Is the tip of nose surgery enough for me? (Photo)

I want to slim down the end of my nose, it became bigger and rounder with the age. I am happy with the nose angle and would preffer just tip of the nose surgery. would the little bump not become more visible though? do I need to shave the bone too? 1.can I adress the little bump when doing just cartilage modification? like fill it in? or will the angle be wrong then? 2. I also want permalip which will change profile(any suggestions what implants and if they are good solution for me?) Thanks

Doctor Answers 10

Is the tip of nose surgery enough for me?

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The tip of your nose is rather bulbous. Contouring it by sculpturing the tip cartilage. Also there is a slight high point on the dorsal profile you might wish to have mildly lowered.

San Francisco Plastic Surgeon


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Hello and thank you for your question. Based on your photograph, 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. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Rhiniplasty for just the tip

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Dear Ev3345,

  • You can have a rhinoplasty where we just adjust the tip
  • In general, if you lift the tip a hint, the bump may become less visible
  • A physical exam would help determine whether we need to shave the bump
  • As for permalip implants, I would suggest you do not get that because the implant does become visible and you can feel the implant if you bite your lip or someone kisses you
  • Instead, you could try a filler or fat grafting for a more permanent option

Dr. Nima

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

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Rhinoplasty Versus Tip Plasty

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You may very well be a candidate for just an isolated tip plasty.  Only a physical exam would clarify which surgery will obtain your goals successfully.  I'm not familiar with a 'permalip'.  If you are referring to lip augmentation, I do not recommend permanent injectable material or surgically placed implants. Either use a long lasting temporary filler like Volbella, or your own fat, which will have a permanent result. Best of luck!

Is the tip of nose surgery enough for me?

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From what I've seen it's close. You could certainly have a narrowing only but may look better with slight reduction to the dorsum. This is an excellent time to use computer imaging to help you decide.

Closed rhinoplasty, 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.


Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 307 reviews

Tip Rhinoplasty

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Your tip can be narrowed and refined but you do want a result where all parts of the nose are proportional. Your profile is acceptable and the small amount of fullness of your bridge can be filed but i would not rotate your tip or shorten your nose. However from the front view your nose does seem wide at the junction of the bridge and the face. Your lip can be shortened through an incision at the base of your nose. I and many others with experience in lip augmentation longer use implants because of the risk of movement and extrusion. I suggest you consult with  rhinoplasty specialist because you have many options which should be discussed in detail.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Full rhinoplasty candidate

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Most patients must undergo a full rhinoplasty to ensure that all of the components of the nose balance with each other, and the entire nose balances with your facial features.  Most of the improvement will be in the tip, however once the tip surgery itself is performed, the rest of the no must be built around the newly fashioned tip. For more information and many before and after examples, please see the link and the video below

Rhinoplasty is complex art with multiple moving parts

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Hello there. Thank you for submitting multiple photos- this makes online analysis easier. Your photos demonstrate the following: (1) bulbous tip, (2) tip asymmetry, (3) columellar- alar lateral disharmony, (4) slight general over projection, (5) slight dorsal hump projection, (6)  indistinct supra-tip.    

Don't get me wrong- you do not have a bad nose, it actually has multiple positive features as well. However, you are a perfect example of someone who has multiple minor aesthetic nasal issues.  Isolated tip surgery alone would be limited in its ability to optimize your aesthetic nasal contour.   My suggestion would be to consider a more extensive treatment of the multiple issues outlined above via a traditional open rhinoplasty that would allow optimization of these multiple areas.  It would not be a radical surgery, but if you were open to having a more comprehensive treatment, you have the potential to achieve a smooth, delicate and elegant result.  I wish you the very best – I would seek out multiple opinions with facial cosmetic surgeons who have extensive experience in cosmetic rhinoplasty. 

Tanuj Nakra, MD, FACS
Austin Oculoplastic Surgeon

Rhinoplasty - Nose Has Gotten Bigger With Age

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What you desire, judging from your photos, appears to be possible with a rhinoplasty; however, all definitive judgment must be reserved until you would be seen in office for a consultation. You are correct in your idea that sometimes working with the cartilage can change the way the bony part of the nose appears. This would be something that could be determined during a consultation. Regarding the permalip, in my practice I prefer fat transplantation because it is the most organic solution since it uses your own fat. Regardless of what you choose, I suggest you make an appointment with a board certified plastic surgeon with years of experience with rhinoplasty surgery. This will ensure that you receive a good result. Read reviews, study befores and afters and educational background.

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.