Is tip plasty worth it for me? (Photo)

Question

I have had 3 nose jobs and my last surgery finally made my nose a lot better. I would just like a smaller tip can I do that only? I have thick skin, I used to be oily but I took accuntane and that shrunk my nose a lot. How much does it usually cost? I want the same shape just smaller and a bit more defined.

Eric M. Joseph, MD · Answer

Digital images are not a replacement for an examination, however we have met patients with thick skin and wide nasal tips after rhinoplasty that is completely due to the overlying skin, not the underlying cartilage. An examination by a rhinoplasty specilalist may be helpful for determining what is causing your persistent tip wideness after three rhinoplasties.Hope this helps you.Dr Joseph

Tanveer Janjua, MD · Answer

It is very difficult if not impossible in some cases to achieve a very well-defined thin nose if the skin is thick to begin with.If work has been done on the nasal tip in the past and all 3 occasions them the risks of a fourth surgery on the nasal tip is high.  She have to take that into consideration before she go for a fourth rhinoplasty on the nasal tip.In your consultation you should specifically ask your surgeon if he or she has had similar patients in the past and if the results were good or not.  That will help to make her decision about proceeding with a tip plasty or leaving it alone.RegardsDr. J

Jennifer Levine, MD · Answer

A revision can be done for the tip. However because this would be a fourth revision, it is important to review the details of the past surgeries in order to figure out the best course of action. The cost will vary depending on what needs to be done.

Garrett H. Bennett, MD · Answer

Your nose is a little bulbous on front view. That being said,  the more times you operate on the nose the less the skin can stretch and the more chance that you will see edges of cartilage below the skin. I don't know how well you are breathing but a smaller nose can decrease your ability to breath as well. I would personally avoid synthetic/plastic material in the nose, especially after 3 surgeries, as it tends to show through the skin as you age and has the potential to become infected as long as it is in the nose. You are very pretty and the enemy of good is perfect. Hope you make a good decision.

Richard Mark Winters, MD · Answer

it depends on:1. what was done/not done during your previous surgeries2. how much of your tip aesthetics are secondary to cartilage issues3. whether your surgery was done open or closed and how much scarring/support your nasal tip hasonce you have gotten up the confidence, an exam with a qualified surgeon ought to shed light on these issues and help you decide whether or not this is worthwhilegood luck

Michelle R. Yagoda, MD · Answer

In order to fairly judge the possibility of a fourth rhinoplasty making a more defined tip, I would need to see your initial "before" photo, and the "after" photo for each surgery you had.  It is certainly possible to have a tip-plasty that addresses only the tip of the nose.  As far whether you will get the result you are looking for, it depends on the elasticity of your skin and its thickness.  That being said, you may get the result you are looking for with a medpor implant, even if you have thick skin.  I would be happy to discuss this further in a private consultation in my office.  Best of luck,Dr. Michelle Yagoda

William Portuese, MD · Answer

The photographs demonstrate a very acceptable nose especially since it's been done 3 times in the past. Due to the  complicated and intricate nature of the cartilaginous/ bony anatomy of the nose, and the unpredictability of the healing process, it is best to leave well enough alone.

William B. Rosenblatt, MD · Answer

Remember : the enemy of good is perfections. Sometimes  you have to settle for good and just accept what you have. Another surgery might muck up the good result.

Steven Wallach, MD · Answer

I think that doing a 4th may not make an improvement.  If 3 times didn't correct it, why would you think a 4th time would?  I have reservations.  Some people's tissues limit the kind of refinement that patients sometimes want.

David Reinstadler, MD · Answer

It is totally reasonable to refine the tip only. I would recommend visiting with some revision rhinoplasty surgeons who can use computer imaging to approximate the changes you desire. That way you are on the same page going into the operating roomBest of luck

Is tip plasty worth it for me? (Photo)

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