What could be the cause of a nose tip changing shape with an unexplained lump and is rhinoplasty the only solution? (Photos)

Question

Over the course of a couple of months my nose appears to have changed shape. Previously it was smooth and now I have what feels like a small pea sized lump slightly off centre on the tip. A dermatologist told me it was just my nose changing with age. Is it possible for the tip of the nose to change "so quickly" and what could be behind it? I thought it was a cyst or papsule at first until I saw him. I have included a photo of how it was 6 months ago and then one from this week.

Eric M. Joseph, MD · Answer

An examination would be necessary to determine the cause of the bump involving your nasal tip. Based on the thin quality of your skin, it may be visible tip cartilage, rather than a cyst or papule. Consider visiting a rhinoplasty specialist or a reputable ENT specialist for a second opinion. If your dermatologist tried to perform a shave biopsy of nasal tip cartilage, that could have left an undesirable result. Hope this helps you. Dr Joseph

Robert Kotler, MD, FACS · Answer

Dear Jm48 in Los Angeles, California:
Your history is very helpful, as well as the photographs.  It is not likely your nose has had a change in architecture.  Rather, this is much more likely a minor problem within the skin.  Either a plastic surgeon or dermatologist can help resolve the issue.  An examination is warranted and it is highly likely that the problem can be eradicated.  
            Best wishes
Robert Kotler, MD, FACS

Arian Mowlavi, MD, FACS (license on probation) · Answer

All I see from your photo is a small milia that can be popped by your dermatologist. Please provide more photos.

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