Rhinoplasty ~ whether tip alteration is required. (photos)

I am looking to narrow the bridge of my nose and shorten the length (protrusion) of the nose and remove a slight hump and some of the septum. Please could you tell me if this would require the TIP to be altered, and whether I would need open or closed surgery. I am happy with the tip shape. Many thanks

Doctor Answers 11


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Dear julie2016june, An open or closed approach can be used which will be decided more by the surgeons preference to attain your desired result. The shape of the tip does not need to be altered however the tip will be addressed to decrease the projection. I would suggest seeking consultation with some experts in the field of rhinoplasty, with imaging you can see the proposed results and determine if this is the desired look you want. Then review the surgeons before and after photographs to ensure he/she can attain your desired result and performs natural looking rhinoplasty procedures. See examples of similar noses in the link below and video above. Best regards, Michael V. Elam, M.D.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

You will Likely Need Your Tip Altered In This Kind Of a Rhinoplasty- Closed or Open Doesn't Really Matter

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I think you're saying that you want your nose to protrude less from your face (which we technically refer to as projection). If this is the case, he will need to have your tip altered in order to accomplish this.  As far as the need for an open or closed procedure, I would simply find a surgeon that you're comfortable with, who has a lot of experience with a rhinoplasty, and who has very good before and after photographs that you like,and let them choose the approach.  You are after the result.  Find a surgeon who is good at it and let them decide how best to do it. Good luck.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 28 reviews

Closed rhinoplasty candidate, some advices:

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Thank you very much for sharing your concerns with us.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 372 reviews

Tip changes in rhinoplasty

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Although the changes you want for a rhinoplasty do not include the tip of the nose, the surgery may change the angle of the tip.  The shape of the tip may not change, but the angle may change, upturning the tip somewhat.  Generally speaking, when doing a rhinoplasty, because the nose is a 3-D unit, changing one area can change the shape/angle of another area.  This can be done through either open or closed approaches.  I recommend that you see a facial plastic surgeon for an in-person consult.

Sunny Park, MD, MPH
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Rhinoplasty Questions

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By definition, the 'tip' would be adjusted with a setback to decrease projection, however, tip shape does not necessarily have to change. This could be done with an open or closed approach.  
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Tip work with rhinoplasty often not needed.

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Tip work with rhinoplasty often not needed. If you are happy with the tip it does not need to be done. Your hump can be removed and the bones narrowed. See  very experienced rhinoplasty surgeon who does natural noses YOU like. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Closed rhinoplasty for dorsal hump removal

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  A closed rhinoplasty approach can address shaving down the dorsal hump which is composed of both cartilage and bone. The tip cartilages look relatively normal, so they may  not need to be adjusted. The bridge line can also be narrowed with osteotomies. For many examples of noses similar to your own, please see the video and the link below to our closed rhinoplasty photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rhinoplasty tip considerations #plasticsurgery

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If you are happy with your nasal tip, then no modification needs to be done to the tip cartilages themselves. However - shortening the nose or changing tip rotation dynamics may alter the appearance of your nasal tip. Open rhinoplasty also weakens the supporting ligaments of the nasal tip, and these structures need to be reconstructed or supported in order to not alter that shape of your tip over the long term.

Nose surgery

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Your photos show some of your concerns, but your questions would be better answered after a thorough evaluation of your entire face and nose (with an external and internal exam).  Your septum is likely deviation, as suggested by the slight right-ward curve in your front view.  The tip can be de-projected and shortened, for a more harmonious appearance.  The approach really depends on the surgeon's preference, and should not limit or affect your outcome.  You would do well to meet with a plastic surgeon well-versed in both cosmetic and functional rhinoplasty to discuss your concerns.  Best of luck!

Inessa Fishman, MD
Atlanta Facial Plastic Surgeon

Rhinoplasty ~ whether tip alteration is required.

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Every nose is different and unique to that individual. If the appearance of your nose concerns you enough to do something about it, it can be improved with a natural artistically performed rhinoplasty. What would be the best option and exact procedure would depend on an in person examination (not just an online consultation) and discussion about desired outcome. In the appropriate patient the nose can be shortened, the hump diminished and the nose narrowed without altering the tip. Excellent results can be achieved with either a closed or open technique.

Keep in mind that following advice from a surgeon on this or any other website who proposes to tell you exactly what to do and how technically to do it based on \very limited two dimensional photos without examining you, physically feeling your tissue, assessing your desired outcome, taking a full medical history and discussing the pros and cons of the operative procedure would not be in your best interest. Natural appearing results need to be individualized and what is appropriate for one patient is not necessarily the best for someone else. I would suggest that you find a surgeon with extensive rhinoplasty experience certified by the American Board of Plastic Surgery and one who is ideally a member of The American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, M.D., FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.