Can the tip of my nose be reduced with closed surgery? (photos)

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.Respectfully,Dr. Emmanuel Mallol Cotes.-

It is entirely possible to get a great result from a closed rhinoplasty to repair your nose tip, which is called a "Box Tip Deformity." Do not worry; this term does not mean you are deformed:  it means that the cartilage at the tip of your nose creates a square, boxy shape.  Please do your research well and choose a board certified plastic surgeon with years of experience in rhinoplasty surgery.

Rather than focusing on the approach (open vs. closed) utilized, one should focus on the results of a given surgeon. Tip refinement is possible via an endonasal (closed) approach although most surgeons favor the external (open) approach for that for very good reasons including longevity and predictability of the results. The tiny incision at the bottom of the nose heals extremely well that the scar is essentially imperceptible once healed. The overall result is way more important than the tiny scar at the bottom that nobody can see. Best wishes!

Thank you for your question.  Yes, tip refinement is possible thru a closed approach but in most surgeons experience does not give the most predictable results.  Most rhinoplasty surgeons will tell you that an open approach would be best for your situation because it is assymetric.  Try to find a rhinoplasty surgeon that does do many closed tip rhinoplasties.  I do a lot of closed rhinoplasty but if the tip is your main concern, I would recommend the open approach.  Good luck.

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. Cartilage grafts may also be used to help improve tip refinement.
You may also benefit from a cephalic rotation of your tip to turn up your tip
slightly and a conservative dorsal hump reduction.  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

Most of the time- the nose needs to be treated in its totality. When you change the tip- all of the other relationships also change and must be addressed. I am a proponent and advocate in cases such as yours- that the closed/ internal nasal technique be used. So, yes- to answer your question- it can be done closed- in the correct hands of a Board Certified PS with extensive experience in closed Rhinoplasty

Yes, a closed rhinoplasty approach can accomplish reduction of the bulbous and asymmetric tip, with all the incisions placed on the inside of the nose. The entire nose will need to be performed which will include shaving down the dorsal hump, decreasing the projection of the nose, and narrowing the bridge line. Closed  rhinoplasty is a difficult endeavor,  so choose your surgeon very wisely. Digital computer imaging performed at the office setting would also be helpful to understand what can and cannot be accomplished with the procedure. For more information and many before-and-after results of closed rhinoplasty, please see the link and the video below 

Improving the nasal tip is a frequent request of patients wanting nasal refinement. It is possible to improve the cosmetic appearance of the tip alone without altering the rest of the nose in some patients. Whether the optimal option in your particular situation would be a tip rhinoplasty alone or a full rhinoplasty would best be determined at a consultation. Either procedure can be performed with a closed or open approach. Following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on very limited 2 dimensional photos without examining you, physically feeling the 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. I would suggest you find a plastic surgeon with extensive nasal surgery experience who is certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or a facial plastic surgeon (ENT) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Robert Singer, MD FACS La Jolla,California

An in-person exam and consultation would be necessary for a definitive answer. In general, Done well, either approach could be appropriate. In tip surgery, especially with asymmetry, most surgeons would agree that there is more predictability/control over results with an open approach -PROVIDED IT IS DONE SKILLFULLY.Whatever technique will provide the most predictable/best result in your surgeon's hands is the "correct" answer.

You appear to be a good candidate for nasal tip surgery but should also consider additional refinement of your bridge to match your new tip.  Being experienced and the use of both open and closed rhinoplasty I would lean toward the open approach using a stair-step incision that I find heals nearly invisibly with consistency.

Meet with a board-certified plastic surgeon or facial plastic surgeon to review photographs and discuss your many options.  Best wishes and good luck.

Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, California