates swelling is still present. be patient and wait another several months before considering a revision. A view of your nose at this time would be helpful. Share your concerns with your surgeon. If your ultimately not satisfied with your surgeon's response get a second opinion from a revision specialist.

Can bulbous tip refinement be reversed? (Photo)

Answers (7)

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